Smoking on the Margins: An Equity Analysis of the Outcomes of an Outdoor Smoke-free Policy

Purpose: To analyze the health and health equity impact of the newly implemented smoke-free policy for Vancouver’s parks and beaches CIHR Operating Grant: Population Health Intervention Research – designed to study an intervention in action not controlled by the investigators End date of funding, March 31, 2013 (with potential 12-month extension

Smoking on the Margins: An Equity Analysis of Vancouver\u27s Outdoor Smoke-free Policy in Parks and on Beaches

Background: Increasingly, jurisdictions worldwide are addressing smoking restrictions in outdoor public spaces to reduce secondhand smoke exposure, discourage youth initiation, enhance cessation, and reduce environmental hazards (i.e., fire and cigarette-related litter). However, there is little research on the policy context and health-equity impact of such policies to help guide wider implementation efforts. Objectives: On September 1, 2010, the Board of Parks and Recreation in Vancouver, Canada, introduced a smoke-free bylaw for the city’s parks and beaches. The Smoking on the Margins project is examining the policy context and potential health-equity impact of this bylaw. Methods: Applying critical multiplism and equity-focused health impact assessment frameworks, mixed-methods research was used to describe the context and examine health-equity impacts of the bylaw through seven sub-projects. Preliminary Results: Sub-project 1: An observation study (N=6 parks/beaches) found significant reductions in the overall observed smoking rates in selected parks/beaches from prelaw (mean rate=20.5/1000 persons) to 12-months post-law (mean rate=4.7/1000 persons). Sub-Project 2: A population telephone-survey (N=500 participants) found that 84% of Vancouver residents endorsed the bylaw; smokers were significantly less likely to do so. Sub-project 3: Two enforcement officer focus-group interviews (n=6 officers/focus-group) found that enforcement practices varied on the basis of park/beach setting, usage patterns, and the likelihood of users to comply. Marginalized populations of smokers were somewhat less likely to be fined for violating the bylaw. Sub-project 4: Key informant interviews in the cities of Vancouver (n=8), Kelowna (n=5), and Surrey (n=4) found that health, environmental and social concerns are common to all jurisdictions considering implementing an outdoor smoke-free policy but to different degrees. Sub-project 5: A print-media study (N=90 articles/letters, retrieved Jan2010 to Dec2011) found that in relation to article slant, 38.9% had positive coverage of the bylaw, 30% were neutral, and 22.2% were negative. News articles were more likely to be positive, letters to be negative. Sub-project 6: A beach-litter study (N=48 beaches/parks) found non-significant changes in cigarette-related litter between 2010 (mean=1018.7 cigarette-butts/filters) and 2011 (mean=919.6 cigarette-butts/filters). Sub-project 7: A by-law citations study (Jan2011-Dec2011) indicates that citations were issued more frequently at beaches (n=26) than parks (n=12). Conclusion: Our data suggest that though the outdoor smoke-free policy had strong support in Vancouver, it also had differential effects for park and beach users. Understanding the impact of the policy on diverse groups can minimize potential unintended consequences of outdoor smoke-free policies while providing directions and considerations to help make similar policies more equitable

Support for a Smoke-Free Bylaw in Parks and on Beaches

BACKGROUND: In September 2010, Vancouver, Canada enacted a smoke-free bylaw in parks and on beaches. OBJECTIVE: To examine demographic and attitudinal factors associated with the public opinion on Vancouver\u27s outdoor smoke-free bylaw. METHODS: From 496 randomly selected Vancouver residents, information on demographics, smoking status, and opinions and support for or opposition to the smoke-free bylaw were obtained by telephone surveys. RESULTS: Approximately 84.2% of the sample endorsed the legislation; a greater proportion of non-smokers supported the bylaw than smokers (88.6% vs. 52.0%). In multivariate analysis, demographic variables significantly associated with supporting the smoke-free bylaw were being female, having completed community college/university or Post Graduate work (as compared to high school education or less), and being a nonsmoker. Furthermore, adjusting for demographic variables, all opinions regarding the smoke-free bylaw were significantly associated with its support, with the exception of the belief that the bylaw would increase stigma towards smokers. CONCLUSION: These findings suggest strong public support in Vancouver for the smoke-free bylaw in parks and on beaches. Jurisdictions considering such legislation should address attitudes which can promote or hinder its adoption. Examination of such policy support on diverse groups within the population may enhance the development of equitable public health policy

A Content Analysis of Media Coverage of the Introduction of a Smoke-Free Bylaw in Vancouver Parks and Beaches

The Board of Parks and Recreation in Vancouver, BC approved a smoke-free bylaw in the city\u27s parks, beaches and recreational facilities, effective 1 September 2010. We analyzed local news coverage and portrayal of the bylaw to understand the potential influence of news media on public perception of the bylaw in order to inform the media advocacy work of public health interest groups. We compiled a data set of newspaper articles (n = 90) and conducted a quantitative content analysis to examine content related to the outdoor smoke-free policy, including article slant, topics related to smoking and tobacco control, and any equity-related concerns raised. Newspaper coverage in Vancouver was largely supportive of the outdoor smoke-free bylaw. However, concerns over rights were frequently discussed in letters to the editor. Such equity concerns were rarely discussed in news articles, showing a potential disconnect between the concerns expressed in the media by members of the public and the coverage provided by print media

A Content Analysis of Media Coverage of the Introduction of a Smoke-Free Bylaw in Vancouver Parks and Beaches

The Board of Parks and Recreation in Vancouver, BC approved a smoke-free bylaw in the city\u27s parks, beaches and recreational facilities, effective 1 September 2010. We analyzed local news coverage and portrayal of the bylaw to understand the potential influence of news media on public perception of the bylaw in order to inform the media advocacy work of public health interest groups. We compiled a data set of newspaper articles (n = 90) and conducted a quantitative content analysis to examine content related to the outdoor smoke-free policy, including article slant, topics related to smoking and tobacco control, and any equity-related concerns raised. Newspaper coverage in Vancouver was largely supportive of the outdoor smoke-free bylaw. However, concerns over rights were frequently discussed in letters to the editor. Such equity concerns were rarely discussed in news articles, showing a potential disconnect between the concerns expressed in the media by members of the public and the coverage provided by print media

Changes in Smoking Behaviours Following a Smokefree Legislation in Parks and on Beaches: An Observational Study

OBJECTIVE: To examine the effect of an outdoor smokefree law in parks and on beaches on observed smoking in selected venues. METHODS: The study involved repeated observations in selected parks and beaches in Vancouver, British Columbia, Canada. The main outcome measure was changes in observed smoking rates in selected venues from prelaw to 12 months postlaw. RESULTS: No venue was 100% smokefree at the 12-month postlaw observation time point. There was a significant decrease in observed smoking rates in all venues from prelaw to 12-month postlaw (prelaw mean smoking rate=20.5 vs 12-month mean smoking rate=4.7, p=0.04). In stratified analysis by venue, the differences between the prelaw and 12-month smoking rates decreased significantly in parks (prelaw mean smoking rate=37.1 vs 12-month mean smoking rate=6.5, p=0.01) but not in beaches (prelaw mean smoking rate=2.9 vs 12-month mean smoking rate=1.0, p=0.1). CONCLUSIONS: Smokefree policies in outdoor recreational venues have the potential to decrease smoking in these venues. The effectiveness of such policies may differ by the type and usage of the venue; for instance, compliance may be better in venues that are used more often and have enforcement. Future studies may further explore factors that limit and foster the enforcement of such policies in parks and beaches

Effects of a Smoke-free Law in Parks and Beaches on Smoking Behaviour: Methods to Determine Effectiveness (2011)

As part of a comprehensive approach to tobacco control,smoke free laws have resulted in reductions of indoor air pollution, improvements in respiratory and cardiovascular health, reduction of smoking uptake by youth, and increasing tobacco use cessation in various jurisdictions. Although many studies have demonstrated the beneficial effects of smoke-free policies in indoor spaces (e.g., restaurants, bars, workplaces, hospital settings, etc.), little is known about the effectiveness of such policies in outdoor public spaces. On September 1st, 2010, Vancouver’s smoke-free by-law for the city’s parks, beaches, and facilities came into effect. The aims of this study are two-fold: a) to examine the effect of this smoke-free law on the frequency of smoking in selected parks and beaches, and b) to determine the change in location of smoking, within parks and beaches, following the enactment of the smoke-free law. The hypotheses guiding this study are: 1) There will be a lower frequency of observed smoking behaviour following the introduction of the law and 2) Smoking behaviour will be dispersed to the peripheries (i.e., margins) of the parks and beaches, following the enactment of the smoke-free law

Effects of a Smoke-free Law in Parks and Beaches on Smoking (2012)Behaviour: Methods to Determine Effectiveness

OVERVIEW As part of a comprehensive approach to tobacco control, smoke free laws have resulted in reductions of indoor air pollution, improvements in respiratory and cardiovascular health, reduction of smoking uptake by youth, and increasing tobacco use cessations in various jurisdictions. Although many studies have demonstrated the beneficial effects of smoke-free policies in indoor spaces (e.g. restaurants, bars, workplaces, hospital settings, etc.), little is known about the effectiveness of such policies in outdoor public spaces. On September 1st, 2010, Vancouver’s smoke-free by-law for the city’s parks, beaches, and facilities came into effect. The aims of this study are two-fold. a) To examine the effect of this smoke-free law on the frequency of smoking in selected parks and beaches, and b) To determine the change in location of smoking, within parks and beaches, following the enactment of the smoke-free law. The hypotheses guiding this study are: 1. There will be a lower frequency of observed smoking behaviour following the introduction of the law and 2. Smoking behaviour will be dispersed to the peripheries (i.e. margins) of the parks and beaches, following the enactment of the smoke-free law

Effects of a Smoke-free Law in Parks and Beaches on Smoking Behaviour: Methods to Determine Effectiveness

OVERVIEW As part of a comprehensive approach to tobacco control, smoke free laws have resulted in reductions of indoor air pollution, improvements in respiratory and cardiovascular health, reduction of smoking uptake by youth, and increasing tobacco use cessations in various jurisdictions. Although many studies have demonstrated the beneficial effects of smoke-free policies in indoor spaces (e.g. restaurants, bars, workplaces, hospital settings, etc.), little is known about the effectiveness of such policies in outdoor public spaces. On September 1st, 2010, Vancouver’s smoke-free by-law for the city’s parks, beaches, and facilities came into effect. The aims of this study are two-fold. a) To examine the effect of this smoke-free law on the frequency of smoking in selected parks and beaches, and b) To determine the change in location of smoking, within parks and beaches, following the enactment of the smoke-free law. The hypotheses guiding this study are: 1. There will be a lower frequency of observed smoking behaviour following the introduction of the law and 2. Smoking behaviour will be dispersed to the peripheries (i.e. margins) of the parks and beaches, following the enactment of the smoke-free law