Non-smokers' and smokers' support for smoke-free legislation in 14 indoor and outdoor settings across 12 European countries

Citation

Nogueira SO, Fu M, Lugo A, Tigova O, Henderson E, López MJ, Clancy L, Semple S, Soriano JB, Fernandez E, Gallus S & the TackSHS Project Investigators (2022) Non-smokers' and smokers' support for smoke-free legislation in 14 indoor and outdoor settings across 12 European countries. Environmental Research, 204 (Part C), Art. No.: 112224. https://doi.org/10.1016/j.envres.2021.112224

Abstract
Background European countries differ considerably in the scope and the extent of their policies to protect people from the harms of secondhand smoke exposure. Public opinion may have a substantial influence on several stages of policy development, implementation, and compliance. For this reason, we aimed to evaluate the population level of support for smoke-free policies and its correlates. Methods We used data from the TackSHS Survey (2017–2018), a cross-sectional study with representative samples of the general population aged ≥15 years from 12 European countries. We described the proportion of non-smokers’ and smokers’ support for the implementation of smoke-free legislation in 14 indoor and outdoor settings and the country-level characteristics associated with it. Results In the total sample (n = 11,902), support for smoke-free legislation were the lowest for restaurants/bar patios (non-smokers = 53.0%; smokers = 29.2%) and the highest for workplaces (non-smokers = 78.5%; smokers = 66.5%). In the country-level analysis, the highest support among non-smokers was for workplaces in Bulgaria (93.1%) and the lowest for restaurants/bars patios in Greece (39.4%). Among smokers, the corresponding estimates were for children's playgrounds in Latvia (88.9%) and for cars in Portugal (21%). For most settings, support for smoke-free legislation was directly related with the countries' prevalence of secondhand smoke presence and reported smoking in each setting. Discussion Our results show that the majority of European adults (including a large proportion of smokers) are supportive of implementing smoke-free legislation in indoor settings and extending it to selected outdoor settings. Such expressive support can be seen as an opportunity to advance legislation and protect the European population from secondhand smoke exposure.

Keywords
Support; Attitudes; Smoke-free; Europe; Smoking ban; Second-hand smoke exposure

Journal
Environmental Research: Volume 204, Issue Part C

• Accepted manuscript