Facilitators and Barriers of Smokers' Compliance with Smoking Bans in Public Places: A Systematic Review of Quantitative and Qualitative Literature

Int J Environ Res Public Health. 2016 Dec 11;13(12):1228. doi: 10.3390/ijerph13121228.

Abstract

Background: Environmental tobacco smoke (ETS) exposure is associated with an increased risk of many diseases. Many countries have ratified a national smoking ban in public places, but studies on factors related to smoking issues in public places post-ban are lacking. Aim: To identify facilitators and barriers that influenced smokers' compliance with smoking bans in public places. Methods: Using PubMed, MEDLINE, and the Web of Science database, we conducted a systematic search of English articles published before June 2015 on factors of smokers' compliance with the smoking bans in public places. Results: A total of 390 references were identified, among which seventeen articles (twelve quantitative studies, two qualitative studies, three mixed-method studies) were included in this review. These studies focused on four types of public places including recreational venues (n = 7), hospital (n = 5), school (n = 4), and workplace (n = 1). Factors at the individual-, interpersonal-, and organizational-level were identified: at the individual level, nicotine dependence, insufficiency of tobacco-related knowledge, and the negative attitudes towards smoking bans were the most commonly identified barriers; at the interpersonal level, the smoking behaviors of people around, close relatives, and friends' approval were the main barriers; and at the organizational level, the main barriers were inefficient implementation of the bans and the inconvenience of the designative smoking areas. Conclusions: This synthesis of the literature provided evidence of the identified barriers and facilitators of smokers' compliance with the smoking bans. It will be beneficial for the policy-maker to consider interventions on multiple levels of factors to overcome the barriers and enhance smokers' compliance with the smoking bans in public places.

Keywords: barriers; environmental tobacco smoke; facilitators; public places; smoking bans.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • China / epidemiology
  • Harm Reduction
  • Humans
  • Prevalence
  • Public Facilities / legislation & jurisprudence*
  • Qualitative Research
  • Smoke-Free Policy / legislation & jurisprudence*
  • Smoking / epidemiology
  • Smoking / legislation & jurisprudence*
  • Smoking / psychology*
  • Social Environment
  • Tobacco Smoke Pollution / legislation & jurisprudence
  • Tobacco Smoke Pollution / prevention & control*
  • Tobacco Smoke Pollution / statistics & numerical data

Substances

  • Tobacco Smoke Pollution