Smoke-free signage in public parks: impacts on smoking behaviour

Platter, Heather; Pokorny, Steven B.

doi:10.1136/tobaccocontrol-2016-053624

Cited by 18 publications

(14 citation statements)

References 17 publications

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“…Moreover, these studies focused their results on the identification of types of places that may constitute hotspots for cigarette butt litter in outdoor environments (i.e. beaches, (17) parks, (18) public transportation stops (14) or hospitality venues, (19)). However, this earlier work limited their results to these places and overlooked the extent of the exposure in the across wider geographical areas, such as a city.…”

Section: Introductionmentioning

confidence: 99%

Estimating and mapping cigarette butt littering in urban environments: A GIS approach

Valiente

Escobar

Pearce

et al. 2020

Environmental Research

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Section: Introductionmentioning

confidence: 99%

Estimating and mapping cigarette butt littering in urban environments: A GIS approach

Valiente

Escobar

Pearce

et al. 2020

Environmental Research

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“…[50][51][52][53] Despite these challenges, which were also noted in the included studies, health benefits could be seen, and these benefits might increase with more widespread adoption and acceptability. Several measures could be taken to improve policy compliance, such as penalties, 50,53 smoke-free signages, 54,55 or information campaigns, 51,56 which can carry additional child health benefits. 57 In general, the reviewed policies were positively perceived by the general population, which can foster effective policy implementation.…”

Section: Discussionmentioning

confidence: 99%

Effect of smoke-free policies in outdoor areas and private places on children's tobacco smoke exposure and respiratory health: a systematic review and meta-analysis

Radó

Mölenberg

Westenberg

et al. 2021

The Lancet Public Health

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Background Smoke-free policies in outdoor areas and semi-private and private places (eg, cars) might reduce the health harms caused by tobacco smoke exposure (TSE). We aimed to investigate the effect of smoke-free policies covering outdoor areas or semi-private and private places on TSE and respiratory health in children, to inform policy. MethodsIn this systematic review and meta-analysis, we searched 13 electronic databases from date of inception to Jan 29, 2021, for published studies that assessed the effects of smoke-free policies in outdoor areas or semi-private or private places on TSE, respiratory health outcomes, or both, in children. Non-randomised and randomised trials, interrupted time series, and controlled before-after studies, without restrictions to the observational period, publication date, or language, were eligible for the main analysis. Two reviewers independently extracted data, including adjusted test statistics from each study using a prespecified form, and assessed risk of bias for effect estimates from each study using the Risk of Bias in Non-Randomised Studies of Interventions tool. Primary outcomes were TSE in places covered by the policy, unplanned hospital attendance for wheezing or asthma, and unplanned hospital attendance for respiratory tract infections, in children younger than 17 years. Random-effects meta-analyses were done when at least two studies evaluated policies that regulated smoking in similar places and reported on the same outcome. This study is registered with PROSPERO, CRD42020190563. FindingsWe identified 5745 records and assessed 204 full-text articles for eligibility, of which 11 studies met the inclusion criteria and were included in the qualitative synthesis. Of these studies, seven fit prespecified robustness criteria as recommended by the Cochrane Effective Practice and Organization of Care group, assessing smoke-free cars (n=5), schools (n=1), and a comprehensive policy covering multiple areas (n=1). Risk of bias was low in three studies, moderate in three, and critical in one. In the meta-analysis of ten effect estimates from four studies, smoke-free car policies were associated with an immediate TSE reduction in cars (risk ratio 0•69, 95% CI 0•55-0•87; 161 466 participants); heterogeneity was substantial (I² 80•7%; p<0•0001). One additional study reported a gradual TSE decrease in cars annually. Individual studies found TSE reductions on school grounds, following a smoke-free school policy, and in hospital attendances for respiratory tract infection, following a comprehensive smoke-free policy. Interpretation Smoke-free car policies are associated with reductions in reported child TSE in cars, which could translate into respiratory health benefits. Few additional studies assessed the effect of policies regulating smoking in outdoor areas and semi-private and private places on children's TSE or health outcomes. On the basis of these findings, governments should consider including private cars in comprehensive smoke-free policies to protect child health.

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“…The fact that representatives of Erasmus MC, among whom where members of the board, addressed smokers may have contributed to the successful implementation of the smoke-free zone, and also might explain the guilty response among many smoking employees. Clear signage in the smoke-free zone likely contributed to smokers’ awareness of the social norm 16 , possibly explaining the high proportion of understanding verbal responses. Changing the social norm in a smoke-free zone is a fundamental part of the implementation.…”

Section: Discussionmentioning

confidence: 99%

Smokers’ responses to being addressed when smoking in an outdoor voluntary smoke-free zone: An observational study

Boderie¹,

Breunis²,

Biney³

et al. 2021

Tob. Prev. Cessation

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INTRODUCTION Addressing smokers who smoke in a voluntary smoke-free area is vital to its successful implementation. Many people perceive barriers in addressing smokers due to fear of negative responses. Insights in actual responses are currently lacking. METHODS This is an observational field study at the voluntary smoke-free zone surrounding the Erasmus MC and two schools in Rotterdam, the Netherlands. In the first month after implementing the zone, Erasmus MC representatives performed rounds to address smokers who were smoking inside the zone. Four people observed addressors for two weeks then they also addressed the smokers. Smokers were classified as employees, patients, students, or other. We noted whether smokers were addressed directly or indirectly, and their verbal and behavioral responses to being addressed. Differences between the responses of the groups were assessed using chi-squared tests. RESULTS In all, 331 smokers were observed of whom 73% were addressed directly. Most verbal reactions were positive (46%) or neutral (18%). Employees were more likely to respond guiltily, whereas patients more often responded angrily than the others. After being addressed, the majority of smokers either extinguished their cigarette (41%) or left to continue smoking outside the smoke-free zone (34%). CONCLUSIONS Most smokers showed a positive or neutral response when being addressed about smoking inside the smoke-free zone and the majority adapted their behavior to comply with the policy. These findings may help decrease barriers for those in doubt about addressing smokers that fail to comply with a smoke-free policy.

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Smoke-free signage in public parks: impacts on smoking behaviour

Cited by 18 publications

References 17 publications

Estimating and mapping cigarette butt littering in urban environments: A GIS approach

Estimating and mapping cigarette butt littering in urban environments: A GIS approach

Effect of smoke-free policies in outdoor areas and private places on children's tobacco smoke exposure and respiratory health: a systematic review and meta-analysis

Smokers’ responses to being addressed when smoking in an outdoor voluntary smoke-free zone: An observational study

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