title: Smoking on the margins: a comprehensive analysis of a municipal outdoor smoke-free policy.
abstract: This study examined the formulation, adoption, and implementation of a ban on smoking in the parks and beaches in Vancouver, Canada.
  
  
  
  Informed by Critical Multiplism, we explored the policy adoption process, support for and compliance with a local bylaw prohibiting smoking in parks and on beaches, experiences with enforcement, and potential health equity issues through a series of qualitative and quantitative studies.
  
  
  
  Findings suggest that there was unanimous support for the introduction of the bylaw among policy makers, as well as a high degree of positive public support. We observed that smoking initially declined following the ban's implementation, but that smoking practices vary in parks by location. We also found evidence of different levels of enforcement and compliance between settings, and between different populations of park and beach users.
  
  
  
  Overall success with the implementation of the bylaw is tempered by potential increases in health inequities because of variable enforcement of the ban; greatest levels of smoking appear to continue to occur in the least advantaged areas of the city. Jurisdictions developing such policies need to consider how to allocate sufficient resources to enhance voluntary compliance and ensure that such bylaws do not contribute to health inequities.
authors.affiliation: BC Women's Hospital + Health Centre, E305, 4500 Oak Street, Vancouver, BC, V6H 3E1, Canada. apederson@cw.bc.ca.
authors.forename: Ann
authors.identifier: 0000-0002-5466-8060
authors.initials: A
authors.lastname: Pederson
authors.affiliation: Faculty of Nursing, University of Kentucky, Lexington, KY, USA.
authors.forename: Chizimuzo T
authors.initials: CT
authors.lastname: Okoli
authors.affiliation: BC Centre of Excellence for Women's Health, Vancouver, BC, Canada.
authors.forename: Natalie
authors.initials: N
authors.lastname: Hemsing
authors.affiliation: University of Victoria, Victoria, BC, Canada.
authors.forename: Renée
authors.initials: R
authors.lastname: O'Leary
authors.affiliation: University of Kentucky, Lexington, KY, USA.
authors.forename: Amanda
authors.initials: A
authors.lastname: Wiggins
authors.affiliation: BC Centre of Excellence for Women's Health, Vancouver, BC, Canada.
authors.forename: Wendy
authors.initials: W
authors.lastname: Rice
authors.affiliation: Institute for Healthy Living and Chronic Disease Prevention, University of British Columbia, Kelowna, BC, Canada.|Faculty of Health Sciences, Australian Catholic University, Melbourne, Australia.
authors.forename: Joan L
authors.initials: JL
authors.lastname: Bottorff
authors.affiliation: BC Centre of Excellence for Women's Health, Vancouver, BC, Canada.
authors.forename: Lorraine
authors.initials: L
authors.lastname: Greaves
mesh_terms: D001493:Bathing Beaches; D001955:British Columbia; D002170:Canada; D002947:Cities; D006801:Humans; D011050:Policy Making; D061845:Smoke-Free Policy / Q000331:legislation & jurisprudence*; D012907:Smoking / Q000331:legislation & jurisprudence*; D014028:Tobacco Smoke Pollution / Q000331:legislation & jurisprudence*
chemical_list: D014028:Tobacco Smoke Pollution
keywords: Beach; Canada; Health equity; Marginalization; Municipal; Outdoor smoking ban; Park; Policy; Tobacco control; population health intervention