Search

Background: Since 2013, City of Denpasar government has adopted a smoke-free law. Implementation of the law faces several obstacles, partly due to the high social acceptability of smoking in the city, where cigarette and smoking has been deeply engrained within social life and become part of hospitality. This study aims to assess the smoke-free law compliance and to explore the social norms that may affect the compliance. Design and Methods: The study was a mix of cross-sectional compliance survey and qualitative exploration conducted in Denpasar in 2019. Survey included 538 samples, which were selected using stratified random sampling and a walking protocol. The qualitative data was collected through in-depth interviews and Focus Group Discussion (FGD) in four sub-districts of Denpasar. Results: Of the 538 venues, 32.9% complied with the seven compliance indicators. The university has the highest compliance (83.3%), while public places including worship places have a low compliance. The three most common violations were the absence of no-smoking signage (58.6%), provision of ashtray (17.5%), and smell of tobacco smoke (15.8%). The poor compliance was related to the lack of awareness of the regulation, and the fact that smoking is highly acceptable and part of the culture. The informants highlighted the essential role of public figures and potency of local policy as social disapproval of smoking. Conclusions: Compliance to the smoke-free law in Denpasar remains low, continuous education, socialization and improved supervision are crucial. Meanwhile, social and cultural acceptance of smoking is considered as an essential factor that hampers the implementation of the smoke free law. [ABSTRACT FROM AUTHOR]

Introduction: The city of Denpasar has implemented the smoke-free law for five years. However, the compliance remains low. Smoking remains highly accepted in society, and the provision of cigarettes in several religious and customary events. Hence, this study aims to assess how social smoking norms affect compliance with smoke-free laws. Methods: This was a cross-sectional study located in Denpasar, Bali, Indonesia. This study was conducted from December 2019 until February 2020. The sample size was 192 and was selected using multistage random sampling. Data were collected through interviews using a structured questionnaire then analyzed using multiple linear regression. Results: Descriptive norms of smoking affected the compliance in worship places (standardized coefficient beta of 0.175 and p=0.01). Moreover, the effect of descriptive norms to compliance was significantly moderated by perceived of injunctive norms (standardized coefficient beta of 0.216; p<0.01); benefits to one-self (standardized coefficient beta of 0.199; p<0.01); benefits to others (standardized coefficient beta of 0.164; p=0.02); anticipatory socialization (standardized coefficient beta of 0.146; p=0.03); similarity (standardized coefficient beta of 0.141; p=0.04); aspiration (standardized coefficient beta of 0.131; p=0.06); and local leader role (standardized coefficient beta of 0.129; p=0.06). Conclusion: The social norms of smoking remain an important predictor of compliance with the smoke-free law, particularly in countries with strong cultural characteristics. However, its effect could be moderated using appropriate culture-sensitive strategies. [ABSTRACT FROM AUTHOR]

Introduction: Indonesia is one of the countries with the highest number of tobacco advertisements, promotion, and sponsorship (TAPS) across the globe, which play a significant role in increasing smoking prevalence. Since 2019, Klungkung District has adopted a TAPS ban at point of sale (PoS). Accordingly, this study aims to evaluate compliance with the total TAPS ban at PoS in Klungkung and the factors associated. Methods: This cross-sectional study was conducted in the Klungkung district from August to October 2021. The survey involved 200 samples of PoS and also the managers, which selected using stratified simple random sampling for registered PoS and a walking protocol for unregistered PoS. Data was collected through observation using a checklist and interview using a structured questionnaire by eight well-trained enumerators. Data were analyzed using SPSS. Results: The study successfully observed 200 PoS and also interviewed 200 PoS managers. The result showed the compliance was 72.5%. Of 9 factors analyzed using regression analysis, it was found that factors associated with the compliance were knowledge and attitude PoS manager toward TAPS ban (OR=11.3; CI:1.233-103.414; p=0.008), perceived of socio-economic impact factor (OR=8.1; CI:3.584-18.400; p<0.01), and tobacco industry interference (OR=2.8; CI:1.441-5.594; p=0,003). Conclusions: Compliance with the TAPS ban at PoS remain sufficient, even though it has not reached the target. Factors mainly associated with the compliance were the attitude of PoS manager, and tobacco industry interference. Hence, socialization and enforcement should be improved and sustained. [ABSTRACT FROM AUTHOR]