Abstract
BackgroundOutdoor smoke-free policies (SFPs) at sports clubs have significant potential to reduce adolescent smoking. However, the realization of this potential may be strongly dependent on how these policies are implemented in practice. The aim of this study is to explore the perceptions of key stakeholders at different sports clubs in the Netherlands concerning how outdoor SFPs are implemented in practice and which determinants influence implementation. MethodsSemi-structured interviews were held with 46 key stakeholders at eight Dutch sports clubs (i.e., field hockey, soccer, tennis, korfball) with an outdoor SFP. A thematic approach was used for the analysis of the transcripts. ResultsOverall, respondents perceived the implementation of an outdoor SFP at sports clubs as feasible. The SFP is often enforced, people who smoke react positively when they are approached, the SFP has led to less (visible) smoking at the venue, and a nonsmoking norm is reinforced. However, we identified three ‘critical situations’ in which implementation is less than optimal: 1) when children are not present at the sports club, 2) when alcohol is involved, and 3) when people who smoke relocate to the entrance of the sports club. Several determinants influenced implementation in those critical situations: 1) determinants related to individual smokers and club members (i.e., support, communication towards people who smoke), 2) determinants related to the SFP itself (i.e., clarity of the policy), 3) determinants related to the sports club (i.e., communication of the policy, characteristics of the sports club), and 4) determinants related to the wider community (i.e., change of social norm with regard to smoking, support from local and national organizations). ConclusionImplementation of an outdoor SFP at sports clubs is feasible because there is a high level of support and experiences are mainly positive. Nevertheless, some situations present challenges to compliance and enforcement. We identified a number of determinants that may facilitate implementation of an outdoor SFP at sports clubs.
Highlights
Outdoor smoke-free policies (SFPs) at sports clubs have significant potential to reduce adolescent smoking
Several determinants influenced implementation in those critical situations: 1) determinants related to individual smokers and club members, 2) determinants related to the SFP itself, 3) determinants related to the sports club, and 4) determinants related to the wider community
We identified a number of determinants that may facilitate implementation of an outdoor SFP at sports clubs
Summary
Outdoor smoke-free policies (SFPs) at sports clubs have significant potential to reduce adolescent smoking. The realization of this potential may be strongly dependent on how these policies are implemented in practice. The aim of this study is to explore the perceptions of key stakeholders at different sports clubs in the Netherlands concerning how outdoor SFPs are implemented in practice and which determinants influence implementation. Smoking is the single most preventable cause of death and disease (World Health Organization, 2020). Experimentation with cigarettes can have serious health consequences, as research shows that smoking a single cigarette in childhood is highly predictive of regular smoking later in life (Hilland et al, 2015; Nuyts, Kuipers, Willemsen & Kunst, 2018). Early smoking prevention strategies are an important public health priority. One way to establish healthy environments with regard to smoking is through the implementation of smoke-free policies (SFPs). SFPs reduce the visibility of smoking, limit the opportunities for adolescents to smoke, and communicate that smoking is socially unacceptable (Alesci, Forster & Blaine, 2003; Eisenberg & Forster, 2003; Wakefield & Forster, 2005)
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