BACKGROUND: Incorporating the five key action areas in Health Promotion based on the Ottawa Charter remains a challenge in tobacco control community-based interventions. This study evaluated the effectiveness of smoke-free local administration organizations (LAOs) implementing comprehensive tobacco control interventions based on the Ottawa Charter in 2022 compared to 2021.
METHODS: A participatory action research (PAR) approach was applied in 23 LAOs nationwide, participating in the smoke–free LAOs project under ASH. Each LAO identified community-specific tobacco consumption issues, including smoking prevalence, establishing public areas as designated smoke-free areas, and ensuring compliance with tobacco sales laws. Comprehensive tobacco control interventions, aligned with the five action areas of the Ottawa Charter, were implemented. Research teams supported capacity building among community personnel, provided ongoing supervision, and developed tools for data collection and evaluation. Samples of 22867 individuals aged 15 years and older were selected using a two-stage stratified cluster sampling in 2021, and 33218 individuals were selected in 2022. Observations were conducted in all public areas and stores selling tobacco products—2581 public places and 2237 stores in 2021, as well as 2409 public places and 2060 stores in 2022. Effectiveness was analyzed using Chi-square tests at a 0.05 significance level.
RESULTS: Significant improvements were observed across the 23 LAOs over two batches (p<0.001). Current smoking prevalence among people aged 15 years and above decreased from 19.6% to 17.5%. The proportion of cigarette smokers purchasing single cigarettes dropped from 22.0% to 14.5%, while non-compliance with tobacco sales laws among retailers declined from 42.3% to 34.5%. Additionally, the proportion of 100% smoke-free public areas meeting legal standards increased from 49.5% to 59.6%.
CONCLUSIONS: Comprehensive tobacco control intervention should be promoted and integrated into annual LAO plans to ensure sustained implementation, protecting people from the harmful effects of tobacco and improving community quality of life.