Breathe Easy in Hanmer Springs Findings from a New Zealand vapefree and smokefree town centre Cheryl Ford Cancer Society of New Zealand Health Promotion Advisor cheryl.ford@cancercwc.org.nz Dr David Brinson & Charlotte Ward Community and Public Health Public Health Analysts Canterbury District Health Board Oceania Tobacco Control Conference: October 2019

Breathe Easy in Hanmer Springs Smokefree and Vapefree Zone across the entire retail/business area Evaluated 6-month trial Stakeholders Cancer Society Canterbury District Health Board Hanmer Springs Community Board Hurunui District Council Hanmer Springs Business Association Local community New Zealand’s Alpine Spa Village Hanmer Springs Population: 1220 17% current smokers Tourist destination 367,669 guest nights 32% international

Timeline Timeline Inaugural Smokefree Outdoor Strategy Smokefree Outdoor Strategy extended Breathe Easy trial implemented & evaluated 2012 2016 2017 2019 2018 Local Government deputations Surveys / consultation

Evaluation aim To assess and report on: general levels of awareness of the zone attitudes of different stakeholder groups overall level of support for the continuation of the zone smoking/vaping prevalence any unintended consequences of the zone

10 hours 46 mins field observations Evaluation methods 166 56 133 548 Residents Business Tourists 31 23 10 hours 46 mins field observations

Observational Study Observational scans used to assess point prevalence of smoking and vaping at baseline and during trial. 10 hours, 46 mins 7,034 adults 1,768 children BASELINE 3,355 adults TRIAL 3,740 adults Point prevalence Smoking & Vaping 1.9% 0.4% Smoking 1.7% 0.3% Vaping 0.1% p < .0001 Method informed by Thomson, G., Russell, M.,Jenkin, G., Patel, v., & Wilson, N. (2013) Health Place, 20, 19-24 Thomson, G., & Pathmanathan, N. (2016) The point prevalence of smoking in selected sports fields and downtown locations in Wellington: Observations in November 2015.

Level of support for Breathe Easy What do you think about the Smokefree and Vapefree Zone in Hanmer Springs ? 939 Respondents 548 Visitor feedback cards 189 point-intercept interviews 53 Business owners 149 Residents

*Only asked of visitors interviewed on the street Perspective matters Should the Smokefree and Vapefree Zone in Hanmer Springs become permanent? - by stakeholder group n=54 n=203 n=105 96.4% n=28 *Only asked of visitors interviewed on the street Percent

Business: Impact of zone Overall, how would you describe any difference to your business since the start of the trial (n=53) n=37 n=9 n=7

Visitors: Level of support Face to face interviews on the street: International 96.4% (27/28) Domestic 84.6% (88/105) Feedback cards from guests at accommodation providers: n=433 Percent

Are smokefree outdoor spaces a deterrent to tourists? Would you be more or less likely to visit other places in New Zealand that have no smoking/no vaping zones? 547 respondents Accommodation guest - feedback cards 115 international 432 domestic

Qualitative themes Views on outdoor vaping Few respondents differentiated between smoking and vaping Some respondents while accepting that vaping probably does not pose a physical risk to others, still felt it interfered with others’ space Smoking behaviour “[vaping] still models addictive behaviour to children” (Resident) “Kids copy what adults do, vaping doesn't harm others but kids still curious about it…” (Visitor) No perceived harm “People have a right to smoke and there are no harms of vaping” (Business owner) Rights of non-smokers “I think both habits are intrusive to others” (Visitor)

Qualitative themes Supportive themes Rights of non-smokers Aligns with Hanmer Springs’ ‘healthy environment’ Long-term vision for smokefree Unsupportive themes Individual rights and curtailment of free choice/liberty Impact to business and tourism Enforcement and effectiveness Concern for tourism impact “We are a tourist town, and need as many people as possible to visit our beautiful area” (Business owner) Marketable point of difference “Great way to market Hanmer Springs as a healthy destination” (Resident)

Smokefree and Vapefree Synergy with Hanmer Springs’ branding

Implications Vaping regulations Tourism and 2025 Locally Nationally