How Social Norms Actually Affected the Compliance with Smoke-Free Law? A Test of the Theory of Normative Social Behavior

Introduction: The city of Denpasar has implemented the smoke-free law for five years. However, the compliance remains low. Smoking remains highly accepted in society, and the provision of cigarettes in several religious and customary events. Hence, this study aims to assess how social smoking norms affect compliance with smoke-free laws. Methods: This was a cross-sectional study located in Denpasar, Bali, Indonesia. This study was conducted from December 2019 until February 2020. The sample size was 192 and was selected using multistage random sampling. Data were collected through interviews using a structured questionnaire then analyzed using multiple linear regression. Results: Descriptive norms of smoking affected the compliance in worship places (standardized coefficient beta of 0.175 and p=0.01). Moreover, the effect of descriptive norms to compliance was significantly moderated by perceived of injunctive norms (standardized coefficient beta of 0.216; p<0.01); benefits to one-self (standardized coefficient beta of 0.199; p<0.01); benefits to others (standardized coefficient beta of 0.164; p=0.02); anticipatory socialization (standardized coefficient beta of 0.146; p=0.03); similarity (standardized coefficient beta of 0.141; p=0.04); aspiration (standardized coefficient beta of 0.131; p=0.06); and local leader role (standardized coefficient beta of 0.129; p=0.06). Conclusion: The social norms of smoking remain an important predictor of compliance with the smoke-free law, particularly in countries with strong cultural characteristics. However, its effect could be moderated using appropriate culture-sensitive strategies.