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Implementation of the smoke-free policy in Medan City, Indonesia: Compliance and challenges

Nasution, F., Gurning, F., Siregar, P. , Ahsan, A. & Kusuma, D. ORCID: 0000-0002-1909-9341 (2022). Implementation of the smoke-free policy in Medan City, Indonesia: Compliance and challenges. International Journal of Preventive Medicine, 13(1), doi: 10.4103/ijpvm.IJPVM_106_20


Background: Indonesia has an estimated 61.4 million current smokers, and the smoking prevalence among adults is persistently high while that among youth is increasing. In 2014, Medan city enacted the smoke-free policy (SFP) to protect community members against the adverse effects of smoking. Our study examines the implementation of SFP in terms of compliance and challenges.

Methods: We conducted a mixed-methods study. Quantitative analyses examined the compliance with six criteria including having signage, no active smoking, no selling, no advertisement, no smoke, and no ashtray at SFP facilities. They included health facilities, educational facilities, places of worship, workplaces, and indoor/outdoor public facilities. The qualitative analysis examined the challenges through in-depth interviews of six key informants.

Results: We found the overall compliance of 44%, ranging from 0% at outdoor public facilities to 83% at health facilities. We found relatively higher compliance among facilities within 1-km from the provincial and city health offices compared to those outside of the buffer (but not significant at 5% level, P = 0.070). The challenges identified were lack of budget, monitoring, enforcement, and sensitization.

Conclusions: The implementation of SFP in Medan city still has lower compliance and faces many challenges.

Publication Type: Article
Additional Information: This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution‑NonCommercial‑ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non‑commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
Publisher Keywords: Challenge, compliance, implementation, Indonesia, Medan, smoke‑free policy
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Departments: School of Health & Psychological Sciences > Healthcare Services Research & Management
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