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Impact of an Outdoor Smoking Ban at Secondary Schools on Cigarettes, E-Cigarettes and Water Pipe Use among Adolescents: An 18-Month Follow-Up

Author

Listed:
  • Andrea D. Rozema

    (Department Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Warandelaan 2, P.O. Box 90153, 5000 LE Tilburg, The Netherlands)

  • Marieke Hiemstra

    (Department Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Warandelaan 2, P.O. Box 90153, 5000 LE Tilburg, The Netherlands)

  • Jolanda J. P. Mathijssen

    (Department Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Warandelaan 2, P.O. Box 90153, 5000 LE Tilburg, The Netherlands)

  • Maria W. J. Jansen

    (Academic Collaborative Centre for Public Health Limburg, Public Health Service South Limburg (GGD ZL), 6400 AA Geleen, The Netherlands
    Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, 6211 LK Maastricht, The Netherlands)

  • Hans J. A. M. Van Oers

    (Department Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Warandelaan 2, P.O. Box 90153, 5000 LE Tilburg, The Netherlands
    National Institute for Public Health and the Environment (RIVM), 3720 BA Bilthoven, The Netherlands)

Abstract

The effectiveness of outdoor smoking bans on smoking behavior among adolescents remains inconclusive. This study evaluates the long-term impact of outdoor school ground smoking bans among adolescents at secondary schools on the use of conventional cigarettes, e-cigarettes (with/without nicotine) and water pipes. Outdoor smoking bans at 19 Dutch secondary schools were evaluated using a quasi-experimental design. Data on 7733 adolescents were obtained at baseline, and at 6 and 18-month follow-up. The impact of outdoor smoking bans on ‘ever use of conventional cigarettes’, ‘smoking onset’, ‘ever use of e-cigarette with nicotine’, ‘e-cigarette without nicotine’, and ‘water pipe’ was measured. Multilevel logistic regression analysis was used. At schools with a ban, implementation fidelity was checked. At schools where a ban was implemented, at 18-month follow-up more adolescents had started smoking compared to the control condition. No effect of implementation of the ban was found for smoking prevalence, e-cigarettes with/without nicotine, and water pipe use. Implementation fidelity was sufficient. No long-term effects were found of an outdoor smoking ban, except for smoking onset. The ban might cause a reversal effect when schools encounter difficulties with its enforcement or when adolescents still see others smoking. Additional research is required with a longer follow-up than 18 months.

Suggested Citation

  • Andrea D. Rozema & Marieke Hiemstra & Jolanda J. P. Mathijssen & Maria W. J. Jansen & Hans J. A. M. Van Oers, 2018. "Impact of an Outdoor Smoking Ban at Secondary Schools on Cigarettes, E-Cigarettes and Water Pipe Use among Adolescents: An 18-Month Follow-Up," IJERPH, MDPI, vol. 15(2), pages 1-14, January.
    • Handle: RePEc:gam:jijerp:v:15:y:2018:i:2:p:205-:d:128732
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    References listed on IDEAS

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    1. Pentz, M.A. & Brannon, B.R. & Charlin, V.L. & Barrett, E.J. & MacKinnon, D.P. & Flay, B.R., 1989. "The power of policy: The relationship of smoking policy to adolescent smoking," American Journal of Public Health, American Public Health Association, vol. 79(7), pages 857-862.
    2. Voigt, K., 2015. "Smoking norms and the regulation of E-cigarettes," American Journal of Public Health, American Public Health Association, vol. 105(10), pages 1967-1972.
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    Cited by:

    1. Gera E. Nagelhout & Lucy Popova & Mirte A. G. Kuipers, 2018. "Why Are New Tobacco Control Interventions Needed?," IJERPH, MDPI, vol. 15(4), pages 1-3, April.
    2. Marieke Hiemstra & Andrea Rozema & Maria Jansen & Hans van Oers & Jolanda Mathijssen, 2021. "Longitudinal Associations of Substance Use Risk Profiles with the Use of Alternative Tobacco Products and Conventional Smoking among Adolescents," IJERPH, MDPI, vol. 18(24), pages 1-11, December.
    3. Anneke Vang Hjort & Mirte A. G. Kuipers & Maria Stage & Charlotta Pisinger & Charlotte Demant Klinker, 2022. "Intervention Activities Associated with the Implementation of a Comprehensive School Tobacco Policy at Danish Vocational Schools: A Repeated Cross-Sectional Study," IJERPH, MDPI, vol. 19(19), pages 1-19, September.

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