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

Andrea D. Rozema, Marieke Hiemstra, Jolanda J. P. Mathijssen, Maria W. J. Jansen and Hans J. A. M. Van Oers
Additional contact information
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
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

IJERPH, 2018, vol. 15, issue 2, 1-14

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.

Keywords: school-based intervention; prevention; tobacco control; adolescents; school smoking policies; smoking prevalence; smoke-free; quasi-experimental design; outdoor school ground; secondary schools (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2018
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (4)

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