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- Smoke-free environments
- law enforcement
- global health
- low/middle income country
- smoking caused disease
- secondhand smoke
- primary healthcare
On February 2009, the Guatemalan Congress passed a nationwide law that banned smoking in all workplaces, including bars and restaurants. The Ministry of Health (MoH) is responsible for monitoring law compliance and fining violators. Individuals and venues are subject to economic fines when they break the law.
After a comprehensive smoking ban is implemented, a major challenge is to ensure proper enforcement to guarantee high compliance, particularly in bars.1 In Guatemala, air nicotine levels were significantly reduced 6 months after law implementation in bars and restaurants and workers' support for the law increased compared with prelaw levels.2 However, 2 years after, law enforcement by the MoH has been deficient. Only five fines were imposed in the first 18 months and no venue has been closed so far.3 4
The Soccer World Cup is the biggest sporting event worldwide (more than 700 hundred million people watched the televised final match).5 In Guatemala, thousands of soccer fans rush to bars and restaurants to watch the games. Employee absenteeism rate is reported to be 20% and sales in bars and restaurants expected to increase up to 300% during the tournament.6–8 Therefore, this was a great opportunity for the MoH to strengthen law enforcement and collect fines. This study sought to monitor law compliance in bars and restaurants during the 2010 Soccer World Cup.
A sample of 102 venues (59 bars and 43 restaurants) was selected on a convenience basis. Venues were selected from zones 1, 4, 9, 10, 11 and 15 from Guatemala City's 22 zones. These six zones were selected as they are the safest and conveniently located near main districts. Surveyors used their judgement to identify what they thought were the most popular bars and restaurants in each zone. From all 64 soccer matches, those beginning at noon Guatemalan time and where one of the top 13 FIFA teams played were analysed. Between two and five research assistants watched each game for customers smoking inside, inappropriate ‘No-Smoking’ signage and availability of a smoking section.
Overall, 114 observations were made during 29 matches (12 venues were visited twice). The mean number of customers per game was 21.4 (SD 3.99) in bars and 56.2 (SD 8.35) in restaurants. The most frequent violation was allowing smoking inside the venue (table 1) while inappropriate ‘No Smoking’ signage in the venue would have yielded the highest total fine revenue. If appropriately enforced, the MoH could have collected US$88 259 in fines. Funds collected over this 1-month period would have been enough to hire 16 MoH staff to effectively monitor, track and fine the offending businesses for 1 year.9
Our results should be interpreted in the light of some limitations. Only the most popular neighbourhoods in Guatemala City were included; therefore, the findings may not be generalisable to other neighbourhoods. However, we hypothesise that they underestimate the number of violations as less popular neighbourhoods might be less likely to get MoH monitoring. Furthermore, only noon (there were two more in the morning) matches were analysed and fines were only recorded during the 90 min of the match. Finally, given that there are no data on the number of violations without the World Cup, we are unable to have a comparison period.
In conclusion, the MoH continues to be deficient in enforcing smoke-free policies in Guatemala City. Sustained promotion, education and enforcement visits are an effective approach to obtain compliance. Noncompliance results in employees' and customers' continuous exposure to the harmful effects of secondhand smoke and further weakens the policy.
Funding This work was funded in part by Research for International Tobacco Control (RITC) of the International Development Research Center (IDRC), Ottawa, Canada. JB is partially supported by an unrestricted grant from the American Cancer Society.
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.
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