<![CDATA[Smoke-free policies are essential for protecting non-smokers from second-hand tobacco smoke, especially in health service facilities. Despite South Tangerang City Regional Regulation Number 4 of 2016, compliance in health facilities remains uneven. This study analysed the implementation of the smoke-free area policy at Cirendeu Public Health Centre, Pisangan Public Health Centre, and Sari Asih Ciputat Hospital. A descriptive qualitative design combined interviews, observation, and document review involving 15 informants, including occupational health and safety coordinators, staff members, smoke-free task-force officers, and visitors. Data were interpreted using Edward III’s policy implementation framework, covering communication, resources, disposition, and bureaucratic structure. The findings showed that the facilities had established core administrative components, including internal staff socialisation, designated task-force personnel, no-smoking signs, and operational references to local regulations. However, implementation gaps remained. Communication with visitors and surrounding communities was not systematic; responsibilities and procedures for sanctions and enforcement were unclear; and community participation was largely limited to passive reporting. Implementers expressed commitment to the policy, while the absence of formal incentives may constrain sustained motivation and proactive enforcement, although this relationship requires further empirical examination. Overall, the policy was institutionally established but incompletely operationalised in public communication, enforcement authority, monitoring, and participation. Strengthening visitor-focused communication, clarifying sanctioning authority, conducting routine monitoring, supporting implementers, and creating participatory reporting mechanisms may improve compliance and protect patients, staff, and visitors from second-hand smoke exposure.]]>
