The impact of workplace smoking bans: results from a national survey

OBJECTIVE: To estimate the impact of workplace smoking restrictions on the prevalence and intensity of smoking among all indoor workers and various demographic and industry groups. DESIGN: Detailed cross sectional data on worker self reported characteristics, smoking histories, and workplace smoking policies were used in multivariate statistical models to examine whether workplace smoking policies reduce cigarette consumption. After analysing the distribution of policies, four main types of workplace programme were defined: (1) 100% smoke-free environments, (2) work area bans in which smoking is allowed in some common areas, (3) bans in some but not all work and common areas, and (4) minimal or no restrictions. SETTING: After environmental tobacco smoke was identified as a health hazard in the mid-1980s, workplace smoking restrictions became more prevalent. By 1993, nearly 82% of indoor workers faced some restriction on workplace smoking and 47% worked in 100% smoke-free environments. PARTICIPANTS: The database included a nationally representative sample from the tobacco use supplements to the September 1992, January 1993, and May 1993 Current Population Surveys of 97,882 indoor workers who were not self employed. MAIN OUTCOME MEASURES: Prevalence of smoking and number of cigarettes smoked daily by smokers. RESULTS: Having a 100% smoke-free workplace reduced smoking prevalence by 6 percentage points and average daily consumption among smokers by 14% relative to workers subject to minimal or no restrictions. The impact of work area bans was lessened by allowing smoking in some common areas. Smoke-free policies reduced smoking for all demographic groups and in nearly all industries. CONCLUSIONS: Requiring all workplaces to be smoke free would reduce smoking prevalence by 10%. Workplace bans have their greatest impact on groups with the highest rates of smoking.     

The effects of household and workplace smoking restrictions on quitting behaviours

OBJECTIVE: To assess the association of household and workplace smoking restrictions with quit attempts, six month cessation, and light smoking. DESIGN: Logistic regressions identified the association of household and workplace smoking restrictions with attempts to quit, six month cessation, and light smoking. SETTING: Large population surveys, United States. SUBJECTS: Respondents (n = 48,584) smoked during the year before interview in 1992-1993, lived with at least one other person, and were either current daily smokers or were former smokers when interviewed. MAIN OUTCOME MEASURES: The outcome measures were an attempt to quit during the last 12 months, cessation for at least six months among those who made an attempt to quit, and light smoking (< 15 cigarettes a day). RESULTS: Smokers who lived (odds ratio (OR) = 3.86; 95% confidence interval (CI) = 3.57 to 4.18) or worked (OR = 1.14; 95% CI = 1.05 to 1.24) under a total smoking ban were more likely to report a quit attempt in the previous year. Among those who made an attempt, those who lived (OR = 1.65, 95% CI = 1.43 to 1.91) or worked (OR = 1.21, 95% CI = 1.003 to 1.45) under a total smoking ban were more likely to be in cessation for at least six months. Current daily smokers who lived (OR = 2.73, 95% CI = 2.46 to 3.04) or worked (OR = 1.53, 95% CI = 1.38 to 1.70) under a total smoking ban were more likely to be light smokers. CONCLUSIONS: Both workplace and household smoking restrictions were associated with higher rates of cessation attempts, lower rates of relapse in smokers who attempt to quit, and higher rates of light smoking among current daily smokers.     

Costs of employee smoking in the workplace in Scotland

BACKGROUND: Employers have responded to new regulations on the effects of passive smoking by introducing a range of workplace policies. Few policies include provision of smoking cessation intervention. OBJECTIVE: To estimate the cost to employers of smoking in the workplace in Scotland to illustrate the potential gains from smoking cessation provision. Costs vary with type of smoking policy in place; therefore, to estimate these costs results from a survey were combined with evidence drawn from a literature review. STUDY DESIGN: A telephone survey of 200 Scottish workplaces, based on a stratified random sample of workplaces with 50 or more employees, was conducted in 1996. Additional evidence was compiled from a review of the literature of smoking related costs and specific smoking related effects. RESULTS: 167 completed responses were received, of which 156 employers (93%) operated a smoking policy, 57 (34%) operated smoke free buildings, and 89 (53%) restricted smoking to a "smoke room". The research literature shows absenteeism to be higher among smokers when compared to non-smokers. The estimated cost of smoking related absence in Scotland is pound40 million per annum. Total productivity losses are estimated at approximately pound450 million per annum. In addition, the resource cost in terms of losses from fires caused by smoking materials is estimated at approximately pound4 million per annum. In addition, there are costs from smoking related deaths and smoking related damage to premises. CONCLUSION: This study shows how smoking cessation interventions in the workplace can yield positive cost savings for employers, resulting in gains in productivity and workplace attendance which may outweigh the cost of any smoking cessation programme.     

The costs of smoking in Vietnam: the case of inpatient care

Objective

To estimate the social costs of smoking related to inpatient care in Vietnam using 2005 data.

Design

The cost of illness as a result of hospitalisation for three major smoking‐related diseases combined with the prevalence‐based approach to obtain the costs of smoking in Vietnam for inpatient care.

Main outcome measure

Smoking‐attributable costs of inpatient care for lung cancer, chronic obstructive pulmonary disease (COPD), and ischaemic heart disease.

Results

The total cost of inpatient health care caused by smoking in Vietnam reached at least 1 161 829 million Vietnamese dollars ($VN) (or $US77.5 million) in 2005. This represents about 0.22% of Vietnam gross domestic product (GDP) and 4.3% of total healthcare expenditure. The majority of these expenses are related to COPD treatment ($VN1 033 541 million or $US68.9 million per year) followed by lung cancer ($VN78 143 million, or $US5.2 million per year) and ischaemic disease ($VN50 145 million, or $US3.3 million per year). The government directly finances about 51% of these costs. The rest is financed either by households (34%) or by the insurance sector (15%).

Conclusions

The social costs of smoking in Vietnam as the percentage of GDP is lower compared to estimates from high‐income countries. The true costs would be substantially higher if all smoking‐related diseases, outpatient care and mortality‐related costs are included. More research is needed to augment the estimates presented in this paper.     

Tobacco interests or the public interest: 20 years of industry strategies to undermine airline smoking restrictions

Objectives

To understand the evolution of 20 years of tobacco industry strategies to undermine federal restrictions of smoking on aircraft in the United States.

Design

We searched and analysed internal tobacco industry records, public documents, and other related research.

Results

The industry viewed these restrictions as a serious threat to the social acceptability of smoking. Its initial efforts included covert letter‐writing campaigns and lobbying of the airline industry, but with the emergence of proposals to ban smoking, the tobacco companies engaged in ever increasing efforts to forestall further restrictions. Tactics to dominate the public record became especially rigorous. The industry launched an aggressive public relations campaign that began with the promotion of industry sponsored petition drives and public opinion surveys. Results from polling research that produced findings contrary to the industry''s position were suppressed. In order to demonstrate smoker outrage against a ban, later efforts included the sponsorship of smokers'' rights and other front groups. Congressional allies and industry consultants sought to discredit the science underlying proposals to ban smoking and individual tobacco companies conducted their own cabin air quality research. Faced with the potential of a ban on all domestic flights, the industry sought to intimidate an air carrier and a prominent policymaker. Despite the intensification of tactics over time, including mobilisation of an army of lobbyists and Congressional allies, the tobacco industry was ultimately defeated.

Conclusions

Our longitudinal analysis provides insights into how and when the industry changed its plans and provides public health advocates with potential counterstrategies.     

Passive smoking in the home: plasma cotinine concentrations in non-smokers with smoking partners

BACKGROUND: Risks of lung cancer and of heart disease attributable to passive smoking have been evaluated mainly in non-smokers married to smokers, but there has been little quantitative assessment of the extent of exposure in marriage partners as indicated by markers of inhaled smoke dose. OBJECTIVE: To relate plasma cotinine concentrations in non-smoking English adults to the smoking behaviour of their partners and to demographic and other factors. DATA: Population survey. Data from two years (1994 and 1996) of the Health Survey for England. MAIN OUTCOME MEASURES: Plasma cotinine concentrations in non-smoking adults married to or cohabiting with a partner. RESULTS: There was a strong dose-response relation between cotinine concentrations in non-smoking adults and the smoking behaviour of their partners, rising from a geometric mean of 0.31 ng/ml in those with non-smoking partners to 1.99 ng/ml in those whose partners smoked 30 or more cigarettes per day. In addition, exposure was greater in men, in the autumn and winter, and in those living in more disadvantaged circumstances, and there was an increasing gradient of exposure from the south to the north of the country. On average, cotinine concentrations in non-smokers with a smoking partner were 0.6-0.7% of those in cigarette smokers. CONCLUSIONS: If cotinine is taken as a measure of risk relevant dose, the implied increase in risk of lung cancer in non-smokers with smoking partners is consistent with the risk observed in epidemiological studies. Smoking by partners in the home is a major source of non-smoking adults' exposure to passive smoking.     

Development of smoking by birth cohort in the adult population in eastern Finland 1972-97

OBJECTIVE: To analyse the dynamics of smoking prevalence, initiation, and cessation in relation to sex, age, birth cohort, study year, and educational level. DESIGN: Six independent cross-sectional population surveys repeated every five years between 1972 and 1997. SETTING: The provinces of North Karelia and Kuopio in eastern Finland. SUBJECTS: Independent random samples of 18,088 men and 19,200 women aged 25-64 years. Those comprising the oldest birth cohort were born in 1913-17 and those in the youngest were born in 1968-72. RESULTS: Among men the prevalence of smoking decreased over time, but the cohort effect observed in smoking initiation was obscured by the changes in smoking cessation. Differences between the educational categories were small. Among women the prevalence of smoking increased during the study period. This was mainly caused by the less highly educated, in whom smoking initiation clearly increased in successive birth cohorts, but a more moderate cohort effect was also present among the more highly educated women. CONCLUSIONS: In men decreased initiation and increased cessation contributed to the downward trend in smoking prevalence, whereas among women, changes in smoking were mostly caused by augmented initiation in successive birth cohorts. During the study period educational inequalities in smoking widened, as the less highly educated came increasingly to form the smoking population.     

新疆葡萄酒产业发展战略调整与对策研究

新疆葡萄酒产业在2001年进入一个高速增长期。2003年葡萄酒产量1．87万t，比2002年翻了一番以上，2004年葡萄酒总产量为3．35万t，比2003年增长1．79倍，实现产值3．41亿元，实现销售收入1.41亿元。面对国际葡萄酒纷纷进入我国葡萄酒市场，国内葡萄酒生产企业之间依然战火不断的新情况，新疆葡萄酒产业应怎样调整发展战略，才能在竞争日益激烈的国内葡萄酒市场立于不败之地，实现持续稳定发展，这是新疆葡萄酒产业目前面临的一个重大战略问题。     

Smoking in Scottish youths: personal income, parental social class and the cost of smoking

Objective

To examine the relation of young people''s personal income and parental social class with smoking from early to mid adolescence.

Design

Longitudinal, school based, study of a cohort of 2586 eleven year‐olds followed up at ages 13 and 15.

Setting

West of Scotland.

Participants

93% baseline participation, reducing to 79% at age 15.

Main outcome measures

Ever smoked (age 11), current and daily smoking (ages 13 and 15) and the proportion of income spent on tobacco (13 and 15) based on recommended retail prices of usual brands.

Results

Strong independent effects of parental social class and personal income were found at 11 years, both reducing with age. The higher incomes of lower class participants attenuated the social class effect on smoking at ages 11 and 13, but not at 15. Analysis within class groups showed variation in the effect of income on smoking, being strongest among higher class youths and weak or non‐existent among lower class youths. This was despite the fact that the proportion of weekly income apparently spent on tobacco was greater among lower class youths.

Conclusions

The results confirm the importance of personal income and parental social class for youth smoking, but they also show that personal income matters more for those from higher class backgrounds. This suggests both that lower class youths have greater access to tobacco from family and friends and to cheaper sources of cigarettes from illegal sources. This complicates the relation between fiscal policies and smoking and might have the unintended consequence of increasing class differentials in youth smoking rather than the reverse.     

Psychosocial factors related to adolescent smoking: a critical review of the literature

OBJECTIVE: To extend the analysis of psychosocial risk factors for smoking presented in the United States surgeon general's 1994 report on smoking and health, and to propose a theoretical frame of reference for understanding the development of smoking. DATA SOURCES: General Science Index, Medline, PsycLIT, Sociofile, Sociological Abstracts, and Smoking and Health. Holdings of the Addiction Research Foundation of Ontario Library as well as the authors' personal files. STUDY SELECTION: Reviewed literature focused on studies that examined the association of sociodemographic, environmental, behavioural, and personal variables with smoking. DATA SYNTHESIS: Adolescent smoking was associated with age, ethnicity, family structure, parental socioeconomic status, personal income, parental smoking, parental attitudes, sibling smoking, peer smoking, peer attitudes and norms, family environment, attachment to family and friends, school factors, risk behaviours, lifestyle, stress, depression/distress, self-esteem, attitudes, and health concerns. It is unclear whether adolescent smoking is related to other psychosocial variables. CONCLUSIONS: Attempts should be made to use common definitions of outcome and predictor variables. Analyses should include multivariate and bivariate models, with some attempt in the multivariate models to test specific hypotheses. Future research should be theory driven and consider the range of possible factors, such as social, personal, economic, environmental, biological, and physiological influences, that may influence smoking behaviour. The apparent inconsistencies in relationships between parental socioeconomic status and adolescent disposable income need to be resolved as does the underlying constructs for which socioeconomic status is a proxy.     

Nicotine replacement therapy, professional therapy, snuff use and tobacco smoking: a study of smoking cessation strategies in southern Sweden

Objectives

The strategies used to support smoking cessation among quitters were investigated according to year of smoking cessation and sociodemographic characteristics.

Methods

The 2004 public health survey in Skåne, Sweden, is a cross‐sectional study. A total of 27 757 people aged 18–80 answered a postal questionnaire. The participation rate was 59%. Different strategies to support smoking cessation—that is, no therapy, nicotine replacement (NRT), professional therapy and snus (snuff) use, were investigated among quitters according to year of smoking cessation, and demographic and socioeconomic characteristics.

Results

14.9% of the men and 18.1% of the women were daily smokers. The prevalence of daily snus use was 19.5% among men but only 2.3% among women. Stratifying the data according to year of smoking cessation (1938–2004) revealed a significant increase in active smoking cessation strategies such as NRT, professional therapy and snus use. NRT was more common among women (23.6%) than men (14.8%) among smokers who quit in 2000–4, but snus use was more common among men (30.4% versus 8.7%). No replacement or other therapy at all was significantly more common among women (63.6%) than men (52.1%). People aged 35–80 years used more nicotine replacement than people aged 18–34, while men aged 18–34 used snus to quit smoking significantly more than men aged 55–80.

Conclusions

Snus is used commonly among men as a support for smoking cessation in Sweden. Women use pharmacological NRT to a greater extent, but this can probably not compensate for the much higher extent of snuff use as a cessation strategy among men.     

Four beliefs that may impede progress in the treatment of smoking

The validity of four often-cited statements about smoking cessation is reviewed and their misinterpretation is discussed. "Most smokers are interested in quitting" is true; however, more important is the fact that smokers try to quit only once every 3.5 years. Thus motivating attempts to quit and removing barriers to treatment are important. "Most smokers quit on their own" is often interpreted to mean that smokers are not nicotine dependent; however, most dependent alcoholics and drug abusers who quit, do so on their own. This statement is also often interpreted to mean that most smokers do not need therapy, but the same was said about clinical depression in the early 1900s. "Quit rates with treatment are low"; however, most successful interventions for chronic disorders are the result of a series of treatments, not just one treatment. "Medication is effective only when accompanied by psychosocial therapy" is a tenet of treatment for traditional drug abuse; however, medications such as over-the-counter nicotine replacement therapies double quit rates even in the absence of psychosocial therapy.     

Medical costs of smoking in the United States: estimates, their validity, and their implications

OBJECTIVE: To compare estimates of the medical costs of smoking in the United States and to consider their relevance to assessing the costs of smoking in developing countries and the net economic burden of smoking. DATA SOURCES: A Medline search through early 1999 using keywords "smoking" and "cost", with review of article reference lists. STUDY SELECTION: Peer-reviewed papers examining medical costs in a single year, covering the non-institutionalised American population. DATA EXTRACTION: Methods underlying study estimates were identified, described, and compared with attributable expenditure methodology in the literature dealing with costs of illness. Differences in methods were associated with implied differences in findings. DATA SYNTHESIS: With one exception, the studies find the annual medical costs of smoking to constitute approximately 6-8% of American personal health expenditures. The exception, a recent study, found much larger attributable expenditures. The lower estimates may reflect the limitation of analysis to costs associated with the principal smoking-related diseases. The higher estimate derives from analysis of smoking-attributable differences in all medical costs. However, the finding from the most recent study, also considering all medical costs, fell in the 6-8% range. CONCLUSIONS: The medical costs of smoking in the United States equal, and may well exceed, the commonly referenced figure of 6-8%. This literature has direct methodological relevance to developing countries interested in assessing the magnitude of their current cost-of-smoking burden and their future burdens, with differences in tobacco use histories and the availability of chronic disease treatment affecting country-specific estimates. The debate over the use of gross or net medical cost estimates is likely to intensify with the proliferation of lawsuits against the tobacco industry to recover expenditures on tobacco-produced disease.     

Assessing the impact of smoking cessation services on reducing health inequalities in England: observational study

Objective

NHS stop smoking services are expected to play a key part in achieving the infant mortality and life expectancy health inequality targets in England by reducing smoking prevalence in deprived areas. This paper assesses the extent to which services have made a contribution to reducing inequalities in smoking between 2003–4 and 2005–6.

Methods

Synthetic estimates of baseline smoking prevalence data were compared with national monitoring data about the numbers of smokers in receipt of services and the proportion who self report quitting at four weeks. The social distribution of service recipients and quitters was compared with estimates of smoking prevalence to assess impact on inequalities. Comparisons were made between officially designated disadvantaged areas (the Spearhead Group) and others.

Results

Short‐term cessation rates were lower in disadvantaged areas (52.6%) than elsewhere (57.9%) (p<0.001), but the proportion of smokers being treated was higher (16.7% compared with 13.4%) (p<0.001). The net effect was that a higher proportion of smokers in the most disadvantaged areas reported success (8.8%) than in more advantaged areas (7.8%) (p<0.001). Using the evidence‐based assumption that three‐quarters of short‐term quitters will relapse within one year, the absolute and relative rate gaps in smoking prevalence between Spearhead areas and others are estimated to fall by small but statistically significant amounts from 5.2 and 1.215 (CIs: 1.216 to 1.213) to 5.0 and 1.212 (CIs: 1.213 to 1.210) between 2003–4 and 2005–6.

Conclusion

NHS stop smoking services have probably made a modest contribution to reducing inequalities in smoking prevalence. To achieve government targets, however, requires both the development of more innovative cessation interventions for the most addicted smokers and action to ensure that other aspects of tobacco control policy make a larger contribution to inequality goals.     

Effectiveness of comprehensive tobacco control programmes in reducing teenage smoking in the USA

OBJECTIVE: To describe the extent to which comprehensive statewide tobacco control programmes in the USA have made progress toward reducing teenage smoking. DATA SOURCES: Literature search of Medline for reviews of effectiveness of programme and policy elements, plus journal articles and personal request for copies of publicly released reports and working papers from evaluation staff in each of the state programmes of California, Massachusetts, Arizona, Oregon, and Florida. STUDY SELECTION: All studies, reports, and commentaries that provided information on aspects of programme implementation and evaluation. DATA SYNTHESIS: Statewide comprehensive programmes show high levels of advertising recall and generally positive improvement in smoking related beliefs and attitudes among teenagers. More fully funded programmes lead to increased mass media campaign advertising and community initiatives; a greater capacity to implement school based smoking prevention programmes; and an increase in the passage of local ordinances that create smoke free indoor environments and reduce cigarette sales to youth. The combination of programme activity and increased tobacco tax reduce cigarette consumption more than expected as a result of price increases alone, and these effects seem to apply to adolescents as well as adults. Programmes are associated with a decline in adult smoking prevalence, with these effects observed to date in California, Massachusetts, and Oregon. Arizona and Florida have yet to examine change in adult prevalence associated with programme exposure. California and Massachusetts have demonstrated relative beneficial effects in teenage smoking prevalence, and Florida has reported promising indications of reduced prevalence. Arizona has yet to report follow up data, and Oregon has found no change in teenage smoking, but has only two years of follow up available. One of the most critical factors in programme success is the extent of programme funding, and consequent level of programme implementation, and the degree to which this is undermined by the tobacco industry and other competitors for funding. CONCLUSIONS: Despite the different strengths and combinations of programme messages and strategies used in these comprehensive programmes, there is evidence that they lead to change in factors that influence teenage smoking, and to reductions in teenage smoking.     

Training pharmacists and pharmacy assistants in the stage-of-change model of smoking cessation: a randomised controlled trial in Scotland

OBJECTIVE—To evaluate a training workshop for community pharmacy personnel to improve their counselling in smoking cessation based on the stage-of-change model.
DESIGN—A randomised controlled trial of community pharmacies and pharmacy customers.
SETTING—All 76 non-city community pharmacies registered in Grampian, Scotland, were invited to participate. Sixty-two pharmacies (82%) were recruited.
SUBJECTS—All the intervention pharmacy personnel were invited to attend the training; 40 pharmacists and 54 assistants attended. A total of 492 customers who smoked (224 intervention, 268 controls) were recruited during the 12-month recruitment period (overall recruitment rate 63%).
MAIN OUTCOME MEASURES—The perceptions of customers and pharmacy personnel of the pharmacy support and self-reported smoking cessation rates for the two groups of customers at one, four, and nine months.
RESULTS—The intervention customer respondents were significantly more likely to have discussed stopping smoking with pharmacy personnel, 85% (113) compared with 62% (99) of the controls (p<0.001). The former also rated their discussion more highly; 34% (45) of the intervention customers compared with 16% (25) of the controls rated it as "very useful" (p = 0.048). Assuming non-responders had lapsed, one-month point prevalence of abstinence was claimed by 30% of intervention customers and 24% of controls (p = 0.12); four months' continuous abstinence was claimed by 16% of intervention customers and 11% of controls (p = 0.094); and nine months' continuous abstinence was claimed by 12% of intervention customers and 7% of controls (p = 0.089). These trends in outcome were not affected by potential confounders (sex, age, socioeconomic status, nicotine dependence, and type of nicotine replacement product used) or adjustment for clustering.
CONCLUSIONS—The intervention was associated with increased and more highly rated counselling, and a trend toward higher smoking cessation rates, indicating that community pharmacy personnel have the potential to make a significant contribution to national smoking cessation targets.


Keywords: community pharmacy; health education; smoking cessation     

Seeing,wanting, owning: the relationship between receptivity to tobacco marketing and smoking susceptibility in young people

OBJECTIVE—To assess the effect of the tobacco industry''s marketing practices on adolescents by examining the relationship between their receptivity to these practices and their susceptibility to start smoking.DESIGN—Paper-and-pencil surveys measuring association with other smokers, exposure to tobacco industry marketing strategies, experience with smoking, and resolve not to smoke in the future.SETTING—25 randomly selected classrooms in five middle schools in San Jose, California.SUBJECTS—571 seventh graders with an average age of 13 years and 8 months; 57% were female. Forty-five per cent of the students were Asian, 38% were Hispanic, 12% were white, and 5% were black.MAIN OUTCOME MEASURES—Exposure to social influences, receptivity to marketing strategies, susceptibility to start smoking.RESULTS—About 70% of the participants indicated at least moderate receptivity to tobacco marketing materials. Children who are more receptive are also more susceptible to start smoking. In addition to demographics and social influences, receptivity to tobacco marketing materials was found to be strongly associated with susceptibility.CONCLUSIONS—Tobacco companies conduct marketing campaigns that effectively capture teenage attention and stimulate desire for their promotional items. These marketing strategies may function to move young teenagers from non-smoking status toward regular use of tobacco. Our results demonstrate that there is a clear association between tobacco marketing practices and youngsters'' susceptibility to smoke. The findings, along with other research, provide compelling support for regulating the manner in which tobacco products are marketed, to protect young people from the tobacco industry''s strategies to reach them.     

Effects of preoperative smoking cessation on the incidence and risk of intraoperative and postoperative complications in adult smokers: a systematic review

Objectives

To establish the effect of preoperative smoking cessation on the risk of postoperative complications, and to identify the effect of the timing of preoperative cessation.

Data sources

The Cochrane Library Database, PsycINFO, EMBASE, Medline, and CINAHL databases were searched, using the terms: “smoking”, “smoking‐cessation”, “tobacco‐use”, “tobacco‐abstinence”, “cigarett$”, “complication$”, “postoperative‐complication$”, “preoperative”, “perioperative” and “surg$”. Further articles were obtained from reference lists. The search was limited to articles on adults, written in English and published up to November 2005.

Study selection

Prospective cohort designs exploring the effects of preoperative smoking cessation on postoperative complications were included. Two reviewers independently scanned abstracts of relevant articles to determine eligibility. Lack of agreement was resolved through discussion and consensus. Twelve studies met the inclusion criteria.

Data extraction

Methodological quality was assessed by both reviewers, exploring validation of smoking status, clear definition of the period of smoking cessation, control for confounding variables and length of follow‐up.

Data synthesis

Only four of the studies specified the exact period of smoking cessation, with six studies specifying the length of the follow‐up period. Five studies revealed a lower risk or incidence of postoperative complications in past smokers than current smokers or reported that there was no significant difference between past smokers and non‐smokers.

Conclusions

Longer periods of smoking cessation appear to be more effective in reducing the incidence/risk of postoperative complications; there was no increased risk in postoperative complications from short term cessation. An optimal period of preoperative smoking cessation could not be identified from the available evidence.     

Exploring pathways to food science careers in Southern California: A case study in food science career development

Southern California is a diverse region that is home to a high concentration of food science companies, with an increasing demand for additional food scientists and technologists to join this workforce. Despite this abundance of food science companies and the high demand for jobs, there is currently a shortage in the number of qualified food scientists and technologists in the region. This shortage is also observed within higher education, with declining enrollments in the food science graduate and undergraduate programs across Southern California. Here, we conduct a case study to explore the factors that influence students from Southern California to pursue or not pursue careers in food science. We surveyed both undergraduate and graduate students currently enrolled in food science as well as industry professionals in the region to determine sources of knowledge about the discipline, and motivations and barriers for pursuing careers in food science. We also surveyed high school educators in the region to gain additional perspectives on how food science is being introduced at the secondary level, if at all. Our results demonstrate that many students and high school educators are not knowledgeable about career options within food science and that students who are pursuing food science largely report similar motivations for pursuing the discipline as those currently working in the food science industry. We conclude by discussing implications for the food science education community within Southern California and beyond.