Antero Heloma

Exposure to secondhand smoke in Finnish workplaces and compliance with national smoke-free workplace legislation

Aims: The present study examined time trends and associations in exposure to secondhand smoke (SHS) at work in Finland in 1985—2008 and compliance with national smoke-free workplace legislation that has been enforced since 1995. Methods: The study population comprised respondents of nationally representative annual postal surveys from 1985 to 2008. The differences in the prevalence of SHS-exposed respondents were measured with particular reference to workplace size and workplace smoking arrangements. Results: From 1985 to 2008 daily exposure to SHS at work decreased in all workplaces. The annual decrease was largest in 1994—95 when the smoke-free workplace legislation was enacted. The proportion of exposed employees in workplaces with designated smoking rooms was two-fold compared to employees in workplaces where no one smoked, and this ratio remained unchanged between 1995 and 2008. Employees in small workplaces were exposed most and exposure to SHS was lowest in the largest workplaces. Conclusions: Totally smoke-free workplaces give better protection against the exposure to SHS than workplaces with designated smoking areas. We urge a law reform that does not allow any designated smoking rooms indoors. In the prevention of SHS exposure, special attention should be directed to small workplaces.

Persistence of socioeconomic differences in adolescents’ environmental tobacco smoke exposure in Finland: 1991–2009

Aims: Socioeconomic differences in children’s exposure to environmental tobacco smoke (ETS) in favour of those with higher positions are known, but research is scarce on whether differences have persisted when smoking restrictions have been tightened. We examined socioeconomic differences in adolescents’ ETS exposure from 1991 to 2009 in Finland where the tobacco law has gradually restricted smoking of population. Methods: National cross-sectional surveys (1991–2009) in 12–18-year-olds (N=72,726, response rate 77–56%). An outcome measure was self-reported exposure to ETS (≥1 hour/day). Parents’ socioeconomic and adolescent’s individual social position (school performance/career) were used as independent variables. Across four time periods, associations were studied by logistic regression. Results: Over the study period 1991–2009, the proportion of adolescents exposed to ETS decreased from 17% to 6% (p≤0.001). There were large and persistent differences between socioeconomic and parents’ smoking groups. The decrease occurred in all groups but was smaller among 16–18-year-olds whose father had a low education. A steeper decline occurred among 16–18-year-olds who were not in school or were in vocational school with poor school performance compared with those with more advanced educational career. Compared with other subgroups, the decline in ETS exposure was greater among those whose parents were smokers. Conclusions: Adolescents’ ETS exposure remarkably decreased over time, when tobacco control measures were tightened, particularly among children of smoking parents. Socioeconomic differences persisted although diminishing differences were observed between educational groups at age 16–18.

Tobacco Control: From North Karelia to the National Level.

After World War II, smoking among men was very common in Finland, and especially in North Karelia, contributing to the high rates of cardiovascular diseases and cancer. Thus, the North Karelia Project, from its very start in 1972, took reduction in smoking as one of its main targets. After 1977, the project actively contributed to national tobacco control work, including comprehensive legislation and many other activities. Smoking in North Karelia declined initially much more than in the rest of Finland, but thereafter there has been a steady national decline, resulting in a prevalence of daily smoking among adults of approximately 15% and contributing to the big reduction in the rates of heart disease and tobacco-related cancers, especially among men.