Objective: To review the published survey data on public support for smoke-free outdoor regulations in the USA and Canada (two countries at the forefront of such policies).
Data sources and study selection: We searched for English language articles and reports using Medline, Google Scholar and Google for the period to December 2014. We retained population-based surveys of the adult general population in jurisdictions in the USA and Canada, with a minimum survey sample of 500.
Data extraction: The analysis focused on assessing levels and trends in public support for different types of places and also explored how support varied between population groups.
Results: Relevant data were found from 89 cross-sectional surveys between 1993 and 2014. Support for smoke-free regulations in outdoor places tended to be highest for smoke-free school grounds (range: 57-95%) playgrounds (89-91%), and building entrances (45-89%) and lowest for smoke-free outdoor workplaces (12-46%) and sidewalks (31-49%). Support was lower among smokers, though for some types of places there was majority smoker support (eg, school grounds with at least 77% support in US state surveys after 2004). Trend data involving the same questions and the same surveyed populations suggested increased general public and smoker support for smoke-free regulations over time (eg, from 67% to 78% during 2002-2008 for smoke-free school grounds in the USA). Higher support was typically seen from women and some ethnic groups (eg, African-Americans).
Conclusions: Outdoor smoke-free regulations can achieve majority public support, including from smokers.
Keywords: Prevention; Public opinion; Public policy; Secondhand smoke; Socioeconomic status.
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/