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BACKGROUND: Smoking in Hawaii’s beach parks poses a serious health risk to smokers and non-smokers exposed to secondhand smoke and generates litter in the form of cigarette butts which are toxic, costly to retrieve and harmful to marine life. To alleviate this problem the City and County of Honolulu passed Bill 25 in July 2013 prohibiting smoking in all City and County operated beaches and parks on the island of Oahu as of January 1, 2014. This observational study was designed to collect information about smoking in Oahu beach parks prior to the implementation of the law.
METHODS: A systematic observation protocol of smoking on beaches was adapted from previously validated observational studies of sun protection factors and physical activity in neighborhood parks. The protocol used paired observers to assess smoking among park visitors by zone (beach front, grassy areas, playing fields, parking lots and sidewalks), sex and age group (child, teen, adult, and senior), and smoking type (cigarette, electronic cigarette, cigar or other). Observations were made at 6 beaches, 4 times per day for a period of 3 days each (two weekdays and one weekend day) in December 2013. Results presented are the average findings between the paired observers.
RESULTS: A total of 12,341 people were observed (24,682 observations). Correlation between observers was 0.99 on the number of people in each zone, 0.99 on the sex of those observed, 0.88 for smoking and 0.93 fo rage group. Beach park users were 53.2% male and adults made up the largest group by age (70.0%) followed by children 13.5%, teens 13.0%, and seniors 6.5%. There were 275 observations of smoking with none among children. The observed smoking rate was 1.3% among adults and teens with 0.7% among females and 1.8% among males. Smoking varied by beach zone from 0.3% and 0.4% on sidewalks and beaches to 2.0% and 2.2% in parking lots and green areas. Smoking prevalence also varied by beach park from 0.7% to 10.0%.
CONCLUSIONS: Systematic observation is a novel and effective method to assess smoking behavior on beaches. Results of this study indicate that smoking point prevalence in beach parks is already lower than the overall population prevalence (14.6%). However, smoking does vary within parks with parking lots and green areas having the highest smoking prevalence. Education efforts and signage to support the smoke free beaches and parks should be targeted to these areas.