Implementation of smoke free policy in restaurant setting - experience of a NGO in Vietnam

Abstract

Background and challenges to implementation: The Vietnam Tobacco Control Law, effective since May 2013, requires all indoor public places including restaurants and cafeterias be 100% smoke-free. However, GATS 2015 findings showed the highest prevalence and the most modest reduction of second-hand smoke exposure in restaurants during 2010-2015 (80.7% and 84.9% respectively) compared to other settings. The challenges were low political commitment and reluctance of authorities to implement smoke-free policies in restaurants, the resistance of business owners due to concerns about losing profits and competitive edge, and high public acceptability of smoking. Intervention or response: In 2015-2016, HealthBridge worked with the Hanoi city and districts' Health Departments and other partners on “Strengthening implementation of smoke-free restaurants (SFR) in Hanoi”. The project's strategies were: i) Advocacy to add SFR implementation into the Hanoi city action plan; ii) Facilitate the role of local authorities at district level in managing, training, monitoring, and enforcing the implementation of SFR instead of focusing authorities at city level; iii) Peer education to engage managers of compliant SFR to share their experience to create the trust and motivation of restaurant owners; iv) Media campaigns to raise public awareness and support. Results and lessons learnt: Managers of 600 restaurants were trained on SFR implementation. 400 of them signed a commitment to be smoke-free. Monitoring visits of authorities at district level was established for the first time and deployed regularly. This proved to be a sustainable enforcement mechanism because of its simple administrative procedure for setting up when compare to interdisciplinary team of authorities at city level. The rate of restaurants going smoke-free increased from 25% to 44% (prepost intervention survey). The knowledge and support from customers and restaurant owners on SFR policy also increased significantly. Conclusions and key recommendations: The project's strategies have proven to be effective in improving the implementation of smoke-free policy in restaurants. These strategies should be scaled up to other areas.