Universidad del Desarrollo

Background Spain implemented an extensive outdoor smoking ban during the COVID-19 pandemic in 2020. We examined support for this restriction during and beyond the pandemic among people who currently and formerly smoked. Methods Cross-sectional study. The 2021 ITC EUREST-PLUS Spain Survey used a multistage sampling to obtain a representative sample of people who currently or formerly smoked (n=1006). We estimated prevalence ratios (PRs) to examine associations with ban support during and after the pandemic. Analyses accounted for the complex sampling design and were weighted to ensure representativeness. Results Most people who currently (79.2%) and formerly smoked (94.6%) supported the outdoor smoking ban when a safe interpersonal distance could not be maintained during the pandemic. Support for a permanent ban remained substantial (61.4% and 87.2%, respectively). Those who currently smoke were more likely to support bans during and after the pandemic if they had smoke-free homes (PR=1.11; PR=1.29, respectively), understood secondhand smoke harms to health (PR=1.40; PR=1.65), had tried to quit (PR=1.14; PR=1.30) and self-reported as healthy (PR=1.40; PR=1.47). Those who formerly smoked were more likely to support bans during the pandemic if they had smoke-free homes (PR=1.08) and did not self-report as healthy (PR=0.95); and after the pandemic if they had quit smoking for ≥6 months (PR=1.23) and used alternative tobacco products (PR=1.17). Conclusions Most people who currently or formerly smoked in Spain supported the outdoor smoking ban during and after the COVID-19 pandemic. This high acceptance suggests that the pandemic may have created an opportunity to strengthen tobacco control.

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