Strengthening Outdoor Secondhand Smoke Control: Building a Smoke-free Environment

Recently, the offices of the Patriotic Hygiene Campaign Committee of Shanghai, the Social Work Department of the Shanghai Municipal Party Committee of the Communist Party of China, the Office of Spiritual Civilization Construction of Shanghai, the Shanghai Municipal Commission of Commerce, the Shanghai Municipal Education Commission, the Shanghai Municipal Transportation Commission, the Shanghai Municipal Administration of Culture and Tourism, the Shanghai Municipal Health Commission, and the Shanghai Municipal Market Supervision Administration jointly issued a notification on further strengthening outdoor secondhand smoke control and promoting the construction of a smoke-free healthy environment. They have clearly defined and regulated specific requirements for eight key locations such as outdoor waiting areas, deepening the city's "Three-Step Smoking Control Action" (indoor smoking ban, no smoking outdoors, smoking areas marked clearly), reinforcing the advocacy and practice of civilized and healthy behaviors of "no smoking outdoors," and jointly building a healthy Shanghai. This is the first provincial-level multi-departmental joint document in the country to strengthen outdoor secondhand smoke control. According to a survey of outdoor secondhand smoke exposure among residents conducted by the Municipal Patriotic Health Office and the Municipal Health Promotion Center, the top five places where residents are most exposed to outdoor secondhand smoke are outdoor waiting areas (such as tourist attractions, restaurants, beverage stores, etc.), sidewalks and intersections, outdoor playgrounds, bus stops, and entrances and exits of shopping malls and business buildings. Residents have strong reactions to outdoor secondhand smoke at three types of locations, namely school entrances (during student drop-off and pick-up times), hospital entrances, and subway station entrances, with particular attention to "walking and smoking" behavior. The prevalence of outdoor secondhand smoke and walking and smoking seriously diminishes residents' travel experiences and quality of life, causing significant negative impacts on public environments and the health of residents.

According to the "Shanghai Public Place Smoking Control Regulations," following the example of international advanced regions and cities, the Municipal Health and Family Planning Commission, along with relevant member units, will jointly promote advocacy for not smoking outdoors indiscriminately. Work requirements will be put forward to the management of eight key types of venues and the responsible administrative departments throughout the city.

One is the outdoor waiting area, which will provide training for staff at scenic spots, restaurants, beverage shops, etc. on the dangers of tobacco to health and smoking cessation skills. Smoke prevention and health reminders related to the harm of tobacco will be added to the waiting area.

Secondly, at pedestrian pathways and intersections with waiting areas for traffic lights, non-smoking advocacy reminders will be added at intersections with audio broadcast prompts, with anti-smoking volunteers carrying out persuasion efforts.

Thirdly, in outdoor amusement parks, "no smoking anywhere" is written in the visitor guidelines. The park management provides training for employees on the dangers of tobacco and smoking prevention skills, and assigns dedicated or part-time anti-smoking workers to conduct inspections during the park's operating hours.

The fourth measure is to post no-smoking signs at bus stops, either on the ground or in other prominent locations, and to conduct spray painting for visibility. Health promotion messages such as the dangers of tobacco and reminders to not smoke everywhere should be displayed on the advertising boards at the platforms. Ashtrays and other smoking devices should not be placed inside the platforms, and the bus station operating company should regularly arrange for cleaning staff to manage the platforms.

The fifth point is the entrances and exits of shopping malls and office buildings, which are managed by the property management for smoke control. It involves increasing education on smoke control for on-site merchants, building tenants, and owners, adding smoke control clauses to lease and rental contracts, and reasonably setting up outdoor smoking areas away from entrances and exits in accordance with the requirements for the establishment and management of outdoor smoking areas. Security personnel are responsible for guiding smokers to designated smoking areas.

At the entrance of the school, smoking cessation education is carried out through campus radio, health education classes, class meetings, parent meetings, and other organizational forms. A "Smoke-Free Campus" sign is also set up to remind people not to smoke in waiting areas. If visitors smoke, security personnel and staff are promptly reminded and discouraged from doing so.

At the entrance of the hospital building, a "Smoke-Free Hospital" sign has been installed. If smokers are found smoking anywhere, security personnel and volunteers are responsible for reminding and dissuading them. Health education videos on the dangers of tobacco and smoking-related diseases are played in the outpatient hall to strengthen smoking cessation clinic promotion and enhance smoking cessation services.

At Exit B of the subway station, smoke control signs and markings are installed based on the characteristics of the exit. Employees receive training in tobacco hazards and smoking prevention skills. Smokers at the gates are discouraged, and regular inspections are conducted at each exit.

The Municipal Health and Family Planning Commission stated that the city will strengthen supervision and law enforcement of smoking control in outdoor designated no-smoking areas in public places, recruit, train, and manage smoking control volunteers, further promote social governance of smoking control, carry out social publicity for typical cases, and promote the healthy concept of "no smoking outdoors everywhere". At the same time, it requires the management of all venues to strengthen smoking control management and work together to create a healthy city.