Chapter 6 230 Abstract Introduction Addressing smokers who smoke in a voluntary smoke-free area is vital for successful implementation. Many people perceive barriers to addressing smokers due to fear of negative responses. Insights in actual responses are currently lacking. Methods Observational field study at the voluntary smoke-free zone surrounding the Erasmus MC and two schools in Rotterdam, the Netherlands. In the first month after implementing the zone, Erasmus MC representatives performed rounds to address smokers who were smoking inside the zone. Four observers observed addressors and after two weeks of observing also addressed smokers themselves. Smokers were classified as employee, patient, student or other. The type of addressing, verbal response and behavioural response were noted. Differences between the responses of the groups were assessed using chi-squared tests. Results 331 smokers were observed, of whom 73% were addressed directly. Most verbal reactions were positive (46%) or neutral (18%). Employees were more likely to respond guiltily, whereas patients more often responded angrily than others. After being addressed, the majority of smokers either extinguished their cigarette (41%) or left to continue smoking outside the smoke-free zone (34%). Conclusion Most smokers showed a positive or neutral response when being addressed on smoking inside the smoke-free zone and the majority adapted their behaviour to comply with the policy. These findings may help decrease barriers for those in doubt to address smokers violating a smoke-free policy.
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