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Smoke-free spaces: a decade of progress, a need for more?
  1. Sean Semple1,
  2. Ruaraidh Dobson1,
  3. Rachel O'Donnell1,
  4. Emilia Zainal Abidin2,
  5. Olena Tigova3,4,5,6,
  6. Gabriel Okello7,8,9,
  7. Esteve Fernández3,4,5,6
  1. 1 Institute of Social Marketing and Health, University of Stirling, Stirling, UK
  2. 2 Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
  3. 3 Tobacco Control Unit, Catalan Institute of Oncology - ICO, WHO Collaborating Centre for Tobacco Control, Catalan Institute of Oncology, L’Hospitalet de Llobregat, Barcelona, Spain
  4. 4 Tobacco Control Research Group, Bellvitge Biomedical Research Institute - IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain
  5. 5 School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
  6. 6 Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
  7. 7 African Centre for Clean Air, Kampala, Uganda
  8. 8 Cambridge Institute for Sustainability Leadership, University of Cambridge, Cambridge, UK
  9. 9 AirQo, College of Computing and Information Sciences, Makerere University, Kampala, Uganda
  1. Correspondence to Dr Sean Semple, Institute of Social Marketing, University of Stirling, Stirling FK9 4LA, UK; sean.semple{at}


Adoption of smoke-free measures has been one of the central elements of tobacco control activity over the past 30 years. The past decade has seen an increasing number of countries and proportion of the global population covered by smoke-free policies to some extent. Despite reductions in global smoking prevalence, population growth means that the number of non-smokers exposed to the harms caused by secondhand smoke remains high. Smoke-free policy measures have been shown to be useful in protecting non-smokers from secondhand smoke, and can additionally increase cessation and reduce smoking initiation. Policies tend to be aimed primarily at enclosed public or workplace settings with very few countries attempting to control exposure in private or semiprivate spaces such as homes and cars, and, as a result, children may be benefiting less from smoke-free measures than adults. Compliance with legislation also varies by country and there is a need for education and empowerment together with guidance and changing social norms to help deliver the full benefits that smoke-free spaces can bring. Restrictions and policies on use of electronic cigarettes (e-cigarettes) in smoke-free settings require more research to determine the benefits and implications of bystanders’ exposure to secondhand e-cigarette aerosol, dual use and smoking cessation.

  • global health
  • denormalisation
  • low/middle-income country
  • secondhand smoke

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  • Contributors This was an invited manuscript. SS generated the first draft and all authors then contributed to the editing and refining of this to produce the final version.

  • Funding This work was carried out as part of employment at the University of Stirling (SS, RD and RO’D), Universiti Putra Malaysia (EZA), University of Cambridge (GO) and the Catalan Institute of Oncology-ICO (OT and EF). This manuscript was invited by the editor and was externally peer reviewed.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.