Ten steps process for establish ‘Smoke Free cities’ against Second hand Smoking in Sri Lanka

Secondhand Tobacco Smoke (SHS) is a serious public health problem, and different approaches were employed all over the world to overcome it. World Health Organization Framework Convention for Tobacco Control (WHO-FCTC) introduced smoke free cities as an effective strategy to control SHS. The National Authority on Tobacco and Alcohol of Sri Lanka has commenced a National Program of establishing ‘Smoke Free Cities’ (SFC) for combating SHS in 2016. Stakeholders have followed their own methods in this regard due to lack of a systematic process or guideline and sustainability was restricted to 16 (±12) months. Therefore, this study focused on developing a systematic process for establishing SFC in Sri Lanka. There were 53 SFC from 20 out of 25 administrative districts were studied for developing this process and self-administered questionnaire survey (n=15), group discussions (n=21) and in-depth interviews (n=17) were employed in data collection. Chi – square test was performed to study the relationships between variables and framework analyzing method was used in qualitative data analysis. Finally, the outcome was forwarded to an expert committee recommendation in order to ensure the quality. Authors have introduced a 10 steps process to establishing SFC in Sri Lanka for future endeavors. This 10 steps process could be used to establish SFC in Sri Lanka and further studies would be needed to research the possibility to practice this process in other countries which have similar socio-economic and cultural background as well as preventive healthcare system