Evaluation On The Implementation Of Tobacco Control Measures On The Shanghai World Expo Site

Objectives:To evaluate the status of tobacco control in the World Expo Zone, to analyze the implementation effect of smoke-free policy and to probe the model of smoke-free expo and its experience. This study provides an initial framework for evaluating smoke-free environments at large-scale events which will be more frequent in China and globally in the future.Method:A comprehensive study method was conducted on World Expo site including both qualitative and quantitative analysis such as observations, questionnaires and interviews. Referring to the ’guide to Tobacco-Free Mega Events’developed by World Health Organization (WHO), we record the placement of smoke-free signs, tobacco display, tobacco advertising, promotion or sponsorship as well as the smoking occurrence. A repeated cross-sectional survey was employed twice a month from July to October of2010. In all, there were3022tourists completed the questionnaire with the response rate of73%. In the meanwhile, there were300smokers surveyed at the designated smoking areas to understand their opinion to the designated smoking areas in the Expo site, the response rate was100%. Qualitative study included two parts. First, during the Expo, face to face in depth interviews were conducted among staff and to explore their understanding to the implementation of the smoke free policy on the Expo site. The interview time was more than20minutes. After the Expo, we conducted face to face in depth interviews to the expo leader concerning the smoke-free policy and the interview time was more than30minutes.Content:1. Evaluation of the status of tobacco control in the World Expo Zone. Observation was applied to record the smoke free signs, tobacco advertising, smoking occurrence and whether there are some discouragements when it occurs.2. Evaluation of the status of tobacco control in the World Expo Zone among visitors, using questionnaires to evaluate their opinions and suggestions. 3. Opinions and suggestions of the implementation of tobacco control measures in the World Expo Zone among working staff through using in-depth interviews.4. Suggestions about the designed smoking zones in the World Expo, using observation and questionnaire survey among workers to assess the application of ignition device, smokers’ attitude and suggestions for the designated smoking area.5. Sum up the experience of successful implementation of tobacco control measures in the World Expo to provide further experience of creating smoke free environment of large scale activity in the future.Results:1. All pavilions and souvenir shops were smoke-free. Restaurants were smoke-free, with only0.1%of customers observed smoking. Smoking was more common in outdoor non-smoking areas, but still relatively rare overall with only4.5%of visitors observed smoking. Tobacco products were not sold or marketed in any public settings, except for Cuba, Zimbabwe and Nicaragua Pavilions that had special exemptions from the policy.2. Overall,71.7%of visitors knew about the’smoke-free expo’ slogan. There were80.3%of visitors knew the smoke-free measures at the World Expo and media remained main method to know this information. In all,92.5%of visitors supported the policy and97.1%of visitors were satisfied with the smoke-free environment.3. Most staff and volunteers we interviewed knew and supported the smoking ban on the World Expo Site. About60%of staff and volunteers thought the tourists were aware of the rules and could comply with them. With the continuous adjustment of the tobacco control measures in the expo site, the tobacco control status has been gradually improving. However, only a few interviewees mentioned that they had duty to stop the smokers. The main reasons were lacking of training or afraid of conflicts with the visitors.4. Only32.7%of smokers had a good impression with the designated smoking areas in World Expo. Our observation showed that54.3%of lighting devices at the designated smoking areas were available. In addition, there were no obvious signs at the designated smoking areas. Conclusion:1. Tobacco control policies at the World Expo sites were generally well enforced and accepted, although compliance was not100%, particularly in outdoor non-smoking areas.2. The successful implementation of smoke-free measures in the expo site should be attributed to the comprehensive propaganda and the timely adjusted measures.3. The Expo Bureau should strengthen the training of staff to help them increase the awareness of responsibility in enforcing smoke free measures and to improve their dissuading skills.