A cross-sectional study on exposure to secondhand smoke in indoor public places and attitudes of residents towards the smoke control ordinance in public places

Introduction: Secondhand smoke (SHS) exposure is a serious public health problem. This study aims to collect data on tobacco control since the implementation of the new version of the Smoke Control Ordinance in Public Places of Hangzhou (the Ordinance), combined with questionnaire surveys to understand the SHS exposure situation in public places, relevant knowledge and attitudes of residents in Hangzhou.

Methods: We used data from a population-based tobacco control survey of 2746 adults aged 15-75 years conducted in Hangzhou, Zhejiang Province in March 2023. Data were collected using a self-administered questionnaire consisting of demographic characteristics, exposure to tobacco, awareness of tobacco hazards, knowledge of the Ordinance, and behaviors and attitudes towards tobacco control in public places. Chi-squared tests were performed to examine the differences in knowledge and attitudes related to tobacco control in indoor public places among residents with different characteristics in Hangzhou. Multivariable logistic regression was used to identify variables affecting satisfaction with the effectiveness of tobacco control in public places.

Results: Of the 2155 non-smokers, 1006 (46.68%) had been exposed to SHS in public places. More than 89.00% of participants supported the Ordinance. Satisfaction with effectiveness of tobacco control in public places in Hangzhou was 68.54%, and the subcomponents that influenced it were satisfaction with tobacco control publicity campaigns (AOR=1.85; 95% CI: 1.19-2.88), satisfaction with tobacco control surveillance and enforcement (AOR=3.91; 95% CI: 2.43-6.30), satisfaction with the smoke-free demonstration for government departments (AOR=5.79; 95% CI: 3.96-8.47), and satisfaction with individual tobacco control behavior (AOR=11.68; 95% CI: 8.53-15.99).

Conclusions: It is necessary to strengthen tobacco control publicity to increase the participation of residents and to gain a deeper understanding of the subjective willingness and needs of residents to participate in tobacco control campaigns in order to improve residents' individual satisfaction.