Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
Department of Occupational Health and Safety, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
Front Public Health. 2024 Apr 17;12:1354980. doi: 10.3389/fpubh.2024.1354980. eCollection 2024.
Non-compliance with smoke-free law is one of the determinants of untimely mortality and morbidity globally. Various studies have been conducted on non-compliance with smoke-free law in public places in different parts of the world; however, the findings are inconclusive and significantly dispersed. Moreover, there is a lack of internationally representative data, which hinders the evaluation of ongoing international activities towards smoke-free law. Therefore, this meta-analysis aimed to assess the pooled prevalence of non-compliance with smoke-free law in public places.
International electronic databases, such as PubMed/MEDLINE, Science Direct, Cochrane Library, CINAHL, African Journals Online, HINARI, Semantic Scholar, google and Google Scholar were used to retrieve the relevant articles. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA) guidelines. The Higgs I statistics were used to determine the heterogeneity of the reviewed articles. The random-effects model with a 95% confidence interval was carried out to estimate the pooled prevalence of non-compliance.
A total of 23 articles with 25,573,329 study participants were included in this meta-analysis. The overall pooled prevalence of non-compliance with smoke-free law was 48.02% (95% CI: 33.87-62.17). Extreme heterogeneity was observed among the included studies (I = 100%; < 0.000). The highest non-compliance with smoke-free law was noted in hotels (59.4%; 95% CI: 10.5-108.3) followed by homes (56.8%; 95% CI: 33.2-80.4), with statistically significant heterogeneity.
As the prevalence of non-compliance with smoke-free law is high in public places, it calls for urgent intervention. High non-compliance was found in food and drinking establishments and healthcare facilities. In light of these findings, follow-up of tobacco-free legislation and creating awareness that focused on active smokers particularly in food and drinking establishments is recommended.
不遵守禁烟法是全球范围内导致过早死亡和发病的决定因素之一。世界各地的不同地方已经进行了多项关于公共场所禁烟法遵守情况的研究；然而，研究结果尚无定论，差异很大。此外，缺乏具有国际代表性的数据，这阻碍了对正在进行的国际禁烟法活动的评估。因此，本荟萃分析旨在评估公共场所禁烟法不遵守情况的总流行率。
使用国际电子数据库，如 PubMed/MEDLINE、Science Direct、Cochrane Library、CINAHL、African Journals Online、HINARI、Semantic Scholar、google 和 Google Scholar 检索相关文章。研究遵循系统评价和荟萃分析报告的首选报告项目 (PRISMA) 指南。使用 Higgs I 统计量来确定综述文章的异质性。采用具有 95%置信区间的随机效应模型来估计不遵守禁烟法的总流行率。
本荟萃分析共纳入 23 篇文章，涉及 25573329 名研究参与者。不遵守禁烟法的总流行率为 48.02%（95%CI：33.87-62.17）。纳入的研究之间存在极高的异质性（I = 100%；<0.000）。在酒店观察到的不遵守禁烟法的情况最为严重（59.4%；95%CI：10.5-108.3），其次是家庭（56.8%；95%CI：33.2-80.4），差异具有统计学意义。
由于公共场所不遵守禁烟法的情况普遍存在，因此需要紧急干预。在饮食场所和医疗机构发现了较高的不遵守禁烟法情况。鉴于这些发现，建议对无烟立法进行后续监测，并开展以积极吸烟者为重点的宣传活动，特别是在饮食场所。
