Chapter 3 60 those more vulnerable to the adverse health effects of SHS.21 For example, in the US and Canada public support for smoke-free playgrounds (89-91%) was substantially higher than for smoke-free outdoor workplaces (12-46%) and sidewalks (31-49%).17 Context-specific determinants may also contribute to differences in public support across settings. Aspects that enhanced successful adoption of smoke-free zones at outdoor school grounds at secondary schools included communication about the policy, collaboration between and within stakeholders, social norms, and evidence about the effectiveness of smoke-free zones.22 A structured overview of the levels and determinants of public support for smokefree policies beyond enclosed public places and workplaces across various settings is currently lacking. Having these insights may guide policy makers with the implementation of policies that receive the highest levels of support, and may help in defining additional strategies that are needed to increase public support in the population. To address this gap in the literature our primary objective is to summarise the level of public support across the globe for novel smoke-free policies and to evaluate if public support changed following implementation of the novel smoke-free policies across various settings. To do so a systematic review and meta-analysis will be conducted. The secondary objective is to identify determinants associated with public support at the following three levels: 1) withinstudy determinants (e.g. age, smoking status, parental status), 2) between-study determinants (e.g. income level of the country, whether smoke-free legislation in enclosed public places and workplaces was already in place), and 3) contextspecific determinants (e.g. setting, framing, enforcement of smoke-free policies). Methods and analysis We used the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) guidelines to facilitate development of this protocol, see appendix I. In this review, we will use the term ‘traditional smoke-free legislation’ to refer to smoke-free legislation covering enclosed public places and workplaces (i.e. compliant with Article 8(2) of the Framework Convention on Tobacco Control; FCTC) and the term ‘novel smoke-free policies’ to refer to policies and legislation regulating smoking in any other places, such as (semi)private places and (partially) outdoor spaces, whether public or (semi)private.23 Policies are used
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