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Factors that influence attitude and enforcement of the smoke-free law in Turkey: a survey of hospitality venue owners and employees
  1. Angela Aherrera1,
  2. Asli Çarkoğlu2,
  3. Mutlu Hayran3,
  4. Gül Ergör4,
  5. Toker Ergüder5,
  6. Bekir Kaplan6,
  7. Jolie Susan1,7,
  8. Laura Zheng1,
  9. Joanna E Cohen7,8,
  10. Ana Navas-Acien1,7,9
  1. 1Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
  2. 2Department of Psychology, Kadir Has University, Istanbul, Turkey
  3. 3Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
  4. 4Izmir Dokuz Eylül School of Medicine, Izmir, Turkey
  5. 5World Health Organization Country Office, Ankara, Turkey
  6. 6Ministry of Health, General Directorate of Health Research, Ankara, Turkey
  7. 7Institute for Global Tobacco Control, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
  8. 8Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
  9. 9Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
  1. Correspondence to Angela Aherrera, Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health 615 N Wolfe St., Office W7033, Baltimore, MD 21205, USA; aaherre2{at}jhu.edu

Abstract

Introduction In 2009, Turkey extended the smoke-free legislation to hospitality venues. Compliance, however, remains low in some hospitality venues. We identified characteristics associated with knowledge of health effects that can be prevented by the smoke-free law, the attitude towards and enforcement of the law.

Methods In 2014, we conducted 400 interviews with hospitality venue owners and employees in 7 cities in Turkey. The venues were identified based on a random sampling strategy in a previous phase of the study.

Results Over one-third (37.3%) of hospitality owners and employees had adequate knowledge of the health effects from secondhand smoke (SHS), 71.3% had a positive attitude towards the law and 19.5% had personally enforced the law. Participants who worked 70 hours or more per week were more likely to have a positive attitude towards the law. Older individuals, women, participants working in bars/nightclubs, venue owners receiving fines for non-compliance and current smokers were less likely to have a positive attitude towards the law. Participants working in traditional coffee houses, former smokers, and participants with a high school education or greater were more likely to enforce the law. Smokers who quit or reduced smoking because of the law were more likely to enforce the law compared with those who were not influenced by the law.

Conclusions Although the attitude towards the law was positive, interventions are needed to increase knowledge on the health effects of SHS and facilitate enforcement of the law, particularly among subgroups less likely to have a positive attitude and enforce the law.

  • Public policy
  • Secondhand smoke
  • Public opinion
  • Priority/special populations
  • Surveillance and monitoring

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Footnotes

  • Correction notice This article has been corrected since it was published Online First. The author surname ‘Eirüder’ has been corrected to ‘Ergüder’.

  • Contributors AN-A, JEC, AÇ, MH and GE developed the idea for this research. AA and AN-A wrote the first draft of the article. AA conducted the data analysis and developed the tables. Presubmission review and editing were completed by AA, AÇ, MH, GE, TE, BK, JS, LZ, JEC, AN-A. AN-A is the guarantor.

  • Funding This study was supported by an award from the Institute for Global Tobacco Control at the Johns Hopkins Bloomberg School of Public Health, with funding from the Bloomberg Initiative to Reduce Tobacco Use.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Johns Hopkins University (Maryland, USA), Kadir Has University (Istanbul, Turkey).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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