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.
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.
Okoli, Chizimuzo T.C. and Pederson, Ann, "Smoking on the Margins: An Equity Analysis of Vancouver's Outdoor Smoke-free Policy in Parks and on Beaches" (2013). Nursing Presentations. 7.