Smoke-free policies for outdoor areas
Outdoor smoke-free policies include private sector rules and public sector regulations that prohibit smoking outside or restrict it to designated areas. Private sector policies generally ban smoking on worksite property, while state and local ordinances often establish smoke-free standards for specified outdoor public areas such as parks and beaches1. Some local governments cannot enact such measures due to state preemption legislation2.
Note: The term “tobacco” in this strategy refers to commercial tobacco, not ceremonial or traditional tobacco. County Health Rankings & Roadmaps recognizes the important role that ceremonial and traditional tobacco play for many Tribal Nations, and our tobacco-related work focuses on eliminating the harms and inequities associated with commercial tobacco.
What could this strategy improve?
Expected Benefits
Our evidence rating is based on the likelihood of achieving these outcomes:
Reduced smoking in outdoor spaces
Potential Benefits
Our evidence rating is not based on these outcomes, but these benefits may also be possible:
Reduced youth smoking
Reduced tobacco consumption
Increased quit rates
Reduced exposure to secondhand smoke
Improved health outcomes
What does the research say about effectiveness?
There is some evidence that outdoor smoke-free policies reduce smoking in designated areas3, 4, 5, especially when implemented as part of comprehensive smoke-free efforts that ban both indoor and outdoor smoking6, 7. Banning smoking in public places, including parks, is a recommended strategy to prevent tobacco use among youth8. However, additional evidence is needed to confirm effects, particularly on health outcomes1.
Policies that restrict smoking at parks and beaches appear to reduce smoking in those areas3, 4. 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 consumption6. 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 quit9.
Comprehensive smoke-free policies can reduce secondhand smoke (SHS) exposure more than weaker policies or policies targeted at specific industries1, and comprehensive smoking bans may decrease myocardial infarction10, 11. 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 quit1, 12. Smoking in outdoor smoking areas adjacent to indoor smoke-free areas appears to increase SHS concentrations in both areas13.
National surveys indicate that a majority of non-smokers and smokers support outdoor smoke-free policies for schools and playgrounds14. However, such policies are in place in only 8% of the country, primarily in higher income areas15. Smoke-free park policies are most common in counties with higher socio-economic status residents and in urban and suburban counties16.
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 adoption17.
How could this strategy advance health equity? This strategy is rated potential to decrease disparities: suggested by intervention design.
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 use21.
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 status22. 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 level22. 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 weekends23. Experts suggest that creating designated outdoor smoking areas may help address some of these challenges24.
In the United States, American Indian and Alaska Native (AIAN) adults use commercial tobacco at significantly higher rates than adults in the general population25. This is consistent with health disparities among AIANs related to commercial tobacco use25.
What is the relevant historical background?
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 cancer21. 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 1960s21.
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 residences24. 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 exposure24.
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 account25.
Equity Considerations
- 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.)?
Implementation Examples
As of 2018, 28 states and Washington, D.C. have comprehensive smoke-free laws that ban smoking in all public places and workplaces18, 19. 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-free20. State legislation pre-empts local government control of smoke-free policies in 12 states2.
As of 2018, there are 2,279 smoke-free university campuses, of which 1,910 are 100% tobacco-free20.
Implementation Resources
‡ Resources with a focus on equity.
ALA-Smoke-free air - American Lung Association. Smokefree air laws. 2018.
ANRF-Smoke-free lists - American Nonsmokers’ Rights Foundation. Smokefree lists and maps. 2018.
ChangeLab-SF places - ChangeLab Solutions. Comprehensive smokefree places: A model California ordinance regulating smoking in indoor & outdoor areas.
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.
CDC SF Toolkit - Loomis B. Evaluation toolkit for smoke-free policies. Atlanta: Centers for Disease Control and Prevention (CDC); 2008.
PHLC-ALA-Smoke-free outdoors - Public Health Law Center (PHLC) and American Lung Association (ALA). Smoke-free outdoor areas enforcement guide. 2022.
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.
Footnotes
* Journal subscription may be required for access.
1 CG-Tobacco - The Guide to Community Preventive Services (The Community Guide). Tobacco.
2 Grassroots Change - Grassroots Change: Connecting for better health. Preemption Watch.
3 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.
4 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.
5 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.
6 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.
7 Lemstra 2008 - Lemstra M. Canadian Journal of Public Health / Revue Canadienne de Sante'e Publique. 2008;101(6):445-447.
8 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.
9 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.
10 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.
11 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.
12 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.
13 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.
14 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.
15 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).
16 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.
17 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.
18 ALA-Smoke-free air - American Lung Association. Smokefree air laws. 2018.
19 ALA-SLATI-SF policies - American Lung Association, Tobacco Policy Project/State Legislated Actions on Tobacco Issues. Smoke-free laws and policies. 2018.
20 ANRF-Smoke-free lists - American Nonsmokers’ Rights Foundation. Smokefree lists and maps. 2018.
21 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 February 10, 2026.
22 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.
23 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.
24 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.
25 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.
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