ObjectiveTo thematically synthesise primary qualitative studies of the barriers, motivators and enablers of smoke-free homes (SFHs).DesignSystematic review and thematic synthesis.Data sourcesSearches of MEDLINE, EBM Reviews (Cochrane Database of Systematic Reviews), PsycINFO, Global Health, CINAHL, Web of Science, Informit and EMBASE, combining terms for families, households and vulnerable populations; SFH and secondhand smoke; and qualitative research, were supplemented by searches of PhD theses, key authors, specialist journals and reference lists.Study selectionWe included 22 articles, reporting on 18 studies, involving 646 participants. Inclusion criteria: peer-reviewed; English language; published from 1990 onwards (to week 3 of April 2014); used qualitative data collection methods; explored participants’ perspectives of home smoking behaviours; and the barriers, motivators and enablers to initiating and/or maintaining a SFH.Data extraction1 of 3 authors extracted data with checking by a second.Data synthesisA thematic synthesis was performed to develop 7 core analytic themes: (1) knowledge, awareness and risk perception; (2) agency and personal skills/attributes; (3) wider community norms and personal moral responsibilities; (4) social relationships and influence of others; (5) perceived benefits, preferences and priorities; (6) addiction and habit; (7) practicalities.ConclusionsThis synthesis highlights the complexity faced by many households in having a SFH, the practical, social, cultural and personal issues that need to be addressed and balanced by households, and that while some of these are common across study settings, specific social and cultural factors play a critical role in shaping household smoking behaviours. The findings can inform policy and practice and the development of interventions aimed at increasing SFHs.Trial registration numberCRD42014014115.
Objective: To examine the association between long‐term health conditions and being out of the labour force among older Australians. Design, setting and participants: Retrospective analysis of cross‐sectional data from the Australian Bureau of Statistics 2003 Survey of Disability, Ageing and Carers for people aged 45–64 years. Main outcome measures: Rates of premature retirement associated with ill health; odds ratios of being out of the labour force associated with each long‐term health condition and number of conditions; weighted population estimates; estimates of gross domestic product lost as a result. Results: 9198 people surveyed were aged 45–64 years, 3010 of whom were not in the labour force. Of these, 1373 (45.6%) had retired because of a chronic health condition, most commonly a back problem (10.4%), or arthritis and related disorders (8.6%). When adjusted for age and sex, all conditions studied except diseases of the ear and mastoid process, other endocrine/nutritional and metabolic disorders, noise‐induced deafness or hearing loss, and high cholesterol were significantly associated with being out of the labour force. Extrapolating from these results, an estimated 663 235 older Australians were not working because of ill health, reducing Australia's gross domestic product by around $14.7 billion per annum. Conclusion: Prevention of long‐term health conditions may help older Australians remain in the labour force longer, thereby increasing revenue to fund health care for the ageing population.
While many women discontinue substance use when becoming pregnant, there is clustering of risk among a small group of disadvantaged women. Programmes should address risks holistically within the social realities of women's lives rather than focusing on individual tobacco smoking. Preventing uptake of substance use is critical.
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