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      Tobacco in hotels: A study of smoke exposure and resident risk

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          Abstract

          Objectives

          Extended-stay hotels (ESH) are a reliable and accessible housing option for low-income, minoritized renters, who are disproportionately exposed to secondhand and thirdhand cigarette smoke (SHS and THS). This study explores ESH residents’ perceptions of their SHS and THS exposure, harms related to this exposure, their willingness to mitigate these harms, and the contextual factors associated with smoking in hotels.

          Methods

          Eighty ESH renters from the metropolitan Atlanta region were recruited to complete a survey about the perceived harm and persistence of tobacco smoke, exposure experiences, knowledge, attitudes, self-efficacy, and intentions to protect oneself. Eleven of these participants completed semi-structured interviews, during which they discussed their daily SHS and THS exposure at their ESHs in greater detail.

          Results

          Of the survey respondents, 62% reported being bothered by their level of smoke exposure, and 77% said they believed smoke particulates remained in their rooms even after housekeeping cleaned them. Approximately half of survey respondents had attempted to stop smoking in the 3 months prior to the study, and 29 of these individuals were still on their smoking cessation journeys. Most interview participants agreed that SHS and THS exposure exacerbated their existing chronic illnesses and could possibly result in death in the long term. Participants agreed with the benefits of smoke-free policies, but also acknowledged other priorities for ESH living—affordability, safety, and proximity to the workplace—that overshadowed their desires for such policies.

          Conclusion

          Overall, study findings suggest that ESH renters understand the dangers of smoking and SHS/THS and want to decrease their exposure, but the persistence of cultural and contextual factors prevents them from fully engaging with 100% smoke-free policies.

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          Most cited references33

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          Basics of Qualitative Research : Techniques and Procedures for Developing Grounded Theory

          The Second Edition of this best-selling textbook continues to offer immensely practical advice and technical expertise that will aid researchers in analyzing and interpreting their collected data, and ultimately build theory from it. The authors provide a step-by-step guide to the research act. Full of definitions and illustrative examples, the book presents criteria for evaluating a study as well as responses to common questions posed by students of qualitative research.
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            The Health Belief Model as an Explanatory Framework in Communication Research: Exploring Parallel, Serial, and Moderated Mediation

            The Health Belief Model (HBM) posits that messages will achieve optimal behavior change if they successfully target perceived barriers, benefits, self-efficacy, and threat. While the model seems to be an ideal explanatory framework for communication research, theoretical limitations have limited its use in the field. Notably, variable ordering is currently undefined in the HBM. Thus, it is unclear whether constructs mediate relationships comparably (parallel mediation), in sequence (serial mediation), or in tandem with a moderator (moderated mediation). To investigate variable ordering, adults (N = 1,377) completed a survey in the aftermath of an 8-month flu vaccine campaign grounded in the HBM. Exposure to the campaign was positively related to vaccination behavior. Statistical evaluation supported a model where the indirect effect of exposure on behavior through perceived barriers and threat was moderated by self-efficacy (moderated mediation). Perceived barriers and benefits also formed a serial mediation chain. The results indicate that variable ordering in the Health Belief Model may be complex, may help to explain conflicting results of the past, and may be a good focus for future research.
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              Exposure to Secondhand Smoke Among Nonsmokers — United States, 1988–2014

              Exposure to secondhand smoke from burning tobacco products can cause sudden infant death syndrome, respiratory infections, ear infections, and asthma attacks in infants and children, and coronary heart disease, stroke, and lung cancer in adult nonsmokers ( 1 ). There is no risk-free level of secondhand smoke exposure ( 2 ). CDC analyzed questionnaire and laboratory data from the National Health and Nutrition Examination Survey (NHANES) to assess patterns of secondhand smoke exposure among U.S. nonsmokers. The prevalence of secondhand smoke exposure among U.S. nonsmokers declined substantially during 1988–2014, from 87.5% to 25.2%. However, no change in exposure occurred between 2011–2012 and 2013–2014, and an estimated one in four nonsmokers, or approximately 58 million persons, were still exposed to secondhand smoke during 2013–2014. Moreover, marked disparities persisted across population groups. Exposure prevalence was highest among nonsmokers aged 3–11 years (37.9%), non-Hispanic blacks (50.3%), and those who were living in poverty (47.9%), in rental housing (38.6%), or with someone who smoked inside the home (73.0%), or among persons who had less than a high school education (30.7%). Comprehensive smoke-free laws and policies for workplaces and public places and smoke-free rules for homes and vehicles can further reduce secondhand smoke exposure among all nonsmokers.
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                Author and article information

                Journal
                Tob Use Insights
                Tob Use Insights
                sptui
                TUI
                Tobacco Use Insights
                SAGE Publications (Sage UK: London, England )
                1179-173X
                2024
                26 September 2024
                : 17
                : 1179173X241272368
                Affiliations
                [1 ]The Dartmouth Institute for Health Policy & Clinical Practice, Dartmouth College Geisel School of Medicine, Hanover, NH, USA
                [2 ]Department of Epidemiology, Dartmouth College Geisel School of Medicine , Hanover, NH, USA
                [3 ]Center for Technology and Behavioral Health, Dartmouth College Geisel School of Medicine , Hanover, NH, USA
                Author notes
                [*]Terri D. Lewinson, The Dartmouth Institute for Health Policy & Clinical Practice and Department of Epidemiology, Dartmouth College, Dartmouth College Geisel School of Medicine, 1 Rope Ferry Rd, Hanover, NH 03755-1404, USA. Email: terri.d.lewinson@ 123456dartmouth.edu
                Author information
                https://orcid.org/0000-0002-1898-1500
                https://orcid.org/0009-0000-0735-9903
                https://orcid.org/0000-0002-5530-7398
                https://orcid.org/0000-0003-2220-199X
                Article
                10.1177_1179173X241272368
                10.1177/1179173X241272368
                11437544
                39345256
                3c0d3521-b10a-4998-ac8e-f8140fa6408f
                © The Author(s) 2024

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 11 January 2024
                : 12 July 2024
                : 17 July 2024
                Funding
                Funded by: Center for Biomedical Research Excellence (COBRE); PI Karagas;
                Award ID: P20GM104416
                Categories
                Original Research Article
                Custom metadata
                ts10
                January-December 2024

                secondhand smoke,thirdhand smoke,extended stay hotels,smoke-free policies,smoking cessation,health belief model,social-ecological model

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