Compliance with smoke-free legislation within public buildings: a cross-sectional study in Turkey

To investigate public compliance with legislation to prohibit smoking within public buildings and the extent of tobacco smoking in outdoor areas in Turkey. Using a standardized observation protocol, we determined whether smoking occurred and whether ashtrays, cigarette butts and/or no-smoking signs...

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Bibliographic Details
Published in:Bulletin of the World Health Organization 2016-02, Vol.94 (2), p.92-102
Main Authors: Navas-Acien, Ana, Çarkoğlu, Asli, Ergör, Gül, Hayran, Mutlu, Ergüder, Toker, Kaplan, Bekir, Susan, Jolie, Magid, Hoda, Pollak, Jonathan, Cohen, Joanna E
Format: Article
Language:English
Subjects:
Cigarettes
Cities
Coffee
Colleges & universities
Compliance
Cross-Sectional Studies
Female
Field study
Houses
Housing
Humans
Implementation
Legislation
Male
Nightclubs
Public buildings
Public Facilities - statistics & numerical data
Public health
Regression analysis
Residential areas
Restaurants
Schools
Shopping centers
Signs
Smoke
Smoke-Free Policy
Smoking
Smoking cessation
Studies
Tobacco
Tobacco smoke
Tobacco smoking
Turkey
Venue
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Summary:To investigate public compliance with legislation to prohibit smoking within public buildings and the extent of tobacco smoking in outdoor areas in Turkey. Using a standardized observation protocol, we determined whether smoking occurred and whether ashtrays, cigarette butts and/or no-smoking signs were present in a random selection of 884 public venues in 12 cities in Turkey. We visited indoor and outdoor locations in bars/nightclubs, cafes, government buildings, hospitals, restaurants, schools, shopping malls, traditional coffee houses and universities. We used logistic regression models to determine the association between the presence of ashtrays or the absence of no-smoking signs and the presence of individuals smoking or cigarette butts. Most venues had no-smoking signs (629/884). We observed at least one person smoking in 145 venues, most frequently observed in bars/nightclubs (63/79), hospital dining areas (18/79), traditional coffee houses (27/120) and government-building dining areas (5/23). For 538 venues, we observed outdoor smoking close to public buildings. The presence of ashtrays was positively associated with indoor smoking and cigarette butts, adjusted odds ratio, aOR: 315.9; 95% confidence interval, CI: 174.9-570.8 and aOR: 165.4; 95% CI: 98.0-279.1, respectively. No-smoking signs were negatively associated with the presence of cigarette butts, aOR: 0.5; 95% CI: 0.3-0.8. Additional efforts are needed to improve the implementation of legislation prohibiting smoking in indoor public areas in Turkey, especially in areas in which we frequently observed people smoking. Possible interventions include removing all ashtrays from public places and increasing the number of no-smoking signs.
ISSN:0042-9686
1564-0604
DOI:10.2471/BLT.15.158238