CONFERENCE PROCEEDING
Out of sight, out of control
1
National Institute of Public Health, University of Southern Denmark, Odense, Denmark
Tob. Prev. Cessation 2026;12(Supplement 1):A170
ABSTRACT
BACKGROUND-AIM:
In 2021, Denmark introduced legislation banning tobacco and nicotine use during school hours. The emergence of smoke-free products, such as nicotine pouches and vapes, has challenged implementation, particularly in vocational schools. Evidence on implementation remains limited. This project examines how the policy is implemented and develops context-sensitive, co-created strategies to strengthen implementation and reduce nicotine use among students aged 15–25.
METHODS:
The project applies a mixed-methods, participatory, and realist evaluation design across four phases: (1) a national survey mapping implementation practices, (2) co-creation of tailored strategies with selected schools based on workshops and interviews, (3) realist evaluation using observations, interviews, and pre–post surveys, and (4) a stakeholder and power analysis of the broader implementation environment, including policy actors and industry influence. The analysis is guided by policy implementation theory and the Advocacy Coalition Framework.
RESULTS:
Preliminary findings show substantial variation in implementation across school contexts, shaped by differing implementation conditions. Implementation is particularly challenged by less visible nicotine products and off-site use during school hours. Organisational capacity, perceived legitimacy, and actor interests further influence local practices. The study will generate context–mechanism–outcome explanations and co-created, context-sensitive strategies, alongside insights into how policy environments and stakeholder dynamics, including lobbying, shape implementation.
CONCLUSIONS:
The project identifies key conditions for implementation and develops concrete, practice-oriented strategies. Findings offer transferable insights for both implementation and design of future tobacco and nicotine policies, particularly in addressing emerging products that challenge existing regulation. The creation of a smoke-free workplace and the promotion of smoking cessation are one of the five priority areas of the WHP Lombardia program. Within this framework, targeted actions were implemented in x companies in 2025: Development of corporate policies and smoking cessation support programs
In 2021, Denmark introduced legislation banning tobacco and nicotine use during school hours. The emergence of smoke-free products, such as nicotine pouches and vapes, has challenged implementation, particularly in vocational schools. Evidence on implementation remains limited. This project examines how the policy is implemented and develops context-sensitive, co-created strategies to strengthen implementation and reduce nicotine use among students aged 15–25.
METHODS:
The project applies a mixed-methods, participatory, and realist evaluation design across four phases: (1) a national survey mapping implementation practices, (2) co-creation of tailored strategies with selected schools based on workshops and interviews, (3) realist evaluation using observations, interviews, and pre–post surveys, and (4) a stakeholder and power analysis of the broader implementation environment, including policy actors and industry influence. The analysis is guided by policy implementation theory and the Advocacy Coalition Framework.
RESULTS:
Preliminary findings show substantial variation in implementation across school contexts, shaped by differing implementation conditions. Implementation is particularly challenged by less visible nicotine products and off-site use during school hours. Organisational capacity, perceived legitimacy, and actor interests further influence local practices. The study will generate context–mechanism–outcome explanations and co-created, context-sensitive strategies, alongside insights into how policy environments and stakeholder dynamics, including lobbying, shape implementation.
CONCLUSIONS:
The project identifies key conditions for implementation and develops concrete, practice-oriented strategies. Findings offer transferable insights for both implementation and design of future tobacco and nicotine policies, particularly in addressing emerging products that challenge existing regulation. The creation of a smoke-free workplace and the promotion of smoking cessation are one of the five priority areas of the WHP Lombardia program. Within this framework, targeted actions were implemented in x companies in 2025: Development of corporate policies and smoking cessation support programs
| eISSN: | 2459-3087 |
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