The Smoke-free Environment Policy was effective in reducing visitors and staff observed smoking on hospital grounds, but had little effect on inpatients' smoking. Identifying strategies to effectively manage nicotine addiction and promote cessation amongst hospital inpatients remains a key priority.

Well-designed trials of efficacy for preferred evidence-based strategies, particularly among middle-aged male Arabic-speaking smokers, appear warranted prior to policy development and implementation.

Waterpipe tobacco (WT) smoking is traditionally practised in the Orient.1 Waterpipe is known by many names, including narghila, nargila, shisha and goza.2 WT smoking involves burning the tobacco with embers or charcoal. The smoke is filtered through a bowl of water and then drawn through a rubber hose to a mouthpiece and inhaled through the mouth. 2The available research suggests that significant adverse health effects are associated with active and passive WT smoke; it is not a safe form of tobacco smoking.2-4 Researchers overseas have expressed concerns about the rising prevalence of WT smoking since the 1990s and erroneous consumer beliefs of relative safety compared with cigarette smoking. 2To our knowledge, we were the first to report the prevalence of WT smoking in an Australian population.5 A telephone survey of tobacco use among Arabic-speakers residing in south-west Sydney found 11.4% current prevalence (1% daily) of WT smoking. The data also indicated Arabic-speakers believed WT smoking was less harmful than cigarettes.To better understand the determinants of WT smoking and to identify at-risk groups, we further analysed this existing data 5 and focused on WT smoking and respondents' knowledge of its harms. We performed bivariate (cross-tabular) and multiple logistic regression analyses to explore the independent factors associated with WT smoking with WT smoking knowledge score, socio-economic and demographic characteristics. We found that current cigarette/cigar/pipe (CCP) smoking status, being aged 40-59, and having low to moderate WT smoking knowledge independently predicted WT smoking prevalence (Table 1). One-quarter of all current CCP smokers smoked WT at least occasionally, while only 7% of ex-CCP smokers and 7% of those who had never smoked CCP smoked WT at least occasionally. The most popular places to smoke WT reported by current WT smokers were at home (outdoors) 65%; at friends' and relatives' homes (outdoors) 50%; and at Arabic cafes (outdoors) 32%. Respondents who did not smoke WT were significantly more likely to agree with the statements 'smoking narghila/shisha (WT) is harmful to your health' (82% vs. 71%, p= ≤0.01) and that 'smoke inhaled from narghila/shisha (WT) contains harmful chemicals' (74% vs. 64%, p=≤0.05).We believe the main tobacco control priority for Arabicspeakers should remain focused on reducing cigarette smoking prevalence for several reasons. First, there is a low prevalence of WT smoking compared with CCP smoking prevalence (11.4% vs. 26%).5 Second, our analysis shows that CCP smoking status is the strongest predictor of WT smoking, with current CCP smokers being more than four times more likely to use waterpipe than non-CCP smokers. Finally, despite mistaken beliefs of the relative safety of WT compared with cigarette smoking, we are not alarmed about potential switching as only one ex-CCP smoker (out of 1,102 respondents) also reported smoking WT on a daily basis.Nevertheless, some specific strategies for WT smoking are still warranted as almost half of all WT smo...

Tobacco control is a health promotion priority, but there is limited evidence on the effectiveness of campaigns targeting culturally and linguistically diverse (CALD) populations. Being the largest population of non-English-speaking smokers residing in New South Wales (NSW), Australia, Arabic-speakers are a priority population for tobacco control. We report findings from baseline and post-intervention cross-sectional telephone surveys evaluating a comprehensive social marketing campaign (SMC) specifically targeting Arabic-speakers residing in south west Sydney, NSW. The project was associated with a decline in self-reported smoking prevalence from 26% at baseline to 20.7% at post (p < 0.05) and an increase in self-reported smoke-free households from 67.1% at baseline to 74.9% at post (p < 0.05). This paper contributes evidence that comprehensive SMCs targeting CALD populations can reduce smoking prevalence and influence smoking norms in CALD populations.

Issue addressed Tobacco consumption contributes to health disparities among Aboriginal Australians who experience a greater burden of smoking‐related death and diseases. This paper reports findings from a baseline survey on factors associated with smoking, cessation behaviours and attitudes towards smoke‐free homes among the Aboriginal population in inner and southwestern Sydney. Methods A baseline survey was conducted in inner and south‐western Sydney from October 2010 to July 2011. The survey applied both interviewer‐administered and self‐administered data collection methods. Multiple logistic regression was performed to determine the factors associated with smoking. Results Six hundred and sixty‐three participants completed the survey. The majority were female (67.5%), below the age of 50 (66.6%) and more than half were employed (54.7%). Almost half were current smokers (48.4%) with the majority intending to quit in the next 6 months (79.0%) and living in a smoke‐free home (70.4%). Those aged 30–39 years (AOR 3.28; 95% CI: 2.06–5.23) and the unemployed (AOR 1.67; 95% CI: 1.11–2.51) had higher odds for current smoking. Participants who had a more positive attitude towards smoke‐free homes were less likely to smoke (AOR 0.79; 95% CI: 0.74‐.85). Conclusions A high proportion of participants were current smokers among whom intention to quit was high. Age, work status and attitudes towards smoke‐free home were factors associated with smoking. So what? The findings address the scarcity of local evidence crucial for promoting cessation among Aboriginal tobacco smokers. Targeted promotions for socio‐demographic subgroups and of attitudes towards smoke‐free homes could be meaningful strategies for future smoking‐cessation initiatives.