Department of Public Health, North South University, Dhaka, Bangladesh.
Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, Ontario, Canada.
PLoS One. 2023 Apr 26;18(4):e0283650. doi: 10.1371/journal.pone.0283650. eCollection 2023.
Bangladesh is one of the highest tobacco-consuming countries in the world, with a large number of adult users of a variety of smoked and/or smokeless tobacco products. Bangladesh tobacco control act prohibits smoking in public places and requires the owners of public places to display 'no smoking' signages.
The objective of this study was to assess the level of compliance with the tobacco control act (smoke-free laws) in public places in a northeast city of Bangladesh.
This cross-sectional study was conducted between June 1 and August 25, 2020, across 673 public places in Sylhet city, Bangladesh. The data was collected using a structured observational checklist that included variables such as the presence of active smoking, the presence of designated smoking areas, the display of 'no smoking' signages, evidence of recent smoking such as ashes, butts/bidi ends, and the presence of smoking aids.
Among 673 public places, a total of 635 indoor locations and 313 outdoor locations were observed. Only 70 (11%) indoor locations were found to be in good compliance, and 388 (61.1%) indoor locations were found to be in moderate compliance with smoke-free laws. On the other hand, only 5 (1.6%) outdoor locations were in good compliance, and 63 (20.1%) outdoor locations were in moderate compliance with smoke-free laws. The overall compliance with smoke-free laws at indoor locations was 52.7%, and at outdoor locations was 26.5%. The highest compliance was observed at healthcare facilities (58.6%) and the least at transit points (35.7%) for indoor locations. In outdoor locations, the highest compliance was observed at offices and workplaces (37.1%) and the least at transit points (2.2%). Higher active smoking was observed in public places where there was an absence of 'no smoking' signage and the presence of points of sale (POSs) (p-value <0.05). Further, higher active smoking was observed in places where any smoking aids, cigarette butts, bidi ends, or ashes were present (p-value <0.05).
This study found moderate compliance at indoor locations and very low compliance at outdoor locations. The government should focus more on implementing smoke-free laws in all kinds of public places, particularly at most frequently visited places and transit sites. 'No smoking' signages should be displayed per legislation across all public places. Policymakers should consider the prohibition of POS in/around a public place as it has a positive effect on smoking.
孟加拉国是世界上烟草消费最高的国家之一，有大量成年用户使用各种吸烟和/或无烟烟草制品。孟加拉国烟草控制法案禁止在公共场所吸烟，并要求公共场所的所有者展示“禁止吸烟”标志。
本研究旨在评估孟加拉国东北部一个城市公共场所对烟草控制法案（无烟法律）的遵守程度。
本横断面研究于 2020 年 6 月 1 日至 8 月 25 日在孟加拉国锡尔赫特市的 673 个公共场所进行。数据收集使用结构化观察检查表，其中包括存在吸烟、存在指定吸烟区、展示“禁止吸烟”标志、最近吸烟的证据（如灰烬、烟蒂/比迪末端）和吸烟辅助工具等变量。
在 673 个公共场所中，共观察到 635 个室内场所和 313 个室外场所。只有 70 个（11%）室内场所被发现遵守情况良好，388 个（61.1%）室内场所被发现遵守情况中等。另一方面，只有 5 个（1.6%）室外场所遵守情况良好，63 个（20.1%）室外场所遵守情况中等。室内场所无烟法律的总体遵守率为 52.7%，室外场所为 26.5%。遵守情况最好的是医疗机构（58.6%），最差的是过境点（35.7%）。在室外场所，遵守情况最好的是办公室和工作场所（37.1%），最差的是过境点（2.2%）。在没有“禁止吸烟”标志和销售点（POS）的公共场所，观察到更高的吸烟率（p 值<0.05）。此外，在有任何吸烟辅助工具、烟蒂、比迪末端或灰烬的地方，观察到更高的吸烟率（p 值<0.05）。
本研究发现室内场所遵守情况中等，室外场所遵守情况非常低。政府应更加重视在所有类型的公共场所实施无烟法律，特别是在最常访问的场所和过境点。所有公共场所都应按法规展示“禁止吸烟”标志。决策者应考虑在公共场所内/周围禁止 POS，因为这对吸烟有积极影响。
