Scandinavian Journal of Public Health

Aim: The population’s attitude towards smoking bans in public arenas is important for their passing, implementation and compliance. Smoking bans are believed to reduce the social acceptability of smoking, and once people experience them, public support increases – also among pre-ban sceptics. This study aimed to examine the temporal changes in public attitude towards smoking bans in public arenas from 2007 to 2010 and whether these changes differed across educational attainment, smoking status and intention to quit among smokers. Methods: Data from two surveys among adults (aged 25–79 years) in 2007 and 2010 in the Capital Region of Denmark (n=36,472/42,504, response rate = 52.3) was linked with data on sex, age and educational attainment from central registers. Age-standardised prevalence of supportive attitude towards smoking bans was estimated. Temporal changes in supportive attitude were explored in workplaces, restaurants and bars using logistic regression models. Results: The prevalence of supportive attitude towards smoking bans increased significantly in all arenas from 2007 to 2010. Positive temporal changes in supportive attitude towards smoking bans were seen across educational attainment, smoking status and intention to quit smoking in restaurants and across smoking status for smoking bans in workplaces and bars. Conclusions: The results of this study show that the public’s attitude towards smoking in public arenas has changed after the implementation of a comprehensive smoking ban. This change in attitude can support implementation of future legislation on smoking and may lead to positive changes in smoking norms.

Aims: Tobacco smoking is among the leading risk factors for chronic disease and early death in developed countries, including Denmark, where smoking causes 14% of the disease burden. In Denmark, many public health interventions, including smoking prevention, are undertaken by the municipalities, but models to estimate potential health effects of local interventions are lacking. The aim of the current study was to model the effects of decreased smoking prevalence in Copenhagen, Denmark. Methods: The DYNAMO-HIA model was applied to the population of Copenhagen, by using health survey data and data from Danish population registers. We modelled the effects of four intervention scenarios aimed at different target groups, compared to a reference scenario. The potential effects of each scenario were modelled until 2040. Results: A combined scenario affecting both initiation rates among youth, and cessation and re-initiation rates among adults, which reduced the smoking prevalence to 4% by 2025, would have large beneficial effects on incidence and prevalence of smoking-related diseases and mortality. Health benefits could also be obtained through interventions targeting only cessation or re-initiation rates, whereas an intervention targeting only initiation among youth had marginal effects on morbidity and mortality within the modelled time frame. Conclusions: By modifying the DYNAMO-HIA model, we were able to estimate the potential health effects of four interventions to reduce smoking prevalence in the population of Copenhagen. The effect of the interventions on future public health depended on population subgroup(s) targeted, duration of implementation and intervention reach.

Aim: Psychosocial factors in the working environment have been shown to be associated with mobility limitations, but this has not yet been confirmed in a Danish population. We aimed to examine how psychosocial factors at work are related to developing mobility limitations in Denmark. Methods: This study is based on data from 2952 middle-aged men and women without mobility limitations in 2000. Results: We found increased risk of incident mobility limitations during 6-year follow up among men who often perceived high work pace (OR 5.45, 95% CI 1.21–24.52) vs. never, who only sometimes or/never perceived the work to be meaningful (OR 6.54, 95% CI 1.55–27.55) vs. always, and who sometimes perceived high emotional demands at work (OR 7.85, 95% CI 1.78–34.65) vs. never. Among women, lower risk of incident mobility limitations was observed among those who in 2000 perceived high work pace sometimes (OR 0.46, 95% CI 0.24–0.87) or often (OR 0.43, 95% CI 0.22–0.85) vs. never in 2000. Also, women who always or often experienced high emotional demands had an increased risk. Conclusions: The most important finding was that high work pace was strongly associated with increased risk of mobility limitations among men, but associated with lower risk of mobility limitations among women. This knowledge may be used to better target interventions among men and women in midlife from physical deterioration later in life.

Background: SOC is associated with wellbeing and health. The Lundby Study is a cohort study of an unselected population (n=3563) in whom mental health and personality traits have been assessed since 1947, with follow ups in 1957, 1972, and 1997. Aim: To describe the relationship of Antonovsky’s 29-item sense of coherence scale (SOC) and its three subscales (comprehensibility, manageability, and meaningfulness) to mental health and mortality in an unselected middle-aged and elderly community cohort, controlling for gender, age, marital status, and socioeconomic status. Another aim was to analyse the three-factor structure of the SOC. Methods: Of the 1797 surviving subjects in 1997, 1559 participated in a semistructured diagnostic interview, and 1164 subjects completed the SOC questionnaire. Psychiatrists performed diagnostic evaluations. Collateral information was obtained from case notes and registers. Dates of death from 1997–2011 were obtained from the cause of death register. Results: SOC scores showed no sex differences, but were positively correlated with age. SOC scores were higher in married relative to unmarried participants and in blue-collar workers and self-employed individuals relative to white-collar workers. Total SOC and subscale scores were negatively correlated with depressive, anxiety, organic, and psychotic disorders. Male gender was positively correlated with comprehensibility and female gender was positively correlated with manageability and meaningfulness. Higher comprehensibility scores were correlated with lower mortality. Conclusions: SOC scores increased with age, were higher for blue-collar workers, and were lower for individuals with psychiatric disorders. Higher comprehensibility scores were associated with lower mortality. However, there was only weak evidence for a three-factor structure.

Background: The aim of the study was to identify and characterize groups with poor mental health defined by the SF-12 Mental Component Summary (MCS-12) scale. Methods: The study is based on the Danish Health and Morbidity Survey 2005 and includes 10,082 participants (16 years or older). Data were analysed by means of logistic regression models. Results: Men and women with poor mental health are characterized by being single, having a long-term illness, not being able to rely on help from others in case of illness and by feeling that family and friends demand too much of them. Men with poor mental health were further characterized by being a heavy smoker, and having a BMI below 25. Women with poor mental health were further characterized by being 16–44 years old and sedentary in leisure time. Conclusions: The prevalence of poor mental health is higher among women than men, and different factors characterize men and women with poor mental health. The present findings support the notion that both socio-demographics and lifestyle factors are independently related with poor mental health. We suggest taking into account all these areas of life when planning activities to prevent poor mental health and when promoting mental health.

Aims: Among children with separated parents, the arrangement of joint physical custody, i.e. children living equally much in both parents’ homes, has increased substantially during the last decades in Sweden. To date, empirical research on the living conditions of this group is limited. This study analyses family type differences in turning to parents for emotional support and in subjective health among adolescents. The focus of the study is adolescents in joint physical custody, who are compared with those living with two original parents in the same household; those living (only) in a single-parent household; and those living (only) in a reconstituted family. Methods: The data come from the Stockholm School Survey of 2004, a total population survey of students in grade 9 (15–16 years) in Stockholm (n=8,840). Ordinary least squares (OLS) regressions were conducted. Results: Turning to both parents about problems is most commonly reported by adolescents in intact families, followed by those in joint physical custody. Adolescents in non-traditional family types report worse subjective health than adolescents in intact families, but the difference is smaller for those in joint physical custody than for those living with a single parent. The slightly poorer health of adolescents in joint physical custody than those in intact families is not explained by their lower use of parents as a source of emotional support. Conclusions: The study suggests that joint physical custody is associated with a higher inclination to use parents as a source of emotional support and better subjective health than other post-divorce family types.

Background: This study aimed to explore the feasibility and effect of an intervention in clinical practice with isolated physical activity in individuals with IGT, recruited by the FINDRISC questionnaire. Methods: The questionnaire was sent to a population of 9734 individuals, 35–75 years old, in Sweden. Those with a risk score ≥15 were encouraged to perform an oral glucose tolerance test. Individuals with IGT were invited to participate in a randomized controlled trial with a focus on physical activity. The participants were allocated to one of three arms; basic intervention, intensive intervention or to care as usual. A total of 52 individuals were carefully examined and questionnaires about diet and lifestyle were completed at baseline and after one year. All analyses were adjusted for differences in age and sex, and calorie intake when relevant. Results :The prevalence of chronic diseases in the study population was high, creating considerable difficulties in conducting a standardized test for fitness. Waist circumference (p=0.020), sagittal diameter (p=0.035), body weight (p=0.038) and BMI (p=0.043) decreased significantly more in the intensive care group than in care as usual and the basic care group. However, the significance was abolished when differences in energy intake were accounted for. Conclusions: In an intention to treat, prospective lifestyle interventions with physical activity are feasible, but a high prevalence of comorbidities needs to be considered. Also, an intervention focused on isolated physical activity inevitably led to changes in diet with weight loss and significant improvement of essential risk factors in spite of the participants’ burden of chronic diseases.