Informing outdoor smokefree policy: Methods for measuring the proportion of people smoking in outdoor public areas

Introduction: To advance the design and implementation of outdoor smokefree area policies, we aimed to develop simple, low-cost methods for measuring smoking in a variety of public places. Methods: Two methods were developed and were used by solo observers during March 2011-February 2012 to measure the proportion of people smoking at a variety of sites. Results: Both methods performed well (n=5553 people observed); the first at 58 sites in the UK and New Zealand (n=3191 observed); the second at 33 sites in New Zealand (n=2362 observed), with significant differences found between the smoking at types of sites and between countries. For the two countries combined, the proportions of people smoking (amongst those over 12 years) in children's play areas was significantly lower compared to all the other sites combined (risk ratio = 0.39; 95%CI: 0.20 to 0.76; p=0.002). Conclusions: Solo observers can establish the proportion of people smoking in a range of outdoor sites. Such methods can inform outdoor smokefree area policymaking by providing baseline and post-policy data to enable location targeting and policy evaluation. (C) 2012 Elsevier Ltd. All rights reserved.