Several established school smoking prevention initiatives involve restrictions on places to smoke. The focus on tobacco control in schools is due to the risk of smoking initiation during adolescence and the perception of this life stage as a period of time when health behavior is established. Hence, this period of time is considered to be ideal for health-promoting initiatives. This paper is part of an ethnographic study on adolescents’ perceptions of tobacco use. Focus groups and field observations were used to explore adolescents’ smoking-related practices related to smoking bans at schools. The findings show that smoking, as a place-based practice, is influenced by locally embedded rules and carries social implications resulting in a distinction between smokers and non-smokers. The distinction between smokers and non-smokers contributes to the retention of a stereotypical view of smokers and, moreover, stigmatizes smokers. According to this, restrictions on places to smoke within the school should be considered carefully in order to avoid stigma or ethical issues.

Youth is a crucial period for smoking preventive interventions. School-based interventions targeting the policy level and the sociocultural processes of smoking show promising effects in reducing smoking uptake and prevalence. This study presents findings from the qualitative process evaluation of a smoking preventive intervention, Focus, in the vocational school (VET) setting. Specifically, the study focused on contextual factors affecting the implementation of smoke-free school hours (SFSH). Participant observations and focus groups were conducted in four VETs during the implementation period October–December 2018. The data encompass participant observation field notes (n = 21 school days), student focus groups (n = 8) (aged 16–20), teacher focus groups (n = 5) and semi-structured individual interviews with VET leaders (n = 3). The study found that SFSH was not clearly communicated to students due to the educational structure and chaotic rhythm of the school days, ambivalent attitudes among teachers toward enforcement of smoking rules and lack of clear managerial support. The interplay of these factors counteracted the implementation of SFSH in the VET context. The presented contextual factors are important when interpreting the effectiveness of the Focus intervention and for informing future preventive efforts aiming to reduce smoking among youth in high risk of smoking cigarettes. Youth represents a crucial period for smoking prevention. School-based interventions show promising effects in this respect. This study presents findings from the qualitative process evaluation of a smoking preventive intervention, Focus, in the vocational school (VET) setting. The aim was to examine the role of context in the implementation process. The data consist of participant observation field notes (n = 21 school days), focus groups (n = 8 with students and n = 5 with teachers) and semi-structured individual interviews with VET leaders (n = 3). The study found that smoke-free school hours was not clearly communicated to students due to several contextual factors, namely an unclear structure and purpose of the school day, ambivalent attitudes among teachers toward smoking rules and lack of managerial support. These factors are important when interpreting the effectiveness of the Focus intervention and for informing future smoking preventive efforts among youth in high risk of smoking cigarettes.

The smoking prevalence among vocational education and training (VET) students is high. This paper describes the development and feasibility test of a multicomponent intervention designed to promote non-smoking behaviour at VET schools. We applied the Behaviour Change Wheel (BCW) stages and the capability, opportunity, and motivation for behaviour (COM-B) model to develop the intervention components based on theory, evidence, and a thorough needs-assessment study. Moreover, we feasibility-tested the preliminary ideas. All in all, our study was based on the literature, survey data, fieldwork, workshops, and expert and stakeholder involvement. The final intervention programme targets VET students’ smoking behaviour at the school, class, and individual levels through (a) a comprehensive tobacco policy to limit the physical and social opportunities to smoke, supplemented with a two-day staff course in conversations about smoking and an edutainment session (a lecture that both educates and entertains) to support a smoke-free environment; (b) classroom curricular with teaching materials to increase knowledge and social support, along with a quit-and-win competition to increase motivation; and (c) the national Quitline adapted to VET students to increase access to cessation support. The BCW model enabled a systematic and comprehensive development of an intervention, which demonstrates relevant techniques and delivery options to have the potential to reduce smoking in VET schools.

Background: Most adult smokers started smoking in their teenage years, which increases the risk of nicotine dependence. In Denmark, there is a high prevalence of youth smoking among students in Vocational Education and Training (VET). However, reducing and preventing smoking in this group is a major challenge. This article presents a needs assessment aimed to explore factors sustaining legitimacy of smoking in VET schools and consider the measures needed to prepare VET schools’ implementation of smoking reduction and prevention interventions. Methods: Participant observations were conducted in four VET classes representing three VET schools in Denmark with a duration of four days each. Individual, semi-structured interviews were conducted with teachers, managers, and a student advisor, as well as four focus groups with a total of 20 students. Interviews were audio-taped, transcribed, and the data material was analyzed following Malterud’s systematic text condensation. Findings: Factors that helped sustain legitimacy of smoking in VET schools included a positive and normalized attitude towards smoking at home and among friends, an understanding of smoking as an integral and expected practice in VET professions and schools, a perceived reliance on smoking as an icebreaker in new social relations and as a pedagogical tool, and smoking as a habit and a means to deal with boredom and stress relief. Conclusions: The factors sustaining legitimacy of smoking in VET schools are reciprocal and call for smoking reduction and prevention intervention efforts which consider and address social influence, habitual behavior, and psychological needs, as well as changes at the policy level.

Danish children spend a significant part of their daily lives in kindergarten. During the critical developmental period in early childhood, a targeted focus on health promotion can contribute to a foundation of long‐term well‐being. Since most Danish children aged 1–6 years attend daycare facilities, the kindergarten represents a physical, pedagogical, and social environment that contributes to monitoring and regulating children's behaviour in general and their participation in health‐promoting activities. However, studies on the child's perspective in relation to kindergarten health promotion are limited. Applying a symbolic interactionist framework, field notes from 37 days of participant observations were analysed to explore 3–6‐year‐old children's perspectives on physical activity practices in two kindergartens. The findings show how the institutional structuring of time, space and rules contributes to a social order that codefines children's room for action and physical activity. In negotiating this social order, some children have the necessary prerequisites to thrive within and influence this order, whereas others experience rejection and exclusion. These findings are relevant in terms of improving health promotion practices in kindergarten settings and reducing inequality in health among Danish children.