Public support for smoke-free policies in outdoor areas and (semi-) private places: a systematic review and meta-analysis 93 4 that, support was generally higher for semi-private places compared to private places. For example, support for smoke-free regulations in multi-unit housing (76%) was higher compared to private housing (59%). Of all places evaluated in our study, the highest level of support was found for smoke-free cars: eight out of ten participants were in favour of cleaning the air in cars when children are present. This is in agreement with a previous brief review of support for smoke-free cars, which included studies up to 2008.133 Our report, including studies up to 2022, similarly shows consistently high levels of support for smoke-free cars with children. This is important given the established impact of smoke-free car policies, which have been shown to reduce exposure to second-hand smoke by 31%,7, 134 and reduced paediatric hospital admissions for asthma in Scotland.135 A similarity between the places with highest support was their link with children, suggesting the effectiveness of approaching tobacco control as a child health issue.136 In addition to protecting children from tobacco smoke exposure, smokefree policies in these places also protect children through role-modelling, i.e. being less exposed to smoking imagery which decreases their risk of becoming a smoker.137, 138 This perspective is especially important to justify smoke-free policies outdoor areas that are well ventilated but have many underage visitors, such as beaches. Another argument for banning smoking in such areas is its impact on reducing littering from cigarette butts, which contain micro plastics and other toxic substances that pollute the environment.139 140 Such aspects may be used to inform the public of why smoke-free policies are important, other than directly protecting individuals from being exposed to other people’s tobacco smoke. The large number of reports included enabled us to evaluate differences in support between population subgroups. Perhaps unsurprisingly, higher levels of support were found among non-smokers and former smokers compared to current smokers.11, 141 Furthermore, subgroup analyses identified a small difference in support among men and women, with higher levels of support among women. This may be because women generally perceive SHS as more harmful compared to men,142 and see smoking as less socially acceptable.143 As voluntary smokefree rules are already often applied by parents in places such as private homes and cars,144-146 we anticipated that levels of support would be higher among parents. However, no significant differences were found between parents and
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