Public attitudes about the support for the establishment of smoke-free environment

This study investigated factors influencing public support for smoke-free environments in China. A cross-sectional survey was conducted among 11,031 adults (45.6% male, 54.4% female) between July and September 2021. The mean support score was 78.75 (SD = 26.996), with the highest scores observed in Central China (e.g., Shanxi, Henan). Multiple regression analysis revealed that being female ( β = 5.505, 95% CI: 4.409–6.601), having an undergraduate education or above ( β = 4.110, 95% CI: [2.475–5.746]), and having children ( β = 1.554, 95% CI: 0.276–2.833) were associated with stronger support. Conversely, being married ( β = −3.375, 95% CI: −4.849 to −1.900), frequent drinking (e.g., weekly: β = −5.275, 95% CI: −6.851 to −3.699), and higher levels of smoking dependence (e.g., severe: β = −21.968, 95% CI: −27.671 to −16.265) were associated with lower support. Psychosocial factors were also significant. Greater family health (FHS-SF: β = 0.645, 95% CI: 0.543–0.746) and social support (PSSS: β = 0.142, 95% CI: 0.092–0.193) predicted stronger support, while a higher BFI-10 total score (BFI-10: β = −0.559, 95% CI: −0.853 to −0.266) and unhealthy eating habits (EBS-SF: β = −0.328, 95% CI: −0.444 to −0.212) predicted weaker support. Subgroup analyses among smokers and ex-smokers confirmed the negative associations of drinking, tobacco dependence, and poor diet with support levels. These findings underscore the multifaceted nature of public support for smoke-free policies in China. Interventions that strengthen family and social support systems, alongside targeted strategies for key demographics, may be particularly effective in bolstering public endorsement.