Browsing by Author "Hayran, Mutlu"

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Citation Count: 29
Compliance with Smoke-Free Legislation Within Public Buildings: a Cross-Sectional Study in Turkey
(World Health Organization, 2016) Çarkoğlu, Aslı; Çarkoğlu, Aslı; Ergör, Gül; Hayran, Mutlu; Ergüder, Toker; Kaplan, Bekir; Susan, Jolie; Magid, Hoda; Pollak, Jonathan; Cohen, Joanna E.
ObjectiveTo investigate public compliance with legislation to prohibit smoking within public buildings and the extent of tobacco smoking in outdoor areas in Turkey. Methods Using a standardized observation protocol we determined whether smoking occurred and whether ashtrays cigarette butts and/or no-smoking signs were present in a random selection of 884 public venues in 12 cities in Turkey. We visited indoor and outdoor locations in bars/nightclubs cafes government buildings hospitals restaurants schools shopping malls traditional coffee houses and universities. We used logistic regression models to determine the association between the presence of ashtrays or the absence of no-smoking signs and the presence of individuals smoking or cigarette butts. Findings Most venues had no-smoking signs (629/884). We observed at least one person smoking in 145 venues most frequently observed in bars/nightclubs (63/79) hospital dining areas (18/79) traditional coffee houses (27/120) and government-building dining areas (5/23). For 538 venues we observed outdoor smoking close to public buildings. The presence of ashtrays was positively associated with indoor smoking and cigarette butts adjusted odds ratio aOR: 315.9
Citation Count: 6
Evaluation of Secondhand Smoke Using PM2.5 and Observations in a Random Stratified Sample in Hospitality Venues from 12 Cities
(MDPI, 2019) Çarkoğlu, Aslı; Çarkoğlu, Aslı; Ergör, Gül; Hayran, Mutlu; Sureda, Xisca; Cohen, Joanna E.; Navas-Acien, Ana
Background: Turkey passed a law banning smoking in all indoor public places in 2008. In response to the indoor smoking restriction many smokers may have relocated to outdoor areas of venues. The aim of this study was to evaluate air pollution related to SHS exposure in indoor and outdoor areas of hospitality venues in 12 cities in Turkey. Method: In this cross-sectional study we evaluated hospitality venues in 12 cities in Turkey. In each visited venue we evaluated a pre-specified number of study locations such as the outdoor area of the main entrance indoor areas and patios or other outdoor dining areas completely or partially covered with window walls. We measured particulate matter 2.5 (PM2.5) in those areas. Results: The fieldworkers visited 72 randomly selected hospitality venues and measured PM2.5 concentrations in 165 different locations (indoor outdoor and patios) of those venues. Overall 2573 people were observed 909 of them smoking. The median (IQR) PM2.5 concentrations were 95 (39-229) g/m(3) indoors 25 (13-48) g/m(3) outdoors and 31 g/m(3) (16-62) in the patios (p < 0.001). After adjustment each additional smoker was associated with a 2% increase in PM2.5 concentrations in patio air (GMR (95% CI): 1.02 (1.00 1.05) and a 4% increase in indoor air (GMR (95% CI): 1.04 (1.02 1.05). Conclusions: There were unhealthy levels of smoking-caused PM2.5 concentrations not only indoors but also in the patios of hospitality venues. Legislative efforts to expand the smoke-free legislation to outdoor areas adjacent to indoor public places and an action plan to increase compliance with the smoke-free policy are urgently needed in Turkey.
Citation Count: 9
Factors that influence attitude and enforcement of the smoke-free law in Turkey: a survey of hospitality venue owners and employees
(Bmj Publishing Group, 2017) Çarkoğlu, Aslı; Çarkoğlu, Aslı; Hayran, Mutlu; Ergör, Gül; Ergüder, Toker; Kaplan, Bekir; Susan, Jolie; Zheng, Laura; Cohen, Joanna E.; Navas-Acien, Ana
Introduction In 2009 Turkey extended the smoke-free legislation to hospitality venues. Compliance however remains low in some hospitality venues. We identified characteristics associated with knowledge of health effects that can be prevented by the smoke-free law the attitude towards and enforcement of the law. Methods In 2014 we conducted 400 interviews with hospitality venue owners and employees in 7 cities in Turkey. The venues were identified based on a random sampling strategy in a previous phase of the study. Results Over one-third (37.3%) of hospitality owners and employees had adequate knowledge of the health effects from secondhand smoke (SHS) 71.3% had a positive attitude towards the law and 19.5% had personally enforced the law. Participants who worked 70 hours or more per week were more likely to have a positive attitude towards the law. Older individuals women participants working in bars/nightclubs venue owners receiving fines for non-compliance and current smokers were less likely to have a positive attitude towards the law. Participants working in traditional coffee houses former smokers and participants with a high school education or greater were more likely to enforce the law. Smokers who quit or reduced smoking because of the law were more likely to enforce the law compared with those who were not influenced by the law. Conclusions Although the attitude towards the law was positive interventions are needed to increase knowledge on the health effects of SHS and facilitate enforcement of the law particularly among subgroups less likely to have a positive attitude and enforce the law.
Citation Count: 0
Factors That Influence Support and Enforcement of the Smoke-Free Law in Turkey
(Oxford University Press, 2016) Çarkoğlu, Aslı; Aherrera, Angela; Çarkoğlu, Aslı; Ergör, Gül; Ergüder, Toker; Kaplan, Bekir; Susan, Jolie; Zheng, Laura; Cohen, Joanna E.; Navas-Acien, Ana
[Abstract Not Available]
Citation Count: 8
Smoke-free Turkey: Evaluation of outdoor areas of public places
(Academic Press Inc Elsevier Science, 2019) Çarkoğlu, Aslı; Grau-Perez, Maria; Çarkoğlu, Aslı; Ergör, Gül; Hayran, Mutlu; Navas-Acien, Ana; Cohen, Joanna E.
Significance: Secondhand tobacco smoke (SHS) exposure is a major cause of morbidity and mortality around the world. The objective of this study was to evaluate the presence of smoking in outdoor areas of public places in three largest Turkish cities (Istanbul Ankara and Izmir). Method: For this cross-sectional observational study the Turkish Statistical Institute randomly selected 10 sampling points in each city. Around each sampling point fieldworkers visited the closest bars/nightclubs cafes government buildings hospitals restaurants schools shopping malls traditional coffee houses universities children's playgrounds parks and open markets. We observed smoking ashtrays and cigarette butts at the outdoor areas of public venues within the urban districts of each city. The fieldwork was conducted in April–May 2016. Results: 477 venues were observed covering 1017 outdoor locations in which 17737 people were observed. Smoking in outdoor areas ranged from 3.7% around schools to 90% in open markets. Ashtrays were almost ubiquitous in hospitals (95.6%) shopping malls (92.0%) and universities (90.9%). Cigarette butts were more often observed in open markets (100%) shopping malls (96%) universities (95.5%) and parks (93.3%). Smoking at outdoor areas around schools was significantly lower than around other venues. Conclusion: Smoking in outdoor areas was common in most public places in Turkey except schools. The current indoor SHS legislation should be extended to cover adjacent outdoor areas of public venues in order to effectively protect people from SHS exposure in Turkey. © 2019 The Authors
Citation Count: 0
Understanding the dynamics of compliance to smoke-free policy regulations: Exploring the perspectives of venue owners and staff in Türkiye
(European Publishing, 2024) Çarkoğlu, Aslı; Carkoglu, Asli; Saraf, Sejal; Ergueder, Toker; Ergoer, Guel; Hayran, Mutlu; Hoe, Connie
INTRODUCTION The study aims to understand the facilitators and barriers associated with enforcing and complying with Turkiye's smoke-free policy from the perspective of hospitality venue owners and employees. METHODS A qualitative open-ended survey was conducted in Istanbul and Ankara in 2021 with 58 respondents from 3 different districts in each city from four types of venues: restaurants, traditional coffee and waterpipe houses, and European-style cafes. The open-ended survey included questions to understand the knowledge, beliefs, and attitudes of respondents about Turkiye's smoke-free policy and their perceptions of the facilitators and/or barriers to smoke-free policy implementation and changes after COVID-19. The data were analyzed using an inductive approach to identify patterns and categorize the data into themes. RESULTS The respondents expressed that the smoke-free policy aimed to protect employees and customers from secondhand smoke (SHS), respect human health, and improve air quality. Findings suggest that the positive attitude of venue owners and staff toward the smoke-free policy serves as a facilitator. However, fear of financial impact, customers' negative attitudes, difficulties in meeting physical requirements, and insufficient enforcement were found to be barriers to implementing the smoke-free policy. The effects of the COVID-19 pandemic were reported as an initial increase in compliance and awareness among customers and staff, but some respondents noted negative changes due to the emotional and financial effects of prolonged restrictions. These challenges have led to decreased attention on the smoke-free policy among venue owners, staff and customers. Respondents' suggested improvements were related to building infrastructure, such as the ventilation systems and educating the public on the harmful health effects of smoking. CONCLUSIONS Despite the general understanding of the dangers of secondhand smoke and the smoke-free policy, this study highlights the challenges in implementing smoke-free policy measures and the continued need to raise awareness about the importance of a 100% smoke-free venue. A comprehensive approach to addressing the tobacco epidemic as a multifaceted public health issue is essential.