Are Danish vocational schools ready to implement “smoke-free school hours”? A qualitative study informed by the theory of organizational readiness for change

Abstract

Background The smoking prevalence is high among students enrolled in vocational education and training, which is considered a lower level of education. The school tobacco policy regarding smoke-free school hours stipulates that students and staff are not allowed to smoke during school hours—inside or outside school premises—and it might be an effective intervention for reducing smoking in vocational schools. For school tobacco policies to be effective, they must be appropriately implemented. A primary predictor for successful implementation is organizational readiness for change. This study seeks to identify and understand the barriers to and facilitators for developing organizational readiness to implement smoke-free school hours in Danish vocational schools. Methods Semi-structured interviews and focus groups were carried out with managers and teachers (n = 22 participants) from six vocational schools. The interview guides were informed by “A theory of organizational readiness for change” developed by Weiner, which was also used as a framework to analyze the data. Results We identified 13 facilitators and barriers. Nine factors acted as facilitators, including the following: believing that health promotion is a school role and duty; believing that society and workplaces are becoming more smoke-free, and believing that smoke-free school hours is a beneficial strategy to achieve fewer educational interruptions. Additional facilitators include establishing clear rules for sanctioning and enforcement, developing a joint understanding about smoke-free school hours, developing skills to deal with student responses to smoke-free school hours, establishing social alternatives to smoking, offering smoking cessation help, and mandating smoke-free school hours by law. Four organizational norms, practices, or discourses acted as barriers: believing that smoke-free school hours violate personal freedom, believing that students have more important problems than smoking, believing that it is difficult to administer the level of enforcement, and believing that the enforcement of smoke-free school hours negatively influences student-teacher relations. Discussion Our results suggest that developing organizational readiness before adopting a comprehensive tobacco policy such as smoke-free school hours is important for successful implementation. Further research should investigate how to strengthen the facilitators for and counter the barriers to developing readiness for implementing smoke-free school hours.

Context matters in smoking prevention: evaluating smoke-free school hours in Danish vocational schools

“…In line with our findings, Hjort et al ( Hjort et al , 2021 ) examined facilitators and barriers for implementing SFSH in VETs. Identified barriers in this study included beliefs that SFSH violate the personal freedom of staff and students, that many students have more important problems than smoking, that enforcement is difficult to manage, and that enforcement of SFSH negatively influences student–teacher relations.…”

“…Hjort et al , however, highlighted several factors which affect the implementation of structural smoking policies, i.e. smoke-free school hours (SFSH) ( Hjort et al , 2021 ). For example, facilitators were perceiving smoking prevention as a structural responsibility and having a mutual understanding and strategy about smoke-free policies, while perceiving SFSH as violation of personal freedom and that enforcement of SFSH would negatively impact the student–teacher relationship were barriers for implementing SFSH.…”

Factors sustaining legitimacy of smoking in Vocational Education and Training (VET) schools: a qualitative needs assessment

“…Accordingly, our findings suggest four key measures to prepare implementation of smoking prevention and reduction interventions in Danish VET schools. First, and most importantly, the intervention should change school policies by introducing a stricter tobacco regulation than smoke-free premises, e.g., a smoke-free school hour policy [ 45 ]. If properly implemented, this regulation is likely to reduce visibility of smoking, and, over time, may contribute to changing the existing perceptions of smoking as a normal and expected practice in VET schools.…”

Facilitating conditions for staff’s confidence to enforce school tobacco policies: qualitative analysis from seven European cities

“…Strengthening tobacco-free environments nationally could further assist schools in adopting and implementing more comprehensive tobacco policies towards tobacco-free schools. For instance, Hjort, Schreuders, Rasmussen, and Klinker [ 46 ] demonstrated in their study that believing that society and workplaces are becoming more smoke-free increased organizational readiness to implement smoke-free school hours (SFSH) in Danish vocational schools. SFSH extends STPs to whole school hours and all tobacco products.…”