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

Saifur Rahman Chowdhury; Tachlima Chowdhury Sunna; Dipak Chandra Das; Mahfuzur Rahman Chowdhury; H M Miraz Mahmud; Ahmed Hossain

doi:10.1371/journal.pone.0283650

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

PLoS One. 2023 Apr 26;18(4):e0283650. doi: 10.1371/journal.pone.0283650. eCollection 2023.

Authors

Saifur Rahman Chowdhury^{1

2}, Tachlima Chowdhury Sunna¹, Dipak Chandra Das¹, Mahfuzur Rahman Chowdhury³, H M Miraz Mahmud⁴, Ahmed Hossain^{5

6}

Affiliations

¹ Department of Public Health, North South University, Dhaka, Bangladesh.
² Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, Ontario, Canada.
³ Department of English, North East University Bangladesh, Sylhet, Bangladesh.
⁴ Bangladesh Center for Communication Programs (BCCP), Dhaka, Bangladesh.
⁵ Health Services Administration, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
⁶ NSU Global Health Institute (NGHI), North South University, Dhaka, Bangladesh.

Abstract

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.

Copyright: © 2023 Chowdhury et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Bangladesh
Cities
Cross-Sectional Studies
Smoke-Free Policy*
Tobacco Products*
Tobacco Smoke Pollution* / analysis
Tobacco Smoke Pollution* / prevention & control

Substances

Tobacco Smoke Pollution

Grants and funding

Support for this study was provided by the Bangladesh Center for Communication Programs (BCCP) with funding awarded by Bloomberg Philanthropies to Johns Hopkins University. Grant number is GC#BCCP/Tobacco Control/2020-57. Saifur Rahman Chowdhury received this grant in reference to the technical and cost proposal from the Bangladesh Center for Communication Programs (https://www.bangladesh-ccp.org/). The content of this publication is solely the responsibility of the authors and do not necessarily represent the official views of Bloomberg Philanthropies or Johns Hopkins University. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.