Signs, Fines and Compliance Officers: A Systematic Review of Strategies for Enforcing Smoke-Free Policy

Wynne, Olivia; Guillaumier, Ashleigh; Twyman, Laura; McCrabb, Sam; Denham, Alexandra M. J.; Paul, Christine; Baker, Amanda; Bonevski, Billie

doi:10.3390/ijerph15071386

Cited by 18 publications

(21 citation statements)

References 36 publications

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“…In the literature, implementation of the tobacco control policies recommended by the World Health Organization has benefitted child health in terms of, for example, asthma exacerbation, respiratory tract infection, and reduced smoking-related mortality 27,28 . Deploying enforcement officers and imposing violation penalties for continuous monitoring, awareness-raising campaigns, and signage display have been suggested as successful policy enforcement measures 29 .…”

Section: Discussionmentioning

confidence: 99%

Association of secondhand smoke exposure with allergic multimorbidity in Korean adolescents

Lee

2020

Sci Rep

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This study aimed to examine the health effect of secondhand smoke (SHS) exposure at home, school, and/or public places on allergic multimorbidity using nationwide data among school-attending adolescents in Korea. Allergic multimorbidity was defined as two or more coexisting allergic diagnoses of asthma, allergic rhinitis, and/or atopic dermatitis during the past 12 months. A multinomial logistic regression analysis was performed to evaluate the association of SHS exposure and allergic multimorbidity. Of the study participants, 24.3% were diagnosed as having any allergic disease currently and 66.3% reported SHS exposure. Any SHS exposure that includes public places conferred increased odds of atopic dermatitis in non-current smokers (adjusted odds ratio 1.21–1.46; 95% confidence interval [CI] 1.10–1.66). Moreover, when controlling for current smoking additionally, SHS exposure at the three sites was 1.37 and 1.96 times more likely to be associated with allergic single and multiple morbidities, respectively (95% CI 1.26–1.49 and 1.65–2.31, respectively). In conclusion, this study found positive associations of SHS exposure with single or multiple allergic morbidity compared to no exposure at all. Further studies with longitudinal designs and objective measurement of SHS exposure and allergic diagnosis are warranted.

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Section: Discussionmentioning

confidence: 99%

Association of secondhand smoke exposure with allergic multimorbidity in Korean adolescents

Lee

2020

Sci Rep

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“…A number of articles outline the benefits of smoke‐free policies for reducing smoking and exposure to environmental tobacco smoke in the hospital context, as well as ways to ensure policy compliance . Methods for ensuring policy compliance in these studies include: policy communication and awareness, signage, enforcement, penalties for breaches, availability of Nicotine Replacement Therapy (NRT), comprehensive smoking bans, mechanisms for monitoring compliance, and organisational changes.…”

Section: Introductionmentioning

confidence: 99%

Implementing and enforcing a smoke‐free policy and by‐law on hospital grounds at Central Coast Local Health District

Giles

Bauer

2019

Health Prom J of Aust

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Issue addressed Smoking by patients, staff and visitors on the grounds of Central Coast Local Health District (CCLHD). Methods NSW Health introduced a smoke‐free buildings and vehicles policy in 1988. A smoke‐free grounds policy was implemented in 1999, and a smoke‐free by‐law adopted by CCLHD in 2013, making smoking on CCLHD grounds an offence. Smoking in high‐profile areas near hospital entrances was counted regularly since 2000. Several methods for communicating, monitoring and enforcing these smoke‐free interventions have been adopted, including signage, Public Address announcements and enforcement patrols to ensure by‐law compliance and to issue fines where required. Compliance with the smoke‐free interventions has been supported with the availability of Nicotine Replacement Therapy for patients and visitors. Results When monitoring counts first commenced in 2000, smoking rates in high‐profile areas were 8.1% at Gosford Hospital and 11.1% at Wyong Hospital. Counts conducted in 2018 indicated a substantial improvement, with the smoking rate in high‐profile areas reducing to 0.25% at Gosford Hospital and 0.5% at Wyong Hospital. Smoking rates in high‐profile areas have held steady at approximately 0.3% since 2014, after the by‐law was implemented. Conclusions The introduction of the smoke‐free by‐law added extra impetus to efforts to reduce smoking on CCLHD hospital grounds by providing the option to fine people who breach the by‐law. Smoking in high‐profile areas has declined substantially since 2011, and is minimal since the establishment of the smoke‐free by‐law. So what? The experiences of CCLHD in implementing the smoke‐free by‐law may provide insights for other health services looking to use a similar intervention at their facilities. There are also methodological lessons for other organisations looking to communicate, monitor and enforce smoke‐free policies, without enforcing fines.

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“…The authors appeal for increased enforcement of Israel’s far-reaching laws to support greater policy impact. PoorlyP enforced smoke-free policies are less likely to yield the benefit of ETS exposure reduction, and enforcement of existing policies requires constant vigilance [14]. Smoking bans are also more effective when accompanied by health communication campaigns that inform the public about the harms of ETS exposure and provide a rationale for bans.…”

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confidence: 99%

The promise – and pitfalls – of smoke-free policy adoption

Rees¹

2019

Isr J Health Policy Res

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Environmental Tobacco Smoke (ETS) is a major, preventable cause of morbidity and mortality, disproportionately impacting vulnerable populations. Policy measures, guided by the WHO’s Framework Convention of Tobacco Control, have focused on the broad adoption of smoke-free laws. While smoke-free policies are effective in reducing ETS exposure, limited policy dissemination and suboptimal implementation strategies have limited their impact. New research reported by Berman and colleagues in this journal brings these issues into sharper focus. Substantial advances in tobacco control policy have been achieved in Israel, including widening of smoke-free laws, since the passing of a Knesset bill in 2012. However, Berman and co-authors present found no reduction in ETS exposure in a nationally representative sample of non-smoking Israeli adults in 2016 compared with an earlier benchmark measured in 2011. In line with research from international settings, they found that ETS exposure was higher among a traditionally vulnerable subpopulation. The findings serve to remind us that the mere adoption of a policy will not translate into meaningful public health impact without applying best practice implementation strategies. Above all, this work emphasizes the continual need for new research to improve existing policies and inform new policy approaches in pursuit of an end to the harm arising from the global tobacco epidemic.

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Signs, Fines and Compliance Officers: A Systematic Review of Strategies for Enforcing Smoke-Free Policy

Cited by 18 publications

References 36 publications

Association of secondhand smoke exposure with allergic multimorbidity in Korean adolescents

Association of secondhand smoke exposure with allergic multimorbidity in Korean adolescents

Implementing and enforcing a smoke‐free policy and by‐law on hospital grounds at Central Coast Local Health District

The promise – and pitfalls – of smoke-free policy adoption

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