At the Frontier of Tobacco Control: A Brief Review of Public Attitudes toward Smoke-Free Outdoor Places

University of Otago, Box 7343, Wellington South, Wellington, New Zealand.
Nicotine & Tobacco Research (Impact Factor: 3.3). 05/2009; 11(6):584-90. DOI: 10.1093/ntr/ntp046
Source: PubMed


Outdoor smoke-free areas have been adopted increasingly in North America, Britain, Ireland, Australasia, and elsewhere. Their use appears to be one of the frontier areas of tobacco control development. We briefly reviewed the available reports on public attitudes about smoke-free public outdoor areas.
We included surveys of the general population or of users of public outdoor locations, reported in English language publications to September 2008.
We identified 16 relevant reports that used surveys from 1988 to 2007. Although the evidence remains limited, this research indicates that, in a number of jurisdictions, the majority of the public supports restricting smoking in various outdoor settings. Support for smoke-free outdoor public places appears to be increasing over time. Among respondents' reasons for support were the following: litter control, establishing positive smoke-free role models for youth, reducing youth opportunities to smoke, and avoiding exposure to secondhand smoke.
Given the recent increase in outdoor smoking restrictions in many developed countries and the growing recognition of the importance of reducing smoking role models for children, this area needs further research related to attitudes and policy evaluation. Given the levels of public support, policy makers in some jurisdictions appear to have an opportunity to establish smoke-free outdoor public places, at least in areas frequented by children.

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    • "These results suggested that outdoor smoke-free policies for hospitals were well accepted by the general public and hospital staff. A review on public attitudes towards smoke-free outdoor places showed that, in a number of jurisdictions, the majority of the public supported restricted smoking in various outdoor settings, including hospitals (Thomson et al., 2009). Another study conducted in Italy found that 79.9% of the population supported smoke-free policies in outdoor areas surrounding hospitals (Gallus et al., 2012). "
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    ABSTRACT: Introduction: On January 2, 2011, the Spanish government passed a new smoking law that banned smoking in hospital campuses. The objective of this study was to evaluate the implementation of smoke-free campuses in the hospitals of Catalonia based on both airborne particulate matter and observational data. Methods: This cross-sectional study included the hospitals registered in the Catalan Network of Smoke-free Hospitals. We measured the concentration of particulate matter < 2.5 μm in μg/m3 at different locations, both indoors and outdoors before (2009) and after (2011) the implementation of the tobacco law. During 2011, we also assessed smoke-free zone signage and indications of smoking in the outdoor areas of hospital campuses. Results: The overall median particulate matter < 2.5 μm concentration fell from 12.22μg/m3 (7.80-19.76μg/m3) in 2009 to 7.80μg/m3 (4.68-11.96μg/m3) in 2011. The smoke-free zone signage within the campus was moderately implemented after the legislation in most hospitals, and 55% of hospitals exhibited no indications of tobacco consumption around the grounds. Conclusions: After the law, particulate matter < 2.5 μm concentrations were much below the values obtained before the law and below the annual guideline value recommended by the World Health Organization for outdoor settings (10μg/m3). Our data showed the feasibility of implementing a smoke-free campus ban and its positive effects.
    Full-text · Article · Oct 2014
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    • "In most studies in which it was considered, acceptability varied with respondents’ own health-related behaviour. For example, non-smokers and ex-smokers were more likely to support tobacco control interventions than smokers [23,24,29,34-36,47,49,80,85],[87,88,92,93,96,99,105-111]. Likewise in a majority of studies, respondents who regularly consumed alcohol were less likely to support intrusive alcohol-related interventions [18,20,22,38,39,69,71,76],[112,113]. "
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    ABSTRACT: Governments can intervene to change health-related behaviours using various measures but are sensitive to public attitudes towards such interventions. This review describes public attitudes towards a range of policy interventions aimed at changing tobacco and alcohol use, diet, and physical activity, and the extent to which these attitudes vary with characteristics of (a) the targeted behaviour (b) the intervention and (c) the respondents. We searched electronic databases and conducted a narrative synthesis of empirical studies that reported public attitudes in Europe, North America, Australia and New Zealand towards interventions relating to tobacco, alcohol, diet and physical activity. Two hundred studies met the inclusion criteria. Over half the studies (105/200, 53%) were conducted in North America, with the most common interventions relating to tobacco control (110/200, 55%), followed by alcohol (42/200, 21%), diet-related interventions (18/200, 9%), interventions targeting both diet and physical activity (18/200, 9%), and physical activity alone (3/200, 2%). Most studies used survey-based methods (160/200, 80%), and only ten used experimental designs.Acceptability varied as a function of: (a) the targeted behaviour, with more support observed for smoking-related interventions; (b) the type of intervention, with less intrusive interventions, those already implemented, and those targeting children and young people attracting most support; and (c) the characteristics of respondents, with support being highest in those not engaging in the targeted behaviour, and with women and older respondents being more likely to endorse more restrictive measures. Public acceptability of government interventions to change behaviour is greatest for the least intrusive interventions, which are often the least effective, and for interventions targeting the behaviour of others, rather than the respondent him or herself. Experimental studies are needed to assess how the presentation of the problem and the benefits of intervention might increase acceptability for those interventions which are more effective but currently less acceptable.
    Full-text · Article · Aug 2013 · BMC Public Health
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    • "Secondhand smoke in open and semi-open settings Environmental Health Perspectives • volume 121 | number 7 | July 2013 767 2008). In a number of jurisdictions, the major­ ity of the public supports restricting smoking in various outdoors settings, and this support appears to be increasing over time (Thomson et al. 2009). However, those who oppose out­ door smoking bans argue that it is ethically unsustainable because it does not respect the principle of freedom and autonomy of indi­ viduals, and that there is insufficient evidence that SHS in these environments has an impact on health (Chapman 2000, 2008). "
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    ABSTRACT: Background: Some countries have recently extended smoke-free policies to particular outdoor settings; however, there is controversy regarding whether this is scientifically and ethically justifiable. Objectives: The objective of the present study was to review research on secondhand smoke (SHS) exposure in outdoor settings. Data sources: We conducted different searches in PubMed for the period prior to September 2012. We checked the references of the identified papers, and conducted a similar search in Google Scholar. Study selection: Our search terms included combinations of “secondhand smoke,” “environmental tobacco smoke,” “passive smoking” OR “tobacco smoke pollution” AND “outdoors” AND “PM” (particulate matter), “PM2.5” (PM with diameter ≤ 2.5 µm), “respirable suspended particles,” “particulate matter,” “nicotine,” “CO” (carbon monoxide), “cotinine,” “marker,” “biomarker” OR “airborne marker.” In total, 18 articles and reports met the inclusion criteria. Results: Almost all studies used PM2.5 concentration as an SHS marker. Mean PM2.5 concentrations reported for outdoor smoking areas when smokers were present ranged from 8.32 to 124 µg/m3 at hospitality venues, and 4.60 to 17.80 µg/m3 at other locations. Mean PM2.5 concentrations in smoke-free indoor settings near outdoor smoking areas ranged from 4 to 120.51 µg/m3. SHS levels increased when smokers were present, and outdoor and indoor SHS levels were related. Most studies reported a positive association between SHS measures and smoker density, enclosure of outdoor locations, wind conditions, and proximity to smokers. Conclusions: The available evidence indicates high SHS levels at some outdoor smoking areas and at adjacent smoke-free indoor areas. Further research and standardization of methodology is needed to determine whether smoke-free legislation should be extended to outdoor settings.
    Full-text · Article · May 2013 · Environmental Health Perspectives
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