Background:
The prevalence of daily smoking among youth at Danish vocational schools is 37 %, while the prevalence among high-school students is 12 %. Vocational schools are an important setting for health promotion to target inequality in health. Implementing Tobacco-Free-Schools (TFS) may reduce smoking among both students and staff. Smoking among students and staff has been found to be an important setting for socializing and bonding and the schools are reluctant to enforce TFS. The objective of this study was to investigate attitudes towards TFS among managers and staff across all Danish vocational schools, and determine characteristics of schools with a positive attitude towards TFS opposed to schools with a more negative attitude.

Methods:
A total of 72 out of 87 (83%) vocational schools in Denmark participated in an electronic survey on health promotion activities and implementation capacity with a least one respondent. Overall a total of 185 respondents from management and 345 teaching staff participated (n=530). Data was analyzed in SPSS using univariate and multilevel modelling to detect differences between managers and staff in attitudes towards TFS and to identify characteristics of progressive TFS schools (28 schools) compared to non-progressive schools (44).

Results:
Staff were more positive than managers towards future implementation of TFS (p< 0,05). Size of school (increasing size), gender (having a female manager), school type (health and teaching) and school health promotion profile (more initiatives and policies in general) were associated with being more positive towards TFS at the school level.

Conclusions:
This study is one of the first to address attitudes towards TFS and characteristics of being a progressive TFS school in a national representative sample. Vocational schools are an important setting to target smoking among youth, and this study highlights the need to address implementation of TFS on multiple levels.