BACKGROUND: Low- and middle-income countries (LMICs) face a disproportionate burden from second-hand smoke (SHS). Creating completely smoke-free indoor public places is a key MPOWER measure to protect against SHS. This study examines how online news outlets in LMICs discuss existing smoke-free policies and their implementation.
METHODS: In September 2023, we used Tobacco Watcher (www.tobaccowatcher.org), a tobacco news surveillance platform, to identify articles using search terms “smoke-free policy” and “implementation” or “compliance" in 10 LMICs between March 2022 and September 2023. Two trained coders independently reviewed all articles to assess their relevance based on the inclusion criteria of either substantially discussing (defined as mentioned in multiple paragraphs) or holding a clear position on smoke-free policy implementation. A content analysis was conducted, with the coders independently coding each article for argument position, content of the argument, evaluation of current implementation efforts, and argument presenters until reaching 80% agreement or higher. Discrepancies in coding were resolved through discussion.
RESULTS: Among 622 articles retrieved, 345 met the inclusion criteria. Most of these articles (81%, n=278) supported implementation of existing smoke-free policies. 31% (n=107) considered current smoke-free policy implementation efforts unsuccessful, citing lack of enforcement, signage, and other violations, while 20% (n=70) considered implementation to be successful. 21% (n=74) suggested a need for stronger smoke-free policies, including the elimination of designated smoking areas. Common argument presenters included government agencies (84%, n=291), non-WHO organizations (e.g. civil society; 40%, n=139), WHO (19%, n=67), and researchers or experts (18%, n=62).
CONCLUSIONS: Discourse around smoke-free policy implementation in online news media of LMICs is generally supportive, praising complete bans and active implementation. Discussion also frequently calls for public mobilization in enforcement efforts. News media can be utilized as avenues for raising awareness surrounding tobacco control challenges, which also indicates the need for stronger policies and implementation.