Compliance with smoke-free regulations in public places and workplaces: evidence from Vietnam 2024

Despite the existence of the smoke-free regulations, smoking prevalence and exposure to secondhand smoke in Vietnam remain high, particularly in hospitality venues. Using data from the Provincial Global Adult Tobacco Survey (PGATS) 2024 in Vietnam, this study aimed to assess adherence with smoke-free regulations in public places, analyze the association between the presence of no-smoking signage and tobacco sales/advertising with smoking evidence status. This was a cross-sectional observational study conducted in Vietnam from July 2024 to December 2024. Compliance with smoke-free regulations is understood as the complete absence of any smoking evidence in public places, regardless of the source. A total of 3,028 observations were conducted across public places and workplaces in 37 provinces and cities in Vietnam, using the PGATS 2024 Observation Checklist. This was a cross-sectional observational study conducted in Vietnam from July 2024 to December 2024. Compliance with smoke-free regulations is understood as the complete absence of any smoking evidence in public places, regardless of the source. A total of 3,028 observations were conducted across public places and workplaces in 37 provinces and cities in Vietnam, using the PGATS 2024 Observation Checklist. Compliance with smoke-free regulations was low in restaurants (36.3%) and high in schools (86.7%). The signage score was positively associated with compliance in some settings (schools: AOR = 4.82; 95%CI: 2.02–11.47). The odds of compliance/non-compliance at venues without tobacco sales or advertising were higher than the odds of compliance/non-compliance at venues with tobacco sales or advertising (bus stations: AOR = 72.93; 95%CI: 22.01–241.65). Compliance with smoke-free regulations in public places in Vietnam was low relative to the legal requirement for smoke-free indoor public places, especially in restaurants, cafes (63.7%), and hotels (63.4%). Additional measures are required to improve compliance and protect non-smokers from secondhand smoke, including strengthening enforcement of existing bans on tobacco sales, advertising and enhancing the number and visibility of “No Smoking” signs in public places.