title: Facilitators and Barriers of Smokers' Compliance with Smoking Bans in Public Places: A Systematic Review of Quantitative and Qualitative Literature.
abstract: Background: Environmental tobacco smoke (ETS) exposure is associated with an increased risk of many diseases. Many countries have ratified a national smoking ban in public places, but studies on factors related to smoking issues in public places post-ban are lacking.Aim: To identify facilitators and barriers that influenced smokers' compliance with smoking bans in public places.Methods: Using PubMed, MEDLINE, and the Web of Science database, we conducted a systematic search of English articles published before June 2015 on factors of smokers' compliance with the smoking bans in public places.Results: A total of 390 references were identified, among which seventeen articles (twelve quantitative studies, two qualitative studies, three mixed-method studies) were included in this review. These studies focused on four types of public places including recreational venues (n= 7), hospital (n= 5), school (n= 4), and workplace (n= 1). Factors at the  individual-, interpersonal-, and organizational-level were identified: at the individual level, nicotine dependence, insufficiency of tobacco-related knowledge, and the negative attitudes towards smoking bans were the most commonly identified barriers; at the interpersonal level, the smoking behaviors of people around, close relatives, and friends' approval were the main barriers; and at the organizational level, the main barriers were inefficient implementation of the bans and the inconvenience of the designative smoking areas.Conclusions: This synthesis of the literature provided evidence of the identified barriers and facilitators of smokers' compliance with the smoking bans. It will be beneficial for the policy-maker to consider interventions on multiple levels of factors to overcome the barriers and enhance smokers' compliance with the smoking bans in public places.
authors.affiliation: Department of Social Medicine and Health Management, School of Public Health, Central South University, Changsha 410078, China. zhouli97328@126.com.
authors.forename: Li
authors.initials: L
authors.lastname: Zhou
authors.affiliation: Department of Social Medicine and Health Management, School of Public Health, Central South University, Changsha 410078, China. angela_niulu@hotmail.com.|Centre for Health Behaviors Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China. angela_niulu@hotmail.com.
authors.forename: Lu
authors.initials: L
authors.lastname: Niu
authors.affiliation: Department of Social Medicine and Health Management, School of Public Health, Central South University, Changsha 410078, China. jh1985126@126.com.
authors.forename: Hui
authors.initials: H
authors.lastname: Jiang
authors.affiliation: Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha 410078, China. xiaoxiaocx123@126.com.
authors.forename: Caixiao
authors.initials: C
authors.lastname: Jiang
authors.affiliation: Department of Social Medicine and Health Management, School of Public Health, Central South University, Changsha 410078, China. xiaosy@csu.edu.cn.
authors.forename: Shuiyuan
authors.initials: S
authors.lastname: Xiao
mesh_terms: D002681:China / Q000453:epidemiology; D040261:Harm Reduction; D006801:Humans; D015995:Prevalence; D011633:Public Facilities / Q000331:legislation & jurisprudence*; D036301:Qualitative Research; D061845:Smoke-Free Policy / Q000331:legislation & jurisprudence*; D012907:Smoking / Q000453:epidemiology / Q000331:legislation & jurisprudence* / Q000523:psychology*; D012931:Social Environment; D014028:Tobacco Smoke Pollution / Q000331:legislation & jurisprudence / Q000517:prevention & control* / Q000706:statistics & numerical data
chemical_list: D014028:Tobacco Smoke Pollution
keywords: barriers; environmental tobacco smoke; facilitators; public places; smoking bans