Challenges and Contextual Dynamics in Implementing Smoke‐Free School Policies in Thailand: A Qualitative Study.

Background: Thailand has one of the strongest tobacco control frameworks in Southeast Asia, including comprehensive smoke‐free laws and a ban on e‐cigarettes. However, implementation of smoke‐free school policies remains uneven across diverse educational settings. This study examined the contextual...

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Publicado en:Journal of School Health Vol. 96; no. 8; pp. 1 - 11
Autores principales: Phetphum, Chakkraphan, Keeratisiroj, Orawan, Boonyom, Supanee
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Aug2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2026
      vid: 96
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1111/josh.70196
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        atl: Challenges and Contextual Dynamics in Implementing Smoke‐Free School Policies in Thailand: A Qualitative Study.
      aug:
        au:
          Phetphum, Chakkraphan
          Keeratisiroj, Orawan
          Boonyom, Supanee
        affil: Department of Community Health, Faculty of Public Health, Naresuan University, Phitsanulok, Thailand
      sug:
        subj:
          School Policies Thailand
          Smoking Prevention and Control
          Public Policy
          Implementation Science
          Thailand
          Human
          Qualitative Studies
          Tobacco Control
          School Administrators
          Teachers
          Thematic Analysis
          Leadership
          Health Promotion
          Semi-Structured Interview
          Program Implementation
          Organizational Culture
          Electronic Cigarettes
          Funding Source
      ab: Background: Thailand has one of the strongest tobacco control frameworks in Southeast Asia, including comprehensive smoke‐free laws and a ban on e‐cigarettes. However, implementation of smoke‐free school policies remains uneven across diverse educational settings. This study examined the contextual and governance dynamics shaping implementation and sustainability across school types. Methods: A qualitative study was conducted using 14 focus group discussions (FGDs) across 14 provinces. Participants (n = 122) included school administrators, teachers, and provincial tobacco control stakeholders. Data were analyzed using reflexive thematic analysis to identify key governance conditions influencing implementation. Results: Six interrelated themes emerged: institutional diversity, structural constraints, enforcement gaps, multi‐level enablers, sustainability challenges, and field‐driven recommendations. Implementation gaps were driven less by policy absence than by differentiated governance conditions. Hybrid authority structures, leadership turnover, digital diffusion of e‐cigarettes, and geographic monitoring disparities constrained enforcement capacity. While teacher networks and provincial endorsement enhanced legitimacy, sustainability depended on institutional embedding rather than individual leadership. Implications for School Health Policy, Practice, and Equity: Uniform national standards require context‐sensitive implementation strategies. Embedding smoke‐free criteria within evaluation systems, institutionalizing peer networks, and addressing geographic inequities are critical to strengthening sustainability and equity. Conclusions: Strong legislation alone is insufficient; tailored governance approaches are essential to achieve equitable and durable implementation.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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