（原文）Protect from tobacco smoke
Progress in implementing smoke-free policies
There was notable progress between 2007 and 2008 in protecting people from the harms of second-hand tobacco smoke. Seven more countries (Colombia, Djibouti, Guatemala, Mauritius, Panama, Turkey and Zambia) joined the group of countries with complete policies in 2008, bringing the total number with comprehensive smokefree laws to 17.
The total global population covered by comprehensive smoke-free laws increased from 3.1% to 5.4% in just one year, so that 154 million additional people worldwide are protected from the harms of second-hand tobacco smoke. Several of these countries progressed from having either no national smoke-free law or only minimal protection in some types of public places or workplaces to full protection in all types of places.
However, 114 countries at all levels of economic development still have the lowest level of legal protection: no smoke-free policies in place at all, or policies that cover only one or two of the eight types of public places assessed.
Nearly half of high-income countries, and nearly two thirds of low- and middleincome countries, have the lowest level of protection. More than a third of high-income countries, about a quarter of middle-income and about a third of low-income countries have attained intermediate levels of achievement with three or more, but not all, types of public places and workplaces completely smokefree.
The greatest progress in enacting comprehensive smoke-free laws was made among middle-income countries, with six out of seven additional countries that have enacted comprehensive policies covering all public places.
In several countries, in order to significantly expand the creation of smoke-free places including restaurants and bars, it was politically necessary to include exceptions to the law that allowed for the provision of designated smoking rooms. The requirements for designated smoking rooms are so technically complex and stringent that, for practical purposes, few or no establishments were expected to implement them. Because no data were requested on the number of complex designated smoking rooms actually constructed, it is not possible to know whether these laws have resulted in the complete absence of such rooms, as intended. For this reason, these few countries have not been categorized in the analyses for this section. Future data collection efforts will include such measures, as well as incorporate evaluation of legislation enforcement. As noted in the beginning of this report, as well as in the WHO FCTC Article 8 guidelines and multiple other governmental and nongovernmental reports, ventilation and other forms of designated smoking areas do not fully protect from the harms of secondhand tobacco smoke, and the only laws that provide complete protection are those that result in the complete absence of smoking in all public places. Smoke-free legislation is more likely to cover some places than others
Only 17 countries currently have smoke-free policies that provide universal and effective protection from second-hand tobacco smoke. In the great majority of countries, workers and members of the public are not protected equally from second-hand smoke, such that in many cases some workers are still exposed to its toxic effects.
About half of the world’s population (49%) is currently protected by national smoke-free policies that cover health-care and educational facilities, but only about 5% are protected by smoke-free laws that cover restaurants, pubs and bars.
About a third of countries protect their population from exposure to secondhand tobacco smoke with laws covering universities, and about 30% protect people at government facilities, but only 22% protect workers in indoor offices.
About 30% of countries protect people with smoke-free legislation that covers public transport facilities; although smoking is frequently banned in transport vehicles, it is more likely to be permitted in stations as well as in semi-private vehicles such as taxis.
Few countries have good compliance with comprehensive smoke-free legislation
Good policy with inadequate compliance does not protect people from the dangers of second-hand tobacco smoke. Policy implementation must also be accompanied by a high level of compliance with those policies, so that the population is actually protected in fact and not merely theoretically protected on paper. Compliance with smoke-free policies varies greatly among countries, with comprehensive bans more likely to be complied with than smokefree laws covering only some public places.
Countries without comprehensive smoking bans are most likely to have the lowest levels of compliance.
Wealthier countries are more likely to achieve high compliance with their comprehensive smoke-free legislation.
Among high-income countries, four of five that have implemented comprehensive national smoke-free legislation have high compliance with the laws (with one country not reporting). Only three of 10 middle-income countries with comprehensive legislation have high compliance, and none of the two lowincome countries with comprehensive laws have high compliance, suggesting that these laws are not fully protecting their citizens.
Compliance with smoke-free policies varies by type of location of the nearly half of countries that have policies in place (about 50%) report high levels of compliance in any one sector. Sectors with highest compliance reported are public transport (50% of countries have high compliance), indoor offices (49%), health-care facilities (42%), educational facilities except universities (38%), and restaurants (32%) and bars (30%).
Countries with comprehensive smoke-free laws are more likely to have strong enforcement provisions For the first time in 2008, data were collected regarding existence of legal provisions for enforcement of smoke-free laws. Strong enforcement mechanisms for smoke-free laws – including provisions such as fining businesses or establishments who are in violation of the law and the presence of a complaints system to report violations – are most likely to have been passed in higher-income countries. Of five high-income countries with comprehensive smoke-free laws, three have legislative language allowing clear, strong mechanisms for enforcement of their smoke-free law. In the middle-income group of countries, eight of ten with comprehensive smoking laws have strong enforcement mechanisms, as do one of two countries in the low-income group where all public places are smoke-free. Smoke-free legislation at the subnational level
In 2008, data were collected for the first time regarding implementation of smoke-free legislation at the subnational level. Many countries have a government system in which state/provincial and local jurisdictions have significant legislative power and have the ability to enact smoke-free legislation (and other laws) independently from national governments.
Among the large number of countries that have not enacted comprehensive smoke-free legislation at the national level, some subnational jurisdictions have been successful in enacting their own comprehensive smoke-free legislation. Often, it is more politically feasible to enact smoke-free legislation that covers a smaller population, such as a specific city or province. In some countries (notably
Australia, Canada and the United States), governments at the state/provincial level have broad legislative powers, which in most other countries are reserved for the national government.
Currently, 7% of people in high-income countries are covered by comprehensive smoke-free legislation at the national level, and an additional 8% are covered at the subnational level. However, there has been almost no implementation of smoke-free legislation at the subnational level in middle- and low-income countries, despite many of these jurisdictions having the legal authority to do so.
If all subnational jurisdictions with the legal authority to implement comprehensive smoke-free policies were to do so, an additional 3.3 billion people would be protected from second-hand tobacco smoke. Among the population not currently protected by smoke-free legislation, 53% could potentially be protected through laws passed at the subnational level.
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