A community led tobacco free city
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1
Faculty of Applies Sciences,Rajarata Universirty of Sri Lanka, Health Promotion, Sri Lanka
2
University of Kelaniya, Department of Public Health, Faculty of Medicine, Sri Lanka
3
Presidential Task Force on Drug Prevention, Sri Lanka, Sri Lanka
4
Medical Officer of Health, Office, Sri Lanka
Publication date: 2018-03-01
Tob. Induc. Dis. 2018;16(Suppl 1):A464
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ABSTRACT
Background and challenges to implementation:
Framework Convention for Tobacco Control
advocates for smoke free cities as an effective strategy. A 'tobacco-free city'
advocated by this project is not only a city that protects exposure to tobacco
smoke, but has reduced demand and availability of cigarettes as well.
Aim was
to evaluate the effectiveness and challenges of reducing availability of
cigarettes in a semi-urban area in Sri Lanka by a community led process.
Intervention or response:
A community group led the process. Collective
actions such as discussions at different community settings, informal campaigns
in public transport, poster campaigns and protests against industrial influence
were implemented to improve awareness on effects on health and economy and
change norms and attitudes. Evaluation was conducted using participatory
mechanisms. Pre and post assessments and the comparison with a control area to
assess long term outcomes used mixed methods.
Results and lessons learnt:
In the pre-test, 91% of shops were selling
cigarettes. In one year, daily cigarette sales reduced by 10,415 sticks (86%).
Percentage of shops selling cigarettes reduced from 91% to 25% in one year.
Among the community, a majority showed a good level of knowledge on health
effects and legislations and negative attitudes related to smoking after a one
year. Of the participants 63.0%: 95% CI (57.2, 68.8) stated they perceived
smoking as a “stupid and a meaningless habit”. The prevalence of smoking (9.09%
& 28.0%) and exposure to tobacco smoke (11.7% &65.0%) was low compared
to the control area in 18 months (p<0.001).
Conclusions and key recommendations:
Community led initiatives based on Health Promotion approach are effective in establishing 'Tobacco-free' cities. The community empowerment processes linked with such approaches can reduce the exposure to passive smoking, generating “smoke free cities” as well. Continuous vigilance at ground level and supportive actions from the national level are needed to sustain the results and enhance long term outcomes.