Are Danish vocational schools ready to implement ‘smoke-free school hours’? A qualitative study informed by the theory of Organizational Readiness to Change

Background: The school tobacco policy of ‘smoke-free school hours’ (SFSH) might prove to be an effective intervention to reduce smoking in Danish vocational schools. SFSH entails that students, staff and visitors are not allowed to smoke during school hours – nor inside or outside school area. The effectiveness of tobacco policies is depended on implementation into routine practice (e.g. enforcement). Organizational readiness for change is a primary predictor for successful implementation.
Purpose of study: The aim of this study is to identify barriers and facilitators to implement SFSH in Danish vocational schools.
Methods/Theory: Semi-structured interviews and focus groups were carried out with management and teachers (n=22) from six schools: Three with- and three without experiences implementing SFSH. The interviews, as well as the data analysis, were informed by the Organizational Readiness to Change (ORC) theory.

Findings: We identified ten factors acting as facilitators or barriers in achieving ORC. Facilitators: Beliefs that SFSH will prevent the uptake of smoking; that SFSH will result in a better learning environment; if clear responsibilities in enforcement-procedures are in place; if legislation about SFSH is ratified; if same tobacco policy is established in apprenticeship-work places. Barriers: Beliefs that SFSH is patronizing and violating personal freedom; that there’s not enough resources to enforce SFSH; that enforcement will negatively influence relations with students; that SFSH will cause student dropout; that SFSH will cause more disturbance in class room cause of pupil’s nicotine cravings.
Conclusion: ORC is necessary to successfully implement SFSH in Danish vocational schools. Facilitators and barriers must be addressed in the process of creating ORC and some schools might need support in this process.