BACKGROUND-AIM:
Since 2008, smoking has been prohibited in almost all indoor spaces in the Netherlands. At that time, there were no smoke-free outdoor sports grounds. Outdoor smoke-free policies at sports grounds represent an important area of tobacco control, as many people, including youth, spend a substantial amount of their free time participating in sports. There is still no legal smoking ban, nevertheless major steps have been taken to create outdoor smoke-free sports grounds.

METHODS:
A bottom-up approach based on voluntary action was chosen. At the end of 2015, the Dutch Heart Foundation, Cancer Society and Lung Foundation launched the campaign and movement ‘Towards a Smoke-free Generation’. This campaign was used to raise awareness for smoke-free environments, including sports grounds. In early 2016, the first outdoor sports clubs were recruited to implement a smoke-free policy, which in turn generated free publicity. A support package and free smoke-free signage were made available to sports clubs. ​Influential frontrunners were sought within professional football clubs to propagate the smoke-free message. Important stakeholders, such as sports associations and municipalities, were lobbied to contribute ​to the goal of smoke-free sports. They provided further persuasive communication and (regulatory) support to sports clubs. This bottom-up movement provides fertile ground for national legislation.

RESULTS:
In 2018 the association NOC*NSF, the umbrella organization for sports and sports federations, set the target for smoke-free sports grounds by 2025. They started a campaign, in collaboration with the ‘Smoke-free Generation’, aimed at the boards of sports clubs to become smoke-free. All stadiums and training facilities of the two Dutch professional football leagues have been smoke-free since the 2020-21 season. Regional public health services and municipalities encourage local sports clubs to implement smoke-free policy. ​Some municipalities have realized smoke-free sports grounds through stipulations in their municipal rental agreements with sports clubs. From 2025, all athletics sports clubs have a complete smoke-free policy. 97% of all field hockey sports clubs implemented a complete (65%) or partial smoke-free policy (32%). For three other popular sports, football, tennis and korfball, it is estimated that about a third to half of all sports clubs have implemented a smoke-free policy. There is a high level of public support, almost 9 out of 10 Dutch people are in favour of smoke-free sports grounds where children also sport.

CONCLUSIONS:
In the Netherlands, many outdoor sports grounds have been made smoke-free despite the lack of a national smoking ban. An approach of strategic communication, showcasing frontrunners and joining forces with important stakeholders, has proven to be effective. However, local or national legislation may be required to make all sports grounds smoke-free and to optimally contribute to a smoke-free generation.