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Smoke-free policies for outdoor areas

Health Factors: Tobacco Use
Decision Makers: Employers & Businesses Local Government State Government Public Health Professionals & Advocates
Evidence Rating: Some Evidence
Population Reach: 100% of WI's population
Impact on Disparities: No impact on disparities likely

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Description

Outdoor smoke-free policies include private sector rules and public sector regulations that prohibit smoking outside or restrict it to designated areas. Private sector policies generally ban smoking on worksite property, while state and local ordinances often establish smoke-free standards for specified outdoor public areas such as parks and beaches (CG-Tobacco use). Some local governments cannot enact such measures due to state preemption legislation (Grassroots Change).

Expected Beneficial Outcomes

Reduced smoking in outdoor spaces
Reduced youth smoking
Reduced tobacco consumption
Increased quit rates
Reduced exposure to secondhand smoke
Improved health outcomes

Evidence of Effectiveness

There is some evidence that outdoor smoke-free policies reduce smoking in the designated areas (Johns 2015, Okoli 2013, Johns 2013), especially when implemented as part of comprehensive smoke-free efforts that ban both indoor and outdoor smoking (Lupton 2015, Lemstra 2008). Banning smoking in public places, including parks, is a recommended strategy to prevent tobacco use among youth (CDC SG 2012-Youth tobacco). However, additional evidence is needed to confirm effects, particularly on health outcomes (CG-Tobacco use).

Policies that restrict smoking at parks and beaches appear to reduce smoking in those areas (Johns 2015, Okoli 2013). Comprehensive campus smoking bans which include all outdoor areas appear to reduce smoking among college students on campus within 1 to 3 years, and may also decrease their daily cigarette consumption (Lupton 2015). An assessment of a large insurance company’s indoor and outdoor smoke-free worksite policy indicates increased quit rates and reduced relapses among tobacco dependence treatment program participants, and decreased daily cigarette consumption among participants who did not quit (Osinubi 2004).

Comprehensive smoke-free policies can reduce secondhand smoke exposure more than weaker policies or policies targeted at specific industries (CG-Tobacco use), and comprehensive smoking bans may decrease myocardial infarction (Bruintjes 2011, Lemstra 2008). Smoke-free policies that primarily affect indoor areas have been shown to improve health, reduce cigarette consumption and secondhand smoke exposure, and may also reduce smoking prevalence and lead smokers to quit smoking (Hoffman 2015, CG-Tobacco use). Smoking in outdoor smoking areas adjacent to indoor smoke-free areas appears to increase secondhand smoke concentrations in both (Sureda 2013).

Evaluations of efforts to implement smoke-free recreation areas in California suggest having a project champion, engaging youth volunteers, collecting and using local data as a persuasive tool, educating the community on smoke-free policies, and working strategically in the local political climate can help lead to successful adoption (Satterlund 2011). A study of costs related to smoke-free outdoor space ordinances in Canadian municipalities indicates that the costs for signage range from $40-$150 per sign and such expenses can be incorporated into existing budgets and staff time (Kennedy 2014).

Implementation

United States

As of 2013, smoke-free legislation has been adopted by 36 states, and over 3,500 municipalities have restrictions on smoking in one or more outdoor areas (US DHHS SG-Smoking 2014). State legislation pre-empts local government control of smoke-free policies in 12 states (Grassroots Change). Between 1993 and 2011, 843 parks and 150 beaches became smoke-free (Bayer 2013). New York City banned smoking on parks and beaches in 2011 (Johns 2015), and Philadelphia instituted a smoke-free policy for city recreation centers and playgrounds in 2010 (Leung 2013). In 2014, 11% of counties in the United States had at least 1 jurisdiction with a smoke-free park (Hood 2014), and as of 2015, over 25% of university campuses in the United States have comprehensive smoking bans (Lupton 2015). Smoke-free park policies are most common in counties with higher socio-economic status residents and more urban/suburban areas (Hood 2014).

Wisconsin

Wisconsin’s statewide smoking ban applies to enclosed places of employment or public spaces, but not outdoor areas. Local authorities can restrict outdoor smoking on public properties but may not prohibit smoking on outdoor areas of private property such as restaurant or bar patios (WI Statute 101.123).

Implementation Resources

CDC Loomis 2008-Evaluation toolkit - Loomis B. Evaluation Toolkit for Smoke-Free Policies. Atlanta: Centers for Disease Control and Prevention (CDC); 2008. Accessed on March 3, 2017
ChangeLab-Smokefree work, outdoors - ChangeLab Solutions. Smokefree workplaces and outdoor areas. Accessed on November 4, 2016
HealthPartners-CHA - HealthPartners Institute for Education and Research. Community health advisor (CHA): Resource for information on the benefits of evidence-based policies and programs: Helping communities understand, analyze, and model costs. Accessed on May 10, 2017
PHLC-Smoke-free outdoors - Tobacco Control Legal Consortium (TCLC). Smoke-free & tobacco-free places: Outdoors. Saint Paul: Public Health Law Center (PHLC). Accessed on November 4, 2016
PHLP 2010-Smokefree recreational areas model ordinance - Public Health Law & Policy (PHLP). Smokefree recreational areas ordinance: A model California ordinance regulating smoking and tobacco product use in recreational areas (with annotations). 2010. Accessed on November 4, 2016
PHLP 2011-Smokefree outdoor areas ordinance - Public Health Law & Policy (PHLP). Smokefree outdoor areas ordinance: A model California ordinance regulating smoking in outdoor areas (with annotations). 2011. Accessed on November 4, 2016

Citations - Description

CG-Tobacco use - The Guide to Community Preventive Services (The Community Guide). Tobacco. Accessed on May 15, 2017
Grassroots Change - Grassroots Change. Connecting for better health. Accessed on August 30, 2017

Citations - Evidence

Bruintjes 2011* - Bruintjes G, Bartelson BB, Hurst P, et al. Reduction in acute myocardial infarction hospitalization after implementation of a smoking ordinance. The American Journal of Medicine. 2011;124(7):647-54. Accessed on November 4, 2016
CDC SG 2012-Youth tobacco - Centers for Disease Control and Prevention (CDC). A report of the Surgeon General: Preventing tobacco use among youth and young adults. 2012. Accessed on November 4, 2016
CG-Tobacco use - The Guide to Community Preventive Services (The Community Guide). Tobacco. Accessed on May 15, 2017
Hoffman 2015 - Hoffman SJ, Tan C. Overview of systematic reviews on the health-related effects of government tobacco control policies. BMC Public Health. 2015;15:744. Accessed on April 27, 2017
Johns 2013* - Johns M, Coady MH, Chan CA, et al. Evaluating New York City's smoke-free parks and beaches law: A critical multiplist approach to assessing behavioral impact. American Journal of Community Psychology. 2013;1(1-2):254-263. Accessed on November 4, 2016
Johns 2015* - Johns M, Farley SM, Rajulu DT, Kansagra SM, Juster HR. Smoke-free parks and beaches: an interrupted time-series study of behavioural impact in New York City. Tobacco Control. 2015;24:497-500. Accessed on November 4, 2016
Kennedy 2014 - Kennedy RD, Zummach D, Filsinger S, Leatherdale ST. Reported municipal costs from outdoor smoke-free by-laws-experience from Ontario, Canada. Tobacco Induced Diseases. 2014;12(1):4-10. Accessed on November 4, 2016
Lemstra 2008* - Lemstra M. Canadian Journal of Public Health / Revue Canadienne de Sante'e Publique. 2008;101(6):445-447. Accessed on November 4, 2016
Lupton 2015* - Lupton RJ, Townsend LJ. A systematic review and meta-analysis of the acceptability and effectiveness of university smoke-free policies. Journal of American College Health. 2015;63(4):238-247. Accessed on November 4, 2016
Okoli 2013 - Okoli C, Johnson A, Pederson A, Adkins S, Rice W. Changes in smoking behaviours following a smokefree legislation in parks and on beaches: An observational study. BMJ Open. 2013;3(6):1-7. Accessed on November 4, 2016
Osinubi 2004* - Osinubi O, Sinha S, Rovner E, et al. Efficacy of tobacco dependence treatment in the context of a "smoke-free grounds" worksite policy: A case study. American Journal of Industrial Medicine. 2004;46:180-187. Accessed on November 4, 2016
Satterlund 2011 - Satterlund TD, Cassady D, Treiber J, Lemp C. Strategies implemented by 20 local tobacco control agencies to promote smoke-free recreation areas, California, 2004-2007. Preventing Chronic Disease. 2011;8(5):A111. Accessed on November 4, 2016
Sureda 2013 - Sureda X, Fernandez E, Lopez MJ, Nebot M. Secondhand tobacco smoke exposure in open and semi-open settings: a systematic review. Environmental Health Perspectives. 2013;121(7):766-773. Accessed on November 4, 2016

Citations - Implementation

Bayer 2013* - Bayer R, Bachynski KE. Banning smoking in parks and on beaches: Science, policy, and the Politics of denormalization. Health Affairs. 2013;32(7):1291-1298. Accessed on November 4, 2016
Grassroots Change - Grassroots Change. Connecting for better health. Accessed on August 30, 2017
Hood 2014* - Hood NE, Bernat DH, Ferketich AK, Danesh D, Klein EG. Community characteristics associated with smokefree park policies in the United States. Nicotine & Tobacco Research. 2014;16(6):828-835. Accessed on November 4, 2016
Johns 2015* - Johns M, Farley SM, Rajulu DT, Kansagra SM, Juster HR. Smoke-free parks and beaches: an interrupted time-series study of behavioural impact in New York City. Tobacco Control. 2015;24:497-500. Accessed on November 4, 2016
Leung 2013 - Leung R, Mallya G, Dean LT, et al. Instituting a smoke-free policy for city recreation centers and playgrounds, Philadelphia, Pennsylvania, 2010. Preventing Chronic Disease. 2013;10:120294. Accessed on November 4, 2016
Lupton 2015* - Lupton RJ, Townsend LJ. A systematic review and meta-analysis of the acceptability and effectiveness of university smoke-free policies. Journal of American College Health. 2015;63(4):238-247. Accessed on November 4, 2016
US DHHS SG-Smoking 2014 - US Department of Health and Human Services (US DHHS). The health consequences of smoking- 50 years of progress: A report of the Surgeon General, executive summary. 2014. Accessed on March 7, 2017
WI Statute 101.123 - Wisconsin State Legislature. WI Statute 101.123: Smoking prohibited. Accessed on November 4, 2016

Page Last Updated

November 8, 2016

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