Smokers’ responses to being addressed when smoking in an outdoor voluntary smoke-free zone: An observational study 235 6 resulted in more positive responses of smokers being addressed. Combined with a positive approach, a positive response is likely. Finally, the indifference in the results when using a Smoke-Free Generation vest stresses that anyone can address smokers. Strengths and limitations The strength of this study lies within the repeated measurements on alternating days and times. Furthermore, during observations at least two researchers were present to ensure quick resolution of conflicting observations. It should be noted that those responding angrily to being addressed were often patients. A rather consistent group of smoking patients seated at a particular bench within the zone was addressed daily and this caused frustration. After several days it was decided to no longer address this group, which may have resulted in an underrepresentation of negative responses. However, including them would also be problematic as this group consisted largely of the same people every day. Double counting may have also occurred. Further limitations are the short timeframe between implementation of the zone and this study, and the homogeneity of addressors in the second two observation-weeks (e.g. female medical students). Future research More in-depth research is needed to assess how smokers actually experience being addressed, what they feel they need to adapt their behaviour and why they feel a certain way after being addressed. Such information is an important step in developing recommendations for effective addressing and increasing compliance with voluntary smoke-free policies. Additionally, further research on how to strengthen self-efficacy of addressors is important, as the feeling that addressing smokers is easy, is an important predictor of doing so18. Conclusions Whereas many people may experience barriers to addressing smokers who smoke within a smoke-free zone, our study shows that addressing of smokers often elicits positive responses and may help increase compliance to the smokefree policy. A positive, calm and non-judgemental approach seems to be key in addressing. Our findings may help increase self-efficacy of those reluctant to address smokers in smoke-free zones.
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