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

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

1
Department of Social Medicine and Health Management, School of Public Health, Central South University, Changsha 410078, China
2
Centre for Health Behaviors Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
3
Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha 410078, China
*
Author to whom correspondence should be addressed.
Academic Editors: Laura L. Jones and Amanda Farley
Received: 15 August 2016 / Revised: 17 November 2016 / Accepted: 28 November 2016 / Published: 11 December 2016
(This article belongs to the Special Issue Exposure and Health Effects of Secondhand Smoke)
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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. View Full-Text
Keywords: facilitators; barriers; smoking bans; public places; environmental tobacco smoke facilitators; barriers; smoking bans; public places; environmental tobacco smoke
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MDPI and ACS Style

Zhou, L.; Niu, L.; Jiang, H.; Jiang, C.; Xiao, S. 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, 13, 1228.

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