Benton Jack S, Berg Sofia, Kapadi Arbaz, Bendel Neil, Jerram Julie, French David P
Department of Geography, School of Environment, Education and Development, The University of Manchester, Manchester, UK
Manchester Centre for Health Psychology, Division of Psychology & Mental Health, School of Health Sciences, The University of Manchester, Manchester, UK.
BMJ Open. 2025 Jul 13;15(7):e105510. doi: 10.1136/bmjopen-2025-105510.
Policies and interventions increasingly aim to reduce smoking in outdoor public spaces, but evidence on factors influencing smoking in specific locations remains limited. Systematic observation can unobtrusively assess behaviours in environmental contexts, reducing biases from self-report. This study aims to develop and test the reliability and validity of MOSMOKE (Method for Observing SMOKing and vaping bEhaviours): a new tool for assessing the number of people holding or inhaling a cigarette or vape in public spaces.
MOSMOKE was adapted from a previously validated observation tool for assessing physical activity and well-being behaviours. Following piloting and refinement, inter-rater reliability for assessing smoking, vaping and age group classification was analysed using intraclass correlation coefficients (ICCs). A main study assessed criterion-related validity through 32 hours of observations over 4 days. A 2×2 study design was used, with four sites selected that varied by two environmental characteristics: presence of a smoking bin and adjacency to an office block.
Four public spaces in Manchester, UK.
Inter-rater reliability was 'good' (ICCs>0.75; n=4) or 'excellent' (ICCs>0.90; n=2) for smoking behaviours, and mostly 'good' (n=4) or 'excellent' (n=1) for vaping behaviours. Observed differences in smoking and vaping behaviours across sites aligned with prespecified hypotheses that smoking would be more prevalent near smoking bins (p=0.02) and office entrances (p=0.006), supporting criterion-related validity.
This study provides preliminary evidence that MOSMOKE is a reliable and valid tool for unobtrusively assessing smoking and vaping in public spaces. It can be used to evaluate policies and interventions targeting smoking or vaping in specific environmental contexts. MOSMOKE is freely available, with a detailed manual to support its use.
政策和干预措施越来越旨在减少户外公共场所的吸烟行为，但关于影响特定场所吸烟因素的证据仍然有限。系统观察可以在不引人注意的情况下评估环境中的行为，减少自我报告带来的偏差。本研究旨在开发并测试MOSMOKE（观察吸烟和吸电子烟行为的方法）的可靠性和有效性：这是一种用于评估公共场所手持或吸食香烟或电子烟人数的新工具。
MOSMOKE改编自先前经过验证的用于评估身体活动和健康行为的观察工具。经过试点和完善后，使用组内相关系数（ICC）分析评估吸烟、吸电子烟和年龄组分类的评分者间信度。一项主要研究通过在4天内进行32小时的观察来评估与标准相关的效度。采用2×2研究设计，选择了四个场所，它们在两个环境特征方面存在差异：是否有吸烟垃圾桶以及是否毗邻办公大楼。
英国曼彻斯特的四个公共场所。
吸烟行为的评分者间信度为“良好”（ICC>0.75；n = 4）或“优秀”（ICC>0.90；n = 2），吸电子烟行为大多为“良好”（n = 4）或“优秀”（n = 1）。各场所吸烟和吸电子烟行为的观察差异与预先设定的假设一致，即吸烟在吸烟垃圾桶附近（p = 0.02）和办公入口附近（p = 0.006）更为普遍，支持了与标准相关的效度。
本研究提供了初步证据，表明MOSMOKE是一种可靠且有效的工具，可用于在不引人注意的情况下评估公共场所的吸烟和吸电子烟行为。它可用于评估针对特定环境中吸烟或吸电子烟的政策和干预措施。MOSMOKE可免费获取，并配有详细的使用手册以支持其使用。
