Smoke-free policies for outdoor areas

Evidence Rating  
Evidence rating: Some Evidence

Strategies with this rating are likely to work, but further research is needed to confirm effects. These strategies have been tested more than once and results trend positive overall.

Health Factors  
Date last updated

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 impact health disparities? This strategy is rated no impact on disparities likely.
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

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.


* 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.