Are smoke-free policies implemented and adhered to at sporting venues?

Implementation of an outdoor smoke-free policy at sports clubs: Critical situations and determinants influencing implementation

BACKGROUND

Outdoor smoke-free policies (SFPs) at sports clubs have significant potential to reduce adolescent smoking. However, the realization of this potential may be strongly dependent on how these policies are implemented in practice. The aim of this study is to explore the perceptions of key stakeholders at different sports clubs in the Netherlands concerning how outdoor SFPs are implemented in practice and which determinants influence implementation.

METHODS

Semi-structured interviews were held with 46 key stakeholders at eight Dutch sports clubs (i.e., field hockey, soccer, tennis, korfball) with an outdoor SFP. A thematic approach was used for the analysis of the transcripts.

RESULTS

Overall, respondents perceived the implementation of an outdoor SFP at sports clubs as feasible. The SFP is often enforced, people who smoke react positively when they are approached, the SFP has led to less (visible) smoking at the venue, and a nonsmoking norm is reinforced. However, we identified three 'critical situations' in which implementation is less than optimal: 1) when children are not present at the sports club, 2) when alcohol is involved, and 3) when people who smoke relocate to the entrance of the sports club. Several determinants influenced implementation in those critical situations: 1) determinants related to individual smokers and club members (i.e., support, communication towards people who smoke), 2) determinants related to the SFP itself (i.e., clarity of the policy), 3) determinants related to the sports club (i.e., communication of the policy, characteristics of the sports club), and 4) determinants related to the wider community (i.e., change of social norm with regard to smoking, support from local and national organizations).

CONCLUSION

Implementation of an outdoor SFP at sports clubs is feasible because there is a high level of support and experiences are mainly positive. Nevertheless, some situations present challenges to compliance and enforcement. We identified a number of determinants that may facilitate implementation of an outdoor SFP at sports clubs.

The Adoption, Implementation, and Impact of Smoke-Free Policies among Gaelic Athletic Association Clubs in Ireland: A Qualitative Study

The Gaelic Athletic Association (GAA) is a major stakeholder in promoting smoke-free policies in Ireland. Several GAA clubs have adopted smoke-free policies, and there is a growing interest among other GAA clubs to also become smoke-free. As such, the purpose of this study is to explore the process of how GAA clubs adopt, implement, and enforce smoke-free policies in order to discover best practices that other clubs could replicate. Representatives from 15 smoke-free clubs were interviewed regarding how their club became smoke-free. Interview data were analyzed, in which four major themes emerged: (1) process (planning a smoke-free policy, communicating the policy to the community, providing smoking cessation resources), (2) barriers (opinions and behaviors of club members who smoke, bars connected to club houses, policy exceptions, visitors and umpires who were unaware of the policy), (3) enforcement (community-based style of enforcement, non-confrontational approach, non-enforcement), and (4) impact (observation of policy compliance and decrease in cigarette litter). The study's findings indicate a general ease of becoming smoke-free with minimal barriers. As such, the GAA should urge each club to become smoke-free and to use the effective methods used by current smoke-free clubs for communicating and enforcing smoke-free policies.

Health in arts: are arts settings better than sports settings for promoting anti-smoking messages?

AIM

Tobacco smoking is a leading cause of preventable mortality and morbidity. Since 1991, the Western Australian Health Promotion Foundation (Healthway) has sponsored the arts and sport in exchange for cigarette smoke-free events, smoke-free policies and the promotion of anti-smoking messages (e.g. Quit, Smoke Free or Smarter than Smoking). As health promoters often look for innovative and effective settings to advocate health, and as the approach of sponsoring the arts to promote health to the general population is uncommon, the purpose of this study was to evaluate the effectiveness of 'health in arts' by measuring the cognitive impact (message awareness, comprehension, acceptance and intention) of promoting anti-smoking messages at arts events, and comparing findings to sports events, a more traditional health promotion setting.

METHOD

A secondary analysis of the 2004-2009 Healthway Sponsorship Monitor data was conducted. A total of 12 arts events (n = 592 respondents) and 9 sports events (n = 420 respondents) sponsored by Healthway to promote an anti-smoking message were evaluated. The study was cross-sectional in design. Participants were residents of Western Australia aged 15 years or above and attended events as part of an audience or as a spectator. Descriptive and regression analyses were conducted.

RESULTS

After adjustment for demographic variables, smoking status and clustering, arts events were found to be as effective in promoting anti-smoking message awareness, comprehension and acceptance and twice as effective on intention to act (p = .03) compared with sports events.

CONCLUSION

This study provides evidence of the effectiveness of arts sponsorship to promote health to the general population, that is, health in arts. Promoting an anti-smoking message in arts settings was as, or more, effective than in sports settings. Results suggest that the arts should be utilised to communicate and reinforce anti-smoking messages to the general population. The suitability of the arts to promote other types of health messages should be investigated further.

Measuring compliance with tobacco-free campus policy

OBJECTIVE

The purpose is to describe psychometric testing and feasibility of the Tobacco-Free Compliance Assessment Tool (TF-CAT) to measure tobacco-free policy compliance at a public university and medical center. The aims are to (1) investigate concurrent validity by comparing the number of cigarette butts in areas covered by the policy with those on adjacent sidewalks; (2) evaluate the interrater reliability of the TF-CAT; and (3) describe the feasibility of using the TF-CAT.

METHODS

Phase I was a pilot study on the health care campus. Phase II was baseline of an intervention study on the main campus. Cigarette butts and smokers were counted in hot spots. Validity was assessed using Mann-Whitney U and Geographical Information System Analysis methods.

RESULTS

There was some support for the validity and high interrater reliability. Data collectors spent 1 hour per week for 8 weeks during Phase I, and 31 hours in 1 week during Phase II.

CONCLUSION

TF-CAT is a feasible, time-intensive method to measure tobacco-free policy compliance.

Is government action out-of-step with public opinion on tobacco control? Results of a New South Wales population survey

OBJECTIVE

To assess community attitudes towards smoking bans, tobacco availability, promotion and product regulation, tobacco industry donations to political parties, and government spending on tobacco control activities. To compare public preferences on these issues with policies of the NSW and Commonwealth governments.

METHOD

Anonymous, computer assisted telephone interviews of adults from randomly selected households in the NSW Electronic White Pages conducted in 2004. All subjects completed a core question set and subsequently, one of three sub-sets.

RESULTS

Overall 49.1% of eligible subjects consented. Data from two sub-samples containing 1,191 and 1,158 subjects are reported. Majority support existed for smoking bans in all six settings assessed: children's playgrounds (89%), sports stadia (77%), licensed premises (72%), outdoor dining (69%), beaches (55%) and motor vehicles carrying children (55%). Respondents nominated vastly higher tobacco control budgets than current levels of government expenditure. On a scale assessing support for tobacco control (maximum score = 13), the mean scores of both non-smokers (10.4) and smokers (8.0) were high. Of seven variables tested, only two: living with a smoker and personal smoking status were independent predictors of having a high pro-tobacco control score.

CONCLUSION

There is strong community support for additional government regulation mandating smoke-free provision and other counter tobacco measures.

IMPLICATIONS

Continued advocacy campaigns are required to align government tobacco control agenda more closely with public preferences.

Health promotion programs related to the Athens 2004 Olympic and Para Olympic games

BACKGROUND

The Olympic Games constitute a first-class opportunity to promote athleticism and health messages. Little is known, however on the impact of Olympic Games on the development of health-promotion programs for the general population. Our objective was to identify and describe the population-based health-promotion programs implemented in relation to the Athens 2004 Olympic and Para Olympic Games.

METHODS

A cross-sectional survey of all stakeholders of the Games, including the Athens 2004 Organizing Committee, all ministries of the Greek government, the National School of Public Health, all municipalities hosting Olympic events and all official private sponsors of the Games, was conducted after the conclusion of the Games.

RESULTS

A total of 44 agencies were surveyed, 40 responded (91%), and ten (10) health-promotion programs were identified. Two programs were implemented by the Athens 2004 Organizing Committee, 2 from the Greek ministries, 2 from the National School of Public Health, 1 from municipalities, and 3 from official private sponsors of the Games. The total cost of the programs was estimated at 943,000 Euros; a relatively small fraction (0.08%) of the overall cost of the Games.

CONCLUSION

Greece has made a small, however, significant step forward, on health promotion, in the context of the Olympic Games. The International Olympic Committee and the future hosting countries, including China, are encouraged to elaborate on this idea and offer the world a promising future for public health.

Critical processes for creating health-promoting sporting environments in Australia

The reach of sporting organizations into the community makes them an ideal vehicle through which to promote health to the general population. There are now a number of documented examples demonstrating that sponsorship can lead to improvements in the health of the sporting environment, but relatively little is known as to why some sponsorships are more successful in achieving these structural changes than others in ostensibly similar sports. The purpose of this study was to identify the processes required for health promotion agencies and sporting organizations working in collaboration to implement structural changes in sporting settings such as smoke-free environments, provision of healthy food choices, responsible alcohol management and sun protection, along with the factors that facilitate and hinder this from being achieved. We conclude that such changes are difficult to achieve, especially in the absence of a programmatic approach to health promotion.

Creating smoke-free environments in recreational settings

To facilitate the banning of tobacco industry sponsorship, Australian health promotion foundations were established to provide health sponsorship to sport, arts, and racing organizations. Health sponsorship dollars procure health sponsorship benefits such as naming rights, signage, personal endorsement of a (health) product by a performer or player, and structural controls such as smoke-free policies. Data are presented from surveys and observations of spectators attending events sponsored by the West Australian Health Promotion Foundation (Healthway) and surveys of Healthway-sponsored organizations and the community. The results demonstrate that by using health sponsorship, Healthway increased the prevalence of smoke-free policies in recreational settings, and there was growing support for these policies. There was evidence of good compliance with smoke-free policies, thus reducing exposure to environmental tobacco smoke. The introduction of smoke-free policies in recreational settings has involved working collaboratively with sectors outside of health, taking an incremental approach to change, and gaining the support of stakeholders by communicating evaluation results.