Does the public support smoke-free policies in semi-private and outdoor places?

Published

2 years ago

May 12, 2023

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By Tarun Sai Lomte May 12 2023 Reviewed by Lily Ramsey, LLM

In a recent study published in the eClinicalMedicine Journal, researchers assessed the levels of public support for smoke-free policies in indoor (semi)-private and outdoor areas.

Study: Public support for smoke-free policies in outdoor areas and (semi-)private places: a systematic review and meta-analysis. Image Credit: LuckyBusiness/Shutterstock.com Background

Second-hand smoke exposure is a significant burden to global public health. Evidence suggests that legislation to protect people from smoke in workplaces and indoor public spaces can decrease the harmful effects of tobacco smoke. Several jurisdictions have extended smoke-free policies to include outdoor and private places.

Public support is critical for policymakers to implement such policies and maximize compliance. Prior studies have observed differences in support within populations and between smoke-free places.

Therefore, it is crucial to gain insights into the determinants and levels of public support for such policies to inform policymaking regarding their expansion covering outdoor and semi-private spaces. About the study

In the present study, researchers systematically reviewed the evidence on public support levels for smoke-free policies encompassing semi-private and outdoor places.

They searched Embase, Medline, Cochrane, PsycINFO, Web of Science, and the cumulative index to nursing and allied health literature (CINAHL) databases for studies published from January 2004 to January 2022, with no restrictions on language.

Studies were eligible if they assessed support for policies in indoor private or semi-private spaces, outdoor hospitality or non-hospitality places, and outdoor semi-private places, with policies already implemented, planned, or hypothetical.

Studies were excluded if the sample size was <400, only non-combustible tobacco products were covered, or support was reported for workplaces or indoor public places. Related StoriesResearchers map the immune system in the gut of kids with inflammatory bowel diseaseGun assault rates doubled for children in 4 major cities during the pandemic, new data showsExperts urge increased attention to the threat of climate change and pollution on children's health

Titles/abstracts and full texts were screened to identify eligible reports, and relevant data were extracted from included studies.

The risk of bias in included studies was assessed using the mixed methods appraisal tool. Logit transformations were applied if support was reported as proportions ranging from zero to one.

If reported as the average score on the Likert scale, it was transformed to the proportion support. A three-level meta-analysis accounted for between-study, within-study, and country-level clustering. Sub-group analyses were also performed by gender, age group, parental status, and smoking status. Findings

The authors identified more than 14,500 records from the databases. Duplicates and pre-2004 studies were removed, resulting in over 6,000 records for screening. Overall, 107 studies from 33 countries were included for analysis.

Sixty-seven studies investigated support for hypothetical scenarios, 36 investigated public support for implemented policies, and four assessed public support for policies likely to be introduced or extended.

Forty-two studies were considered to have a low risk of bias, and 65 were deemed as having a moderate or high risk of bias. Eight studies were excluded from the meta-analysis. The meta-analysis included data from almost 900,000 participants.

The highest public support levels for smoke-free places were for private indoor spaces (73%) and semi-private indoor places (70%). Public support for policies in outdoor non-hospitality and hospitality places was 69% and 50%, respectively.

For semi-private outdoor places, support was 67%. The lowest support was for outdoor private places (41%). Public support was the highest for making cars with children onboard smoke-free at 86%, followed by playgrounds and school grounds at 80% and 76%, respectively.

Parks, beaches, and outdoor hospitality or private places had the lowest public support. There was substantial heterogeneity within or between studies and between countries.

Support was significantly higher among ex- or non-smokers than among current smokers. Females were significantly more often in favor of policies than males.

People in low- and middle-income countries (LMICs) had similar levels of support for policies as those from high-income countries, except for higher support for outdoor non-hospitality policies in LMICs.

Twelve studies assessed public support for policies pre- and post-implementation. Six reported that support was significantly higher after implementation, whereas others did not find significant changes. Sensitivity analyses found no significant differences in support between studies with a low and high risk of bias, indicating that the evidence was robust. Conclusions

The authors observed that public support for smoke-free policies covering outdoor and semi-private spaces was particularly high for places where children are commonly present, such as playgrounds, school grounds, and cars with children.

Support was more than 50% or higher for all areas except private outdoor spaces. Ex- and non-smokers were more in support of policies than smokers.

The findings suggest high support for smoke-free spaces covering outdoor and semi-private areas from the surveyed populations. Policymakers should proceed with further steps in protecting the public, especially children, from the adverse effects of smoke exposure by expanding smoke-free policies. Journal reference:

Boderie, N.W., Sheikh, A., Lo, E., Sheikh, A., Burdorf, A., Van Lenthe, F.J., Mölenberg, F.J.M. & Been, J.V. (2023) Public support for smoke-free policies in outdoor areas and (semi-)private places: a systematic review and meta-analysis. eClinicalMedicine, p.101982. doi: 10.1016/j.eclinm.2023.101982. https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00159-1/fulltext

UK

Police recover body in search for suspect in Valentine’s Day pub shooting

Published

2 hours ago

March 9, 2025

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Police recover body in search for suspect in Valentine's Day pub shooting

Police searching for the suspect in the Kent pub shooting on Valentine’s Day have recovered a body from the River Thames.

Lisa Smith, 43, was killed after she was shot outside The Three Horseshoes in Knockholt on the evening of Friday 14 February.

Later that night, the suspect, named as Edvard Smith, was believed to have fallen into the Thames from the Queen Elizabeth II Bridge which crosses the river at Dartford 17 miles away.

Around that time, the suspect’s car containing a handgun was found abandoned on the bridge and a man was seen on the wrong side of the barrier.

About a week after the shooting, Kent Police said they believed Edvard Smith had died after falling into the water.

The force has now said a body was found in the Thames near Rainham in Essex on Friday afternoon. It has not been formally identified but the suspect’s family have been told of the development.

Edvard Smith was known to Ms Smith and there had been no prior contact between the police and the victim or suspect.

‘So much commotion’

Following the shooting, the landlady of The Three Horseshoes, Michelle Thomas, told Sky News she heard two loud bangs that she initially “thought were fireworks” on the night of the attack.

She said there was “so much commotion – screaming, shouting, crying” and the shooting had left the community in “absolute shock”.

She said Ms Smith, from Slough, had been to the pub before, “mostly in the summer” but “wasn’t a regular”.

Ms Thomas also said about 30 people were at the pub for dinner, while 20 more were in the bar as the incident unfolded just after 7pm.

Kent Police said on Saturday: “A body has been recovered by police from the River Thames, which is being linked to a murder investigation in Knockholt.

“On Friday 14 February 2025, Lisa Smith, 43, was killed after she was shot outside a pub in Main Road. The suspect was known to Lisa and later that evening officers found his car abandoned on the Queen Elizabeth II Bridge. Enquiries established he had fallen into the water below.

“At around 3.45pm on Friday 7 March, a body was located near Rainham, Essex. Formal identification has not yet taken place; however, the man’s family have been informed.”

UK

UK weather: Warm weekend brings 20C temperatures – hotter than Spain and Italy

Published

2 hours ago

March 9, 2025

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UK weather: Warm weekend brings 20C temperatures - hotter than Spain and Italy

Parts of the UK are expected to be hotter than the Balearic Islands, Costa del Sol and the Amalfi Coast this weekend.

The country is set to reach the highest temperatures of the year so far, with central England heating up to 20C on Sunday.

Saturday is also set to reach temperatures in the high teens, with East Anglia, northwest England, the north Midlands and North Wales hitting 18-19C, the Met Office said.

Those temperatures are believed to be above average for this time of year.

Get the latest forecast for your area here

Craig Snell, a meteorologist at the Met Office, said there are a “few exceptions” to the “fine and sunny” weekend weather, including areas in the far north of Scotland, but those areas will still be generally dry and sunny.

Meanwhile, popular holiday destinations in Europe are expected to record cooler temperatures.

A high of 15C is forecast this weekend for Marbella on the south coast of Spain, a maximum of 17C is expected in Ibiza, and 18C is forecast for Sorrento on Italy’s Amalfi Coast.

Sky News meteorologist Chris England said the warm weekend is not expected to last, with conditions “cooling off from the North on Sunday night and through Monday”.

A spell of rain will move south across the country early next week, bringing the return of a few wintry showers in the North and North East.

“While there is uncertainty in the extent of rain and wintry showers through the middle of next week, there is higher confidence that below average temperatures will continue through the week, bringing a very different feel to the mild weather over the weekend,” deputy chief meteorologist Chris Bulmer said.

Temperatures will drop back below average across the UK from Tuesday, according to the Met Office.

Rural spots in Scotland could plummet as low as -4C, with maximum daytime temperatures typically between 5-8C.

World

Zelenskyy condemns ‘vile and inhumane’ Russian attacks after one of year’s deadliest days for Ukrainian civilians

Published

4 hours ago

March 9, 2025

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Zelenskyy condemns 'vile and inhumane' Russian attacks after one of year's deadliest days for Ukrainian civilians

Volodymyr Zelenskyy has thanked Ukraine’s allies for condemning Russian strikes after one of the deadliest days for civilians in his country so far this year.

Ukraine’s president described the attacks as a “vile and inhumane intimidation tactic” by Russia.

While a warning by Donald Trump to Vladimir Putin to stop “pounding” Ukraine or else, appears to have fallen on deaf ears.

Russia launched heavy aerial attacks overnight into Saturday after the White House administration suspended intelligence sharing with Ukraine.

The US has been piling pressure on President Zelenskyy’s government to cooperate in convening peace talks with Russia.

American aerospace company Maxar Technologies said on Friday it had disabled access to its satellite imagery for Kyiv. Its ability to strike inside Russia and defend itself from bombardment is very much diminished without such images.

At least 22 people were killed in multiple Russian attacks, including 11 in the frontline town of Dobropilla in Ukraine’s embattled eastern Donetsk region.

Russia fired two ballistic missiles into the town centre, then launched a strike targeting rescuers who responded, according to Mr Zelenskyy. Forty-seven people, including seven children, were injured in the attack.

“It is a vile and inhumane intimidation tactic to which the Russians often resort,” he said.

The president added: “It was one of the most brutal strikes, a combined one. The strike was deliberately calculated to cause maximum damage. Missiles, along with a Shahed drone, targeted the central part of the town.

“Nine residential buildings were hit. Also, the shopping centre and stores were struck.”

Another seven people were killed in four towns close to the frontline where Russian troops have been making steady advances, said regional governor Vadym Filashkin.

Three others died when a Russian drone hit a civilian workshop in the northeastern Kharkiv region, emergency services reported. And one man was killed by shelling in the region.

The UN Human Rights Monitoring Mission in Ukraine said it was one of 2025’s deadliest attacks for Ukrainian civilians.

Some 24 hours earlier, Russia struck Ukrainian energy facilities using dozens of missiles and drones.

The attacks hampered Ukraine’s ability to supply power to its citizens and run weapons factories vital to its defences.

When asked on Friday if Russian President Vladimir Putin was taking advantage of the US pause on intelligence-sharing to attack Ukraine, Mr Trump responded: “I think he’s doing what anybody else would.”

Mr Zelenskyy did not mention intelligence-sharing on Saturday, but said he welcomed Mr Trump’s proposal to bring in banking sanctions and tariffs on Russia until a ceasefire and final peace settlement is reached.

Mr Zelenskyy also said: “I am grateful to all the leaders, all those diplomats of our partner countries, all public figures who support Ukraine, who have condemned these Russian strikes and who call all things by their proper names.

“And it is essential that we continue coordinating all our efforts with our partners to ensure that our defence works effectively and that we do everything to bring peace closer.”

Mr Zelenskyy has said he and other senior Ukrainian officials will go to Saudi Arabia next week to discuss proposals aimed at ending the war.

In a post on X, he wrote he was set to meet Saudi Arabia’s Crown Prince Mohammed bin Salman on Monday, and his team would remain in the country to have talks with US officials.