Creating smoke-free environments in recreational settings.

To facilitate the banning of tobacco industry sponsorship, Australian health promotion foundations were established to provide health sponsorship to sport, arts, and racing organizations. Health sponsorship dollars procure health sponsorship benefits such as naming rights, signage, personal endorsement of a (health) product by a performer or player, and structural controls such as smoke-free policies. Data are presented from surveys and observations of spectators attending events sponsored by the West Australian Health Promotion Foundation (Healthway) and surveys of Healthway-sponsored organizations and the community. The results demonstrate that by using health sponsorship, Healthway increased the prevalence of smoke-free policies in recreational settings, and there was growing support for these policies. There was evidence of good compliance with smoke-free policies, thus reducing exposure to environmental tobacco smoke. The introduction of smoke-free policies in recreational settings has involved working collaboratively with sectors outside of health, taking an incremental approach to change, and gaining the support of stakeholders by communicating evaluation results.

Increasing the reach of health sponsorship: using a "sponsorship kit" to promote health.

In Australia, a tobacco tax provides funding for Healthway, the Western Australian Health Promotion Foundation. Healthway provides sponsorships for the arts and racing and sporting events to replace funds previously provided by tobacco companies. These sponsorships provide visibility for Healthway and positive health messages. Normally, Healthway staff attends these events to help promote health messages. To reduce Healthway staff time spent helping event organizers promote health messages, Healthway developed a sponsor kit of promotional materials which communicate health messages without requiring Healthway staff to attend events. Recognition, awareness, comprehension, and acceptance of health messages was comparable at events that featured Healthway staff versus the sponsor kits, but the average cost of the sponsorship kits was only 40% of the cost when Healthway staff was featured.

Are smoke-free policies implemented and adhered to at sporting venues?

OBJECTIVE: This study investigated the level of implementation of and adherence to smoke-free policies in two major sporting venues in Perth. METHOD: Smoking status and attitude toward the smoke-free policies in the venues were determined in a random sample of spectators as they entered each venue. An observational study of randomly selected non-smoking seated areas in each venue was conducted on the same day to determine compliance with smoke-free policies. A butt-count was conducted to validate these observations. RESULTS: There was a high level of both awareness and agreement with the smoke-free policies, however, this level of agreement was higher in non-smokers than smokers. The results of the observational study and the butt-count indicated that the policies were implemented and there was a high level of adherence with the smoke-free policy at both venues. CONCLUSION: The results provide further evidence that smoke-free policies in sporting venues are both supported and adhered to by spectators. IMPLICATIONS: The implementation of the smoke-free policies at venues is highly effective in protecting non-smokers from the effects of environmental tobacco smoke.

Banning tobacco sponsorship: replacing tobacco with health messages and creating health-promoting environments.

OBJECTIVE: To evaluate the replacement of Western Australian tobacco sponsorship with health promotion sponsorship by the Western Australian Health Promotion Foundation (known as "Healthway"), following the Tobacco Control Act 1990. DESIGN: Process measures of performance were collected from 25 tobacco replacement projects (sponsorship by Healthway of sport, racing, and arts groups previously supported by tobacco companies) and 727 other health sponsorship projects, that is, new sponsorship provided by Healthway to these groups. Cross-sectional survey data were obtained from 917 respondents at tobacco replacement and 2352 at other sponsorship venues. SETTING: Sport, racing, and arts venues sponsored by the Western Australian Health Promotion Foundation (Healthway) in 1991-95. MAIN OUTCOME MEASURES: Population reach, occasions of media publicity, healthy structural changes, cognitive/attitudinal impact of health messages, and the prevalence of five health-risk behaviours. RESULTS: Tobacco replacement and other sponsorship projects achieved comparable performance in publicity for health messages and in healthy structural change, but replacement projects achieved a fourfold higher level of direct population reach for a given amount of funding. Structural change towards a smoke-free environment occurred more often in tobacco replacement projects and a permanent smoke-free policy was achieved in 47% of projects, compared with 15% in other sponsorship projects. The prevalence ratio of current smoking at tobacco replacement venues was 1.86 (95% confidence interval 1.62 to 2.04) relative to other sponsorship venues. There was evidence of higher cognitive resistance to health messages at venues previously sponsored by tobacco companies. CONCLUSIONS: A comprehensive ban on tobacco sponsorship linked to health promotion activities funded by tobacco tax delivers potential public health benefits that exceed those achieved by prohibition of tobacco sponsorship alone. Tobacco replacement venues offer opportunities for environmental modification, promotion of anti-smoking messages, and targeting groups that are hard to reach.

In vivo role of glucocorticoids in barotrauma vascular repair and fibrosis.

To determine the important repair events leading to vascular collagen accumulation following barotrauma, in vivo changes were assessed during dexamethasone (DEX) treatment, as well as physiological healing. Hypercholesterolemic rabbits underwent bilateral iliac artery endothelial denudation, followed by angioplasty. Messenger ribonucleic acid (RNA) (procollagen types I, III and transforming growth factor [TGF]beta1), and bio-histometric composition of iliac arteries of animals treated with DEX (2, 7 and 7 days; 1 mg/kg1/day1), were compared to that in controls 2, 7 and 30 days after angioplasty. Type I and III procollagen mRNA transcripts were up-regulated following injury in either group. Similarly, TGFbeta1 mRNA levels were also elevated; however, treatment with DEX led to down-regulation at day 30 post-angioplasty. Linear regression and correlation of the densitometric ratios of procollagen alpha1(I) and TGFbeta1 mRNA during repair were observed significantly in either group (DEX-treated, r2= 0.84; non-treated, r2=0.79). Biochemically derived total vascular RNA concentration decreased transiently (7 days), with DEX-treatment (P = 0.003). Arterial lumen cross-sectional area was reduced between days 2 and 30 (P=<0.02), accompanied by an increase in fibrillar collagen concentration in both groups of animals post-angioplasty. These results suggest that during barotrauma repair, administration of DEX (approximately 1 week), does not affect vascular intimal hyperplasia or fibrosis, and that despite treatment, significant production of type I procollagen mRNA continues, influencing subsequent collagen deposition. The data also confirm a strong correlation between TGFbeta1 and type I procollagen mRNA expression, and modestly with type III procollagen during post-angioplasty repair.

Warning: attending a sport, racing or arts venue may be beneficial to your health.

Concerted efforts to create health-promoting sport, racing and arts venues have become possible since the advent of health promotion foundations in four of Australia's eight states and territories. Large numbers of Australians attend sport, racing and arts venues in pursuit of leisure activities. There is evidence that sport and racing participants and spectators, and certain subgroups of the arts community, have adverse risk-factor profiles that make them an ideal target for health promotion interventions. Through the use of sponsorship, health promotion foundations 'purchase' health-promoting policies in sport, racing and arts settings-policies that have the potential to become institutionalised once sponsorship dollars are depleted. This paper discusses the policies 'purchased' by the foundations and outlines a comprehensive surveillance and evaluation system developed for the Western Australian Health Promotion Foundation. The system monitors the implementation of health-promoting environments at the micro level (sponsorship project); intermediate level (sponsored group); and macro level (community). The article concludes by outlining some of the lessons learned in Western Australia. These provide the basis for development of best practice in working with sport, racing and arts groups, and other sectors outside health, to create health-promoting environments.