The Implementation of Smoke-Free Area Policy in Makassar’s Health Facilities: The Role of Organizational, Environmental, and Sustainability Factors Influencing Process Indicators

The implementation of Smoke-Free Area policies in health facilities is critical in promoting public health, especially in rapidly urbanizing regions such as Makassar. Smoking remains one of the leading causes of preventable illness and death globally. Thus, understanding the factors influencing the establishment and enforcement of smoke-free policies has become increasingly important. This study aimed to examine the influence of organizational, environmental, and sustainability factors on process indicators for smoke-free area policy implementation in healthcare facilities in Makassar, Indonesia. A quantitative correlational study was conducted across seven healthcare facilities that provide inpatient services. Using random cluster sampling, 232 healthcare workers were selected. Path analysis was employed to evaluate causal relationships between independent variables (organizational, environmental, and sustainability factors) and dependent variables (process indicators including functional role arrangements, health education, policy dissemination, smoke-free area signage). The findings indicate that sustainability factors significantly influenced health education, policy dissemination, and smoke-free signage, while organizational factors had a notable impact on policy announcement, whereas environmental factors showed no significant effects on the process indicators of smoke-free policy implementation. These findings emphasize the importance of reinforcing sustainability and organizational commitment to ensure long-term compliance with smoke-free regulations in health facilities.