Smoke-free policies for outdoor areas

There is some evidence that outdoor smoke-free policies reduce smoking in designated areas (Johns 2015, Okoli 2013, Johns 2013), especially when implemented as part of comprehensive smoke-free efforts that ban both indoor and outdoor smoking (Lupton 2015, Lemstra 2008). Banning smoking in public places, including parks, is a recommended strategy to prevent tobacco use among youth (US DHHS SG Tobacco 2012). However, additional evidence is needed to confirm effects, particularly on health outcomes (CG-Tobacco).

Policies that restrict smoking at parks and beaches appear to reduce smoking in those areas (Johns 2015, Okoli 2013). Comprehensive campus smoking bans which include all outdoor areas appear to reduce smoking among college students on campus within one to three years, and may also decrease their daily cigarette consumption (Lupton 2015). An assessment of a large insurance company’s indoor and outdoor smoke-free worksite policy indicates increased quit rates and reduced relapses among tobacco dependence treatment program participants, and decreased daily cigarette consumption among participants who did not quit (Osinubi 2004).

Comprehensive smoke-free policies can reduce secondhand smoke (SHS) exposure more than weaker policies or policies targeted at specific industries (CG-Tobacco), and comprehensive smoking bans may decrease myocardial infarction (Lin 2013, Bruintjes 2011). Smoke-free policies that primarily affect indoor areas have been shown to improve health, reduce cigarette consumption and SHS exposure, and may also reduce smoking prevalence and lead smokers to quit (Hoffman 2015, CG-Tobacco). Smoking in outdoor smoking areas adjacent to indoor smoke-free areas appears to increase SHS concentrations in both areas (Sureda 2013).

National surveys indicate that a majority of non-smokers and smokers support outdoor smoke-free policies for schools and playgrounds (Thomson 2016). However, such policies are in place in only 8% of the country, primarily in higher income areas (Lowrie 2018). Smoke-free park policies are most common in counties with higher socio-economic status residents and in urban and suburban counties (Hood 2014).

Evaluations of efforts to implement smoke-free recreation areas in California suggest having a project champion, engaging youth volunteers, collecting and using local data, and educating the community on smoke-free policies can help lead to successful adoption (Satterlund 2011).

Smoke-free policies for outdoor areas have the potential to decrease disparities in environmental tobacco smoke exposure, which may reduce tobacco-related health disparities, if they are adapted and implemented for populations that experience high disparity rates. Many communities and subpopulations such as rural communities, military veterans, LGBTQIA+ adults, individuals with lower incomes, and those without health insurance are disproportionately affected by cigarette smoking and tobacco use (ALA-Top 11 communities).

While cigarette smoking has declined since 1965, disparities in tobacco use and exposure have persisted. Disparities in smoking by education level have increased, along with secondhand smoke (SHS) exposure by race and socioeconomic status (US DHHS tobacco fact sheet). SHS exposure is greater among Black adults, adults 25 years or older with less than a college degree, and families with incomes below the federal poverty level (US DHHS tobacco fact sheet). Many public housing agencies and other housing for residents with low incomes are adopting smoke-free policies that reduce exposure to SHS; however, implementation and enforcement come with many challenges such as dependence on housing staff to enforce policies and inconsistent policy enforcement, particularly in the evenings and on weekends (Anthony 2019). Experts suggest that creating designated outdoor smoking areas may help address some of these challenges (Hafez 2019).

In the United States, American Indian and Alaska Native (AIAN) adults use commercial tobacco at significantly higher rates than adults in the general population (Soto 2022). This is consistent with health disparities among AIANs related to commercial tobacco use (Soto 2022).

Tobacco has been used in a variety of forms for recreational purposes for centuries. Beginning in the early 1900s and continuing through the 1950s, research was conducted to confirm the link between smoking and lung cancer (ALA-Tobacco control milestones). Alongside this research, public health advocates highlighted the growing evidence of health hazards associated with smoking, such as lung cancer, resulting in educational campaigns, policy changes, and the inclusion of health warnings on tobacco products starting in the late 1960s (ALA-Tobacco control milestones).

Since the 1970s, smoke-free policies for outdoor areas have been implemented by states, communities, and private businesses to address the harm caused by secondhand smoke (SHS) and to reduce the risk of lung cancer. However, there is still uneven access to smoke-free policies, especially in housing situations such as multi-unit residences (Hafez 2019). Individuals with low incomes use tobacco at a higher rate than the general population and are more likely to live in multi-unit homes that lack enforcement of smoke-free policies, which may contribute to increased SHS exposure (Hafez 2019).

In the United States, tribal communities are exempt from smoke-free laws within their state. Tribes can adopt smoke-free policies that meet their communities' unique needs and take their culture and traditions into account (Soto 2022).

• Are smoke-free policies in outdoor spaces common in your community? How are they implemented and enforced?
• If your community includes members of local tribes, are local smoke-free policies considerate of tribal sovereignty and are they culturally sensitive to the use of tobacco for ceremonial purposes?
• What places in your community would benefit from having smoke-free policies in outdoor spaces (e.g., businesses, restaurants, playgrounds and parks, etc.)?

As of 2018, 28 states and Washington, D.C. have comprehensive smoke-free laws that ban smoking in all public places and workplaces (ALA-Smoke-free air, ALA-SLATI-SF policies). As of 2017, 1,531 municipalities and counties have banned smoking in parks, 535 in outdoor transit waiting areas, 489 on outdoor dining and bar patios, and 317 have beaches that are completely smoke-free (ANRF-Smoke-free lists). State legislation pre-empts local government control of smoke-free policies in 12 states (Grassroots Change).

As of 2018, there are 2,279 smoke-free university campuses, of which 1,910 are 100% tobacco-free (ANRF-Smoke-free lists).

ALA-Smoke-free air - American Lung Association. Smokefree air laws. 2018.

ANRF-Smoke-free lists - American Nonsmokers’ Rights Foundation. Smokefree lists and maps. 2018.

CDC SF Toolkit - Loomis B. Evaluation toolkit for smoke-free policies. Atlanta: Centers for Disease Control and Prevention (CDC); 2008.

ChangeLab-SF places - ChangeLab Solutions. Comprehensive smokefree places: A model California ordinance regulating smoking in indoor & outdoor areas.

HealthPartners-CHA - HealthPartners Institute for Education and Research. Community health advisor (CHA): Resource for information on the benefits of evidence-based policies and programs: Helping communities understand, analyze, and model costs.

PHLC-ALA-Smoke-free outdoor areas - Public Health Law Center (PHLC) and American Lung Association (ALA): California. Smoke- and tobacco-free outdoor areas model ordinance. 2021.

PHLC-ALA-Smoke-free outdoors - Public Health Law Center (PHLC) and American Lung Association (ALA). Smoke-free outdoor areas enforcement guide. 2022.

* Journal subscription may be required for access.

ALA-SLATI-SF policies - American Lung Association, Tobacco Policy Project/State Legislated Actions on Tobacco Issues. Smoke-free laws and policies. 2018.

ALA-Smoke-free air - American Lung Association. Smokefree air laws. 2018.

ALA-Tobacco control milestones - American Lung Association (ALA). (2026, February 6). Tobacco control milestones. Research & Reports: State of Tobacco Control. Retrieved March 11, 2026.

ALA-Top 11 communities - American Lung Association (ALA). (2026, February 6). Top 11 communities most affected by cigarette smoking and tobacco use. Research & Reports: State of Tobacco Control. Retrieved March 11, 2026.

ANRF-Smoke-free lists - American Nonsmokers’ Rights Foundation. Smokefree lists and maps. 2018.

Anthony 2019* - Anthony, J., Goldman, R., Rees, V. W., Frounfelker, R. L., Davine, J., Keske, R. R., Brooks, D. R., & Geller, A. C. (2019). Qualitative assessment of smoke-free policy implementation in low-income housing: Enhancing resident compliance. American Journal of Health Promotion, 33(1), 107–117.

Bruintjes 2011* - Bruintjes G, Bartelson BB, Hurst P, et al. Reduction in acute myocardial infarction hospitalization after implementation of a smoking ordinance. The American Journal of Medicine. 2011;124(7):647-54.

CG-Tobacco - The Guide to Community Preventive Services (The Community Guide). Tobacco.

Grassroots Change - Grassroots Change: Connecting for better health. Preemption Watch.

Hafez 2019* - Hafez, A. Y., Gonzalez, M., Kulik, M. C., Vijayaraghavan, M., & Glantz, S. A. (2019). Uneven access to smoke-free laws and policies and its effect on health equity in the United States: 2000–2019. American Journal of Public Health, 109(11), 1568–1575.

Hoffman 2015 - Hoffman SJ, Tan C. Overview of systematic reviews on the health-related effects of government tobacco control policies. BMC Public Health. 2015;15:744.

Hood 2014* - Hood NE, Bernat DH, Ferketich AK, Danesh D, Klein EG. Community characteristics associated with smokefree park policies in the United States. Nicotine & Tobacco Research. 2014;16(6):828-835.

Johns 2013* - Johns M, Coady MH, Chan CA, et al. Evaluating New York City's smoke-free parks and beaches law: A critical multiplist approach to assessing behavioral impact. American Journal of Community Psychology. 2013;1(1-2):254-263.

Johns 2015* - Johns M, Farley SM, Rajulu DT, Kansagra SM, Juster HR. Smoke-free parks and beaches: an interrupted time-series study of behavioural impact in New York City. Tobacco Control. 2015;24:497-500.

Lemstra 2008* - Lemstra M. Canadian Journal of Public Health / Revue Canadienne de Sante'e Publique. 2008;101(6):445-447.

Lin 2013 - Lin H, Wang H, Wu W, et al. The effects of smoke-free legislation on acute myocardial infarction: A systematic review and meta-analysis. BMC Public Health. 2013;13:529.

Lowrie 2018 - Lowrie C, Pearson AL, Thomson G. Inequities in coverage of smokefree outdoor space policies within the United States: school grounds and playgrounds. BMC Public Health. 2018;18(1).

Lupton 2015* - Lupton RJ, Townsend LJ. A systematic review and meta-analysis of the acceptability and effectiveness of university smoke-free policies. Journal of American College Health. 2015;63(4):238-247.

Okoli 2013 - Okoli C, Johnson A, Pederson A, Adkins S, Rice W. Changes in smoking behaviours following a smokefree legislation in parks and on beaches: An observational study. BMJ Open. 2013;3(6):1-7.

Osinubi 2004* - Osinubi O, Sinha S, Rovner E, et al. Efficacy of tobacco dependence treatment in the context of a "smoke-free grounds" worksite policy: A case study. American Journal of Industrial Medicine. 2004;46:180-187.

Satterlund 2011 - Satterlund TD, Cassady D, Treiber J, Lemp C. Strategies implemented by 20 local tobacco control agencies to promote smoke-free recreation areas, California, 2004-2007. Preventing Chronic Disease. 2011;8(5):A111.

Soto 2022* - Soto, C., Ramos, G., Martinez, D., Moerner, L., Salinas, E., Battle, R., & Yerger, V. (2022). A qualitative assessment of the perceptions and attitudes towards commercial tobacco policies and education among tribal communities in California. The American Journal of Drug and Alcohol Abuse, 48(1), 49–57.

Sureda 2013 - Sureda X, Fernandez E, Lopez MJ, Nebot M. Secondhand tobacco smoke exposure in open and semi-open settings: a systematic review. Environmental Health Perspectives. 2013;121(7):766-773.

Thomson 2016* - Thomson G, Wilson N, Collins D, Edwards R. Attitudes to smoke-free outdoor regulations in the USA and Canada: A review of 89 surveys. Tobacco Control. 2016;25(5):506-516.

US DHHS SG Tobacco 2012 - U.S. Department of Health and Human Services (U.S. DHHS). A report of the Surgeon General: Preventing tobacco use among youth and young adults; 2012.

US DHHS tobacco fact sheet - U.S. Department of Health and Human Services (U.S. DHHS), Office of the Surgeon General. (2024, November 18). Tobacco reports and publications: Addressing tobacco-related health disparities, TRHD fact sheet. Retrieved February 10, 2026.

WI Statute 101.123 - Wisconsin State Legislature. WI Statute 101.123: Smoking prohibited.