Compliance with smoke-free policies at indoor and outdoor public places: an observational study in Pakistan

Ahsan, Hanaa; Hoe, Connie; Aslam, Fouad; Wright, Keith; Cohen, Joanna E.; Kennedy, Ryan David

doi:10.26719/emhj.22.005

Cited by 6 publications

(15 citation statements)

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“…was 56.4% [32]. Similarly, a study conducted in 2019 in Karachi, Pakistan, showed almost identical results, where compliance with smoke-free indicators was 57% [34]. The difference in our study is that we assessed the compliance level separately for indoor and outdoor locations.…”

Section: Plos Onementioning

confidence: 55%

“…A study conducted in 2019 in the Biratnagar metropolitan city in Province 1 of Nepal revealed that the overall compliance with smoke-free legislation was 56.4% [ 32 ]. Similarly, a study conducted in 2019 in Karachi, Pakistan, showed almost identical results, where compliance with smoke-free indicators was 57% [ 34 ]. The difference in our study is that we assessed the compliance level separately for indoor and outdoor locations.…”

Section: Discussionmentioning

confidence: 81%

“…The study conducted in the Biratnagar metropolitan city in Province 1 of Nepal found that active smoking was present in 44.8% of all public places [ 32 ]. Moreover, the study conducted in Karachi, Pakistan, found active smoking in 24% of observed public places [ 34 ]. The successful implementation of smoke-free policy can be attributed to multiple factors like vigorous enforcement of smoke-free legislation in Bangladesh and the involvement of multiple stakeholders that could reduce the prevalence of active smoking in public places.…”

Section: Discussionmentioning

confidence: 99%

Section: Plos Onementioning

confidence: 97%

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Compliance with smoke-free legislation in public places: An observational study in a northeast city of Bangladesh

et al. 2023

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Background Bangladesh is one of the highest tobacco-consuming countries in the world, with a large number of adult users of a variety of smoked and/or smokeless tobacco products. Bangladesh tobacco control act prohibits smoking in public places and requires the owners of public places to display ‘no smoking’ signages. Objectives The objective of this study was to assess the level of compliance with the tobacco control act (smoke-free laws) in public places in a northeast city of Bangladesh. Methods This cross-sectional study was conducted between June 1 and August 25, 2020, across 673 public places in Sylhet city, Bangladesh. The data was collected using a structured observational checklist that included variables such as the presence of active smoking, the presence of designated smoking areas, the display of ’no smoking’ signages, evidence of recent smoking such as ashes, butts/bidi ends, and the presence of smoking aids. Results Among 673 public places, a total of 635 indoor locations and 313 outdoor locations were observed. Only 70 (11%) indoor locations were found to be in good compliance, and 388 (61.1%) indoor locations were found to be in moderate compliance with smoke-free laws. On the other hand, only 5 (1.6%) outdoor locations were in good compliance, and 63 (20.1%) outdoor locations were in moderate compliance with smoke-free laws. The overall compliance with smoke-free laws at indoor locations was 52.7%, and at outdoor locations was 26.5%. The highest compliance was observed at healthcare facilities (58.6%) and the least at transit points (35.7%) for indoor locations. In outdoor locations, the highest compliance was observed at offices and workplaces (37.1%) and the least at transit points (2.2%). Higher active smoking was observed in public places where there was an absence of ‘no smoking’ signage and the presence of points of sale (POSs) (p-value <0.05). Further, higher active smoking was observed in places where any smoking aids, cigarette butts, bidi ends, or ashes were present (p-value <0.05). Conclusion This study found moderate compliance at indoor locations and very low compliance at outdoor locations. The government should focus more on implementing smoke-free laws in all kinds of public places, particularly at most frequently visited places and transit sites. ‘No smoking’ signages should be displayed per legislation across all public places. Policymakers should consider the prohibition of POS in/around a public place as it has a positive effect on smoking.

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Section: Plos Onementioning

confidence: 55%

Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Plos Onementioning

confidence: 97%

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Compliance with smoke-free legislation in public places: An observational study in a northeast city of Bangladesh

et al. 2023

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“…Numerous studies have been carried out on non-compliance with smoke-free law across the world ( 15–17 , 19 , 21–38 ). However, the findings are inconclusive, which could hinder the evaluation of ongoing interventions and the redesign of other effective interventional activities.…”

Section: Introductionmentioning

confidence: 99%

Non-compliance with smoke-free law in public places: a systematic review and meta-analysis of global studies

Daba,

Atamo,

Gasheya

et al. 2024

Front. Public Health

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IntroductionNon-compliance with smoke-free law is one of the determinants of untimely mortality and morbidity globally. Various studies have been conducted on non-compliance with smoke-free law in public places in different parts of the world; however, the findings are inconclusive and significantly dispersed. Moreover, there is a lack of internationally representative data, which hinders the evaluation of ongoing international activities towards smoke-free law. Therefore, this meta-analysis aimed to assess the pooled prevalence of non-compliance with smoke-free law in public places.MethodsInternational electronic databases, such as PubMed/MEDLINE, Science Direct, Cochrane Library, CINAHL, African Journals Online, HINARI, Semantic Scholar, google and Google Scholar were used to retrieve the relevant articles. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA) guidelines. The Higgs I2 statistics were used to determine the heterogeneity of the reviewed articles. The random-effects model with a 95% confidence interval was carried out to estimate the pooled prevalence of non-compliance.ResultsA total of 23 articles with 25,573,329 study participants were included in this meta-analysis. The overall pooled prevalence of non-compliance with smoke-free law was 48.02% (95% CI: 33.87–62.17). Extreme heterogeneity was observed among the included studies (I2 = 100%; p < 0.000). The highest non-compliance with smoke-free law was noted in hotels (59.4%; 95% CI: 10.5–108.3) followed by homes (56.8%; 95% CI: 33.2–80.4), with statistically significant heterogeneity.ConclusionAs the prevalence of non-compliance with smoke-free law is high in public places, it calls for urgent intervention. High non-compliance was found in food and drinking establishments and healthcare facilities. In light of these findings, follow-up of tobacco-free legislation and creating awareness that focused on active smokers particularly in food and drinking establishments is recommended.

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Impact of secondhand smoke on air quality in partially enclosed outdoor hospitality venues: a review

Tong,

Goodman,

Vardoulakis

2024

BMC Public Health

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Background Smoking is a leading cause of premature mortality and morbidity globally. The pollutants generated from smoke are not only harmful to smokers, but also to those exposed to secondhand smoke. As a result of increasingly restrictive indoor smoke-free policies in many countries, there is a tendency for tobacco smoking to move outdoors into partially enclosed settings in hospitality venues. The aim of this systematic review was to evaluate the impact of secondhand smoke on air quality in outdoor hospitality venues. Methods Two electronic databases PubMed and Scopus were searched from 1 January 2010 to 30 June 2022 for studies of air quality impacts from tobacco smoking in outdoor hospitality venues. A total of 625 studies were screened and 13 studies were included in this review. Results The majority (9 studies) of reviewed studies monitored PM2.5 concentration as an indicator of secondhand smoke. PM2.5 was reported from 10.9 µg/m3 to 91.0 µg/m3 in outdoor smoking areas, compared to 4.0 µg/m3 to 20.4 µg/m3 in outdoor control sites unaffected by smoking. Secondhand smoke can also drift into adjacent outdoor areas or infiltrate into indoor environments thus affecting air quality in spaces where smoking is not permitted. Conclusions The reviewed studies indicated that air quality within outdoor hospitality venues where smoking is permitted is unlikely to meet current World Health Organization (WHO) ambient air quality guidelines for PM2.5. Customers and staff in outdoor hospitality venues with active smoking, and in adjacent outdoor and indoor non-smoking areas, are potentially exposed to secondhand smoke at levels exceeding WHO guidelines. Stronger smoking control policies are recommended for outdoor hospitality venues to protect the health of customers and staff from harmful secondhand smoke exposure. Prospero registration CRD42022342417.

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Compliance with smoke-free policies at indoor and outdoor public places: an observational study in Pakistan

Cited by 6 publications

References 0 publications

Compliance with smoke-free legislation in public places: An observational study in a northeast city of Bangladesh

Compliance with smoke-free legislation in public places: An observational study in a northeast city of Bangladesh

Non-compliance with smoke-free law in public places: a systematic review and meta-analysis of global studies

Impact of secondhand smoke on air quality in partially enclosed outdoor hospitality venues: a review

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