Abstract:
Background The Shanghai Regulation on Smoking Control in Public Places was implemented on March 1, 2010. The revision of the regulaton, which was revised by the Standing Commitee of the People's Congress of Shanghai, was implemented on March 1, 2017. The revision is a more comprehensive smoke-free law than the old version, which expands non-smoking places from partcular indoor public places to all indoor public places, indoor workplaces, and on public transport, indicatng an important step forward.
Objectve This paper evaluates the impact of the revision of the regulaton in indoor public places, indoor workplaces, and on public transport in Pudong New Area of Shanghai.
Methods Three investigations were conducted at the pre-implementation stage (December 2016) and the post-implementation stage (1 month, April 2017; and 6 months, September 2017) in 237 indoor public places, indoor workplaces, and on public transport in Pudong New Area of Shanghai, and included observatons and questonnaire survey. The observatons included smoking control publicity materials, no-smoking signs, hotline numbers, ashtrays, smoking areas, cigarete buts, and smoking behavior. The intercept questonnaire survey was about the public attudes and support towards the regulaton/the revision of the regulaton and the awareness of smoking harms. A total of 230 places were included in the study (7 were withdrawn), and 2 327, 2 300, and 2 277 partcipants completed the questonnaires in the three waves of intercept surveys, respectvely.
Results Afer the implementaton, more places provided tobacco control publicity materials and posted hotline numbers to report illegal smoking (P < 0.001), while less were observed with ashtrays, cigarete buts, and smoking behavior (P < 0.001). The changes of smoke-free environment differed among different types of places. Smoking behavior was found in places for kids (3/28, 10.7%), medical and health insttutons (1/18, 5.6%), restaurants (8/37, 21.6%), entertainment places (6/38, 15.8%), hotels (1/20, 5.0%), ofce buildings and residual buildings (4/14, 28.6%), manufacturing enterprises (2/6, 33.3%), and public transport (1/7, 14.3%). Increased proportons of partcipants were aware of and supported the regulaton/the revision of the regulaton, agreed with the noton that "every person deserves the right to breathe tobacco-smoke-free air", and were aware the hazards of smoking (P < 0.05). The logistc regression analysis results showed that age was associated with the awareness of the regulaton revision, and the odds ratos of the 30-49 years age group and the 50-years age group versus the 15-29 years age group were 2.585 (95%CI:1.928-3.466) and 1.778 (95%CI:1.294-2.444) respectvely (P < 0.001); gender and age had no associatons with the support of the regulaton revision; smoking status was signifcantly associated with the support of the regulaton revision, and the odds rato of current smokers versus never-smokers was 0.220 (95%CI:0.061-0.790) (P=0.020), but there was no difference between former smokers and never-smokers.
Conclusion The half-year implementation of the revised regulation has produced some positive effects that more citizens support banning smoking in all indoor public places and are aware of the hazards of smoking, but strengthened supervision and management is needed in some types of the places.