Implementation of a smoke-free policy on school premises and tobacco control as a priority among municipal health promotion activities: nationwide survey in Japan

We conducted a nationwide survey to evaluate the effect of implementing a smoke-free policy in municipalities that forbid teachers to smoke on school premises. Questionnaires were mailed to 3207 municipalities throughout Japan. After we adjusted for population size and the standardized mortality ratio for male lung cancer, we found that assigning a high priority to tobacco control in municipal health promotion activities was significantly associated with implementation of school tobacco-control policies (odds ratio = 1.50, 95% confidence interval=1.24, 1.81).