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      Nichtraucherschutz und Tabakentwöhnung : Ein Thema für Mitarbeitende in Einrichtungen der deutschen Kinder- und Jugendpsychiatrie? Translated title: Non-smoker protection and tobacco cessation

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          Abstract

          Zusammenfassung. Fragestellung: Mitarbeitende in kinder- und jugendpsychiatrischen (KJP) Einrichtungen stehen im Spannungsverhältnis zwischen der Durchsetzung von Rauchverboten für Patient_innen und dem eigenen Rauchverhalten. Bisher fehlen Daten, ob und wo Mitarbeitende rauchen und welche Entwöhnungsangebote KJP-Einrichtungen ihnen anbieten. Methodik: In einer Onlinestudie beantworteten n = 78 leitende Mitarbeitende deutscher KJP-Einrichtungen (41.9 % aller Angeschriebenen) Fragen zu stationsübergreifenden sowie stationsspezifischen Nichtraucherschutzmaßnahmen sowie zu Tabakentwöhnungsmaßnahmen. Ergebnisse: Umfassende Rauchverbote werden selten umgesetzt (< 20 % der Einrichtungen). Mitarbeitende dürfen vorrangig im Außengelände rauchen (z. B. in Raucherzonen: 69 bis 78 % je nach Stationstyp). Entwöhnungsangebote für Mitarbeitende bietet nur jede zweite KJP an (47 %). Schlussfolgerungen: Die Daten weisen auf zukünftige Handlungsfelder der Tabakkontrolle in der KJP-Pflege hin: transparente Regeln, Weiterbildungen und Ausbau betrieblicher Entwöhnungsangebote.

          Non-smoker protection and tobacco cessation

          Abstract. Objective: Whereas, on the one hand, employees in child and adolescent psychiatric institutions (CAP) have to enforce smoking bans among patients, on the other hand, they have a high likelihood of being smokers themselves. Little data are available on the enforcement of smoking regulations and what cessation support is offered by CAP institutions. Method: In an online survey, n = 78 senior staff members or directors of German CAP institutions (41.9 % of all addressed CAP institutions) responded to questions on smoking regulations, exceptions, and cessation support for employees. Results: The enforcement of comprehensive smoking bans is rarely reported (<20 % of CAP institutions). Employees are exempted or allowed to smoke mostly outside of the building (e. g., in designated smoking areas: 69-78 % depending on ward type). Cessation support was offered by less than half of the CAP institutions (47%). Conclusions: The data presented point toward future areas for tobacco control in CAP care, including transparent regulations, staff training, and dissemination of support for occupational smoking cessation.

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          Most cited references23

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          The hazards of smoking and the benefits of cessation: a critical summation of the epidemiological evidence in high-income countries

          In high-income countries, the biggest cause of premature death, defined as death before 70 years, is smoking of manufactured cigarettes. Smoking-related disease was responsible for about 41 million deaths in the United States, United Kingdom and Canada, cumulatively, from 1960 to 2020. Every million cigarettes smoked leads to one death in the US and Canada, but slightly more than one death in the UK. The 21st century hazards reveal that smokers who start smoking early in adult life and do not quit lose a decade of life expectancy versus non-smokers. Cessation, particularly before age 40 years, yields large reductions in mortality risk. Up to two-thirds of deaths among smokers are avoidable at non-smoking death rates, and former smokers have about only a quarter of the excess risk of death compared to current smokers. The gap between scientific and popular understanding of smoking hazards is surprisingly large.
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            Effect of implementation of a smoke-free policy on physical violence in a psychiatric inpatient setting: an interrupted time series analysis.

            Smoke-free policies are important to protect health and reduce health inequalities. A major barrier to policy implementation in psychiatric hospitals is staff concern that physical violence will increase. We aimed to assess the effect of implementing a comprehensive smoke-free policy on rates of physical assaults in a large UK mental health organisation.
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              Global risk factor rankings: the importance of age-based health loss inequities caused by alcohol and other risk factors

              Background Achieving health equity is a priority of the World Health Organization; however, there is a scant amount of literature on this topic. As the underlying influences that determine health loss caused by risk factors are age-dependent, the aim of this paper is to examine how the risk factor rankings for health loss differ by age. Methods Rankings were based on data obtained from the 2010 Global Burden of Disease study. Health loss (as measured by Disability Adjusted Life Years lost) by risk factor was estimated using Population-Attributable Fractions, years of life lost due to premature mortality, and years lived with disability, which were calculated for 187 countries, 20 age groups and both sexes. Uncertainties of the risk factor rankings were estimated using 1,000 simulations taken from posterior distributions Results The top risk factors by age were: household air pollution for neonates 0–6 days of age [95% uncertainty interval (UI): 1 to 1]; suboptimal breast feeding for children 7–27 days of age (95% UI: 1–1); childhood underweight for children 28 days to less than 1 year of age and 1–4 years of age (95% UI: 1–2 and 1–1, respectively); iron deficiency for children and youth 5–14 years of age (95% UI: 1–1); alcohol use for people 15–49 years of age (95% UI: 1–2); and dietary risks for people 50 years of age and older (95% UI: 1–1). Rankings of risk factors varied by sex among the older age groups. Alcohol and smoking were the most important risk factors among men 15 years of age and older, and high body mass and intimate partner violence were some of the most important risk factors among women 15 years of age and older. Conclusions Our analyses confirm that the relative importance of risk factors is age-dependent. Therefore, preventing harms caused by various modifiable risk factors using interventions that target people of different ages should be a priority, especially since easily implemented and cost-effective public health interventions exist. Electronic supplementary material The online version of this article (doi:10.1186/s13104-015-1207-8) contains supplementary material, which is available to authorized users.
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                Author and article information

                Contributors
                Journal
                kij
                Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie
                Hogrefe AG, Bern
                1422-4917
                1664-2880
                03. Mai 2022
                Affiliations
                [ 1 ]Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Medizinische Fakultät, Technische Universität Dresden, Dresden, Deutschland
                [ 2 ]Deutsches Netz Rauchfreier Krankenhäuser & Gesundheitseinrichtungen (DNRfK e. V.), Berlin, Deutschland
                [ 3 ]IFT Institut für Therapieforschung, München, Deutschland
                [ 4 ]Klinische Psychologie und Psychotherapie, Technische Universität Chemnitz, Chemnitz, Deutschland
                [ 5 ]Klinik für Psychiatrie und Psychotherapie, LMU Klinikum München, München, Deutschland
                [ 6 ]Klinik und Poliklinik für Psychiatrie und Psychotherapie, Medizinische Fakultät, Technische Universität Dresden, Dresden, Deutschland
                Author notes
                Dr. rer. nat. Dipl.-Psych. Sören Kuitunen-Paul, Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Medizinische Fakultät, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Deutschland soeren.kuitunen-paul@ 123456ukdd.de
                Author information
                https://orcid.org/0000-0001-8224-6490
                https://orcid.org/0000-0002-5051-7927
                https://orcid.org/0000-0002-3717-6339
                https://orcid.org/0000-0002-1873-7081
                https://orcid.org/0000-0001-5398-5569
                Article
                kij_a000870_-1_1
                10.1024/1422-4917/a000870
                daa3a443-45e8-42d6-8e62-3a90ced8cfca
                Distributed as a Hogrefe OpenMind article under the license CC BY 4.0 ( http://creativecommons.org/licenses/by/4.0)

                Distributed as a Hogrefe OpenMind article under the license CC BY 4.0 ( http://creativecommons.org/licenses/by/4.0)

                History
                : 21. September 2021
                : 25. Februar 2022
                Funding
                Förderung: Open-Access-Veröffentlichung ermöglicht durch die Technische Universität Dresden (TU Dresden).
                Categories
                Originalarbeit

                Pediatrics,Psychology,Family & Child studies,Development studies,Clinical Psychology & Psychiatry
                tobacco control,betriebliches Gesundheitsmanagement,nursing staff,Pflegepersonal,Tabakkontrolle,structural prevention,Tabakentwöhnung,Verhältnisprävention,Tobacco withdrawal,occupational health management

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