Smoke-free outdoor areas: Can tobacco control advocacy with local government be effective?

摘要

Exposure to secondhand tobacco smoke (SHS) is a risk factor for illness and disease. Most studies and legislation have focussed on SHS in indoor settings. However, research increasingly demonstrates exposure to SHS is measurable in outdoor locations and potentially harmful. This has resulted in interest in establishing policy and legislation for smoke-free outdoor areas (SFOA). This study aimed to examine the proportion of NSW councils with SFOA policy and to explore the enablers and barriers to councils introducing SFOA policy. In addition, we explored whether the diffusion of innovation theory explained the uptake of SFOA policy by councils.In 2011, a survey of NSW Council staff members was undertaken to examine the existence and specifics of SFOA policy, and enablers and barriers associated with its introduction. The perceived usefulness of a resource kit was also measured. Eighty-five (57%) NSW councils had SFOA policy, with playgrounds (99%) most likely to be covered. More urban councils (79.5%) had SFOA policy compared to rural councils (33%). The most frequently cited enabler was direct advocacy letters, followed by having a champion councillor or council staff member. The most commonly mentioned barrier was a lack of resources to implement the policy. Cost of implementing the policy varied between councils, with the average cost being $18,747. Uncertainty of how the policy would be enforced was another barrier to adoption. However, most councils reported the policy was self-regulated by the community, rather than enforced with infringement notices. Of participants that had seen the SFOA resource kit over 80% indicated that it was useful. We found that urban councils more readily adopted SFOA policy, with advocacy and support from NGOs being important elements increasing the likelihood of policy being introduced. It appears that urban councils are more likely to be innovators or early adopters in the introduction of SFOA policy. With this in mind, public health advocates in other jurisdictions may work with such councils in the early stages of similar projects to accelerate the adoption of public health and tobacco control policies. Strategies that support rural councils also need to be implemented to address disparities in policy introduction.