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The impact of banning smoking in workplaces

What are the early effects?
  • Shane Allwright
Leading Article

Abstract

Smoke-free workplace legislation reduces the exposure of both the general public and the workforce to second-hand smoke (SHS) without evidence of an increased exposure to SHS in children in the home. The reductions in exposure are linked to improved respiratory health in previously heavily exposed occupational groups such as bar, restaurant and casino staff. From some countries, there is evidence suggesting that smoking bans have led to declines in hospital admissions for myocardial infarction. There is general agreement that smoking bans, if associated with other tobacco control measures such as tax increases, together with provision of cessation supports, lead to a reduction in the numbers of cigarettes smoked and probably lower smoking rates. Most cities, regions and countries report neutral or positive economic impacts.

Keywords

Cotinine Cotinine Concentration License Premise Hospitality Venue Indoor Public Place 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgements

No sources of funding were used to assist in the preparation of this article. The author has no conflicts of interest that are directly relevant to the content of this article.

References

  1. 1.
    American Nonsmokers’ Rights Foundation. Summary of 100% smokefree state laws and population protected by 100% U.S. Smokefree Laws. 2008 Jul 1 [online]. Available from URL: http://www.no-smoke.org/goingsmokefree.php?.id=519 [Accessed 2008 Oct 1]
  2. 2.
    American Nonsmokers’ Rights Foundation. Smokefree status of hospitality venues around the world. 2008 Apr 1 [online]. Available from URL: http://www.no-smoke.org/pdf/internationalbarsandrestaurants.pdf [Accessed 2008 May 2]
  3. 3.
    Clearing the Air Healthier Scotland. Beyond Scotland: what’s happening elsewhere [online]. Available from URL: http://www.clearingtheairscotland.com/background/map.html [Accessed 2008 May 2]
  4. 4.
    World Health Organization. WHO report on the global tobacco epidemic, 2008: the MPOWER package. Geneva: WHO, 2008Google Scholar
  5. 5.
    World Health Organization. WHO framework convention on tobacco control (WHO FCTC) [online]. Available from URL: http://www.who.int/fctc/en/ [Accessed 2008 Aug 26]
  6. 6.
    World Health Organization. Guidelines for the implementation of article 8 protection from exposure to tobacco smoke, WHO Framework Convention on Tobacco Control [online]. Available from URL: http://www.who.int/fctc/cop/guidelines_art8/en/index.html [Accessed 2008 Aug 26]
  7. 7.
    Office of Tobacco Control. Smoke-free workplace legislation implementation public health (tobacco) acts, 2002 and 2004: progress report 29 March 2004–31 March 2005. Clane: Office of Tobacco Control, 2005Google Scholar
  8. 8.
    Office of Tobacco Control. Annual report. Naas: Office of Tobacco Control, 2007Google Scholar
  9. 9.
    Clearing the Air Healthier Scotland. Smoke-free legislation: national compliance data. Summary [online]. Available from URL: http://www.clearingtheairscotland.com/latest/index.html [Accessed 2008 May 2]
  10. 10.
    Biener L, Garrett CA, Skeer M, et al. The effects on smokers of Boston’s smoke-free bar ordinance: a longitudinal analysis of changes in compliance, patronage, policy support, and smoking at home. J Public Health Manag Pract 2007 Nov–Dec; 13(6): 630–6PubMedGoogle Scholar
  11. 11.
    Gorini G, Chellini E, Galeone D. What happened in Italy? A brief summary of studies conducted in Italy to evaluate the impact of the smoking ban. Ann Oncol 2007 Oct 1; 18(10): 1620–2PubMedCrossRefGoogle Scholar
  12. 12.
    Edwards R, Thomson G, Wilson N, et al. After the smoke has cleared: evaluation of the impact of a new national smoke-free law in New Zealand. Tob Control 2008 Jan 1; 17: e2PubMedCrossRefGoogle Scholar
  13. 13.
    Office of Tobacco Control. Office of Tobacco Control research indicates supportive environment for introduction of smoke-free workplace legislation [online]. Available from URL: http://www.otc.ie/article.asp?.article=195 [Accessed 2008 May 14]
  14. 14.
    Fong GT, Hyland A, Borland R, et al. Reductions in tobacco smoke pollution and increases in support for smoke-free public places following the implementation of comprehensive smoke-free workplace legislation in the Republic of Ireland: findings from the ITC Ireland/UK Survey. Tob Control 2006 Jun 1; 15 Suppl. 3: iii51–8PubMedCrossRefGoogle Scholar
  15. 15.
    Thomson G, Wilson N. One year of smokefree bars and restaurants in New Zealand: impacts and responses. BMC Public Health 2006; 6: 64PubMedCrossRefGoogle Scholar
  16. 16.
    Pursell L, Allwright S, O’Donovan D, et al. Before and after study of bar workers’ perceptions of the impact of smoke-free workplace legislation in the Republic of Ireland. BMC Public Health 2007; 7: 131PubMedCrossRefGoogle Scholar
  17. 17.
    Hilton S, Semple S, Miller B, et al. Expectations and changing attitudes of bar workers before and after the implementation of smoke-free legislation in Scotland. BMC Public Health 2007; 7: 206PubMedCrossRefGoogle Scholar
  18. 18.
    Benowitz NL. Biomarkers of environmental tobacco smoke exposure. Environ Health Perspect 1999; 107: 349–55Google Scholar
  19. 19.
    Chen R, Tavendale R, Tunstall-Pedoe H. Measurement of passive smoking in adults: self reported questionnaire or serum cotinine? J Cancer Epidemiol Prev 2002; 7(2): 85–95PubMedCrossRefGoogle Scholar
  20. 20.
    Bates MN, Fawcett J, Dickson S, et al. Exposure of hospitality workers to environmental tobacco smoke. Tob Control 2002; 11: 125–9PubMedCrossRefGoogle Scholar
  21. 21.
    Mulcahy M, Byrne MA, Ruprecht A. How does the Irish smoking ban measure up? A before and after study of particle concentrations in Irish pubs [abstract]. Int J Indoor Environ Health 2005; 15 Suppl. 11: 86Google Scholar
  22. 22.
    Mulcahy M, Evans DS, Hammond SK, et al. Secondhand smoke exposure and risk following the Irish smoking ban: an assessment of salivary cotinine concentrations in hotel workers and air nicotine levels in bars. Tob Control 2005 Dec 1; 14(6): 384–8PubMedCrossRefGoogle Scholar
  23. 23.
    McNabola A, Broderick B, Johnston P, et al. Effects of the smoking ban on benzene and 1,3-butadiene levels in pubs in Dublin. J Cancer Environ Sci Health A 2006 May; 41(5): 799–810CrossRefGoogle Scholar
  24. 24.
    Skogstad M, Kjaerheim K, Fladseth G, et al. Cross shift changes in lung function among bar and restaurant workers before and after implementation of a smoking ban. Occup Environ Med 2006 Jul; 63(7): 482–7PubMedCrossRefGoogle Scholar
  25. 25.
    Ellingsen DG, Fladseth G, Daae HL, et al. Airborne exposure and biological monitoring of bar and restaurant workers before and after the introduction of a smoking ban. J Environ Monit 2006; 8: 362–8PubMedCrossRefGoogle Scholar
  26. 26.
    Tominz R, Poropat C, Bovenzi M. Changes in PM10 and PM2.5 air levels in bars after the enforcement of the smoking ban in the Italian legislation [in Italian]. Epidemiol Prev 2006 Nov–Dec; 30(6): 325–33PubMedGoogle Scholar
  27. 27.
    Semple S, Maccalman L, Naji AA, et al. Bar workers’ exposure to second-hand smoke: the effect of Scottish smoke-free legislation on occupational exposure. Ann Occup Hyg 2007 Oct; 51(7): 571–80PubMedCrossRefGoogle Scholar
  28. 28.
    Goodman PG, McCaffrey M, McLaughlin J, et al. Air quality in Dublin pubs before and after the introduction of the workplace smoking ban in Ireland. Central Eur J Occup Environ Med 2007; 13(1): 91–9Google Scholar
  29. 29.
    Gorini G, Moshammer H, Sbrogi L, et al. Italy and Austria before and after study: second-hand smoke exposure in hospitality premises before and after 2 years from the introduction of the Italian smoking ban. Indoor Air 2008 Apr 21; 18(4): 328–34PubMedCrossRefGoogle Scholar
  30. 30.
    Hyland A, Travers MJ, Dresler C, et al. A 32-country comparison of tobacco smoke derived particle levels in indoor public places. Tob Control 2008 Jun 1; 17(3): 159–65PubMedCrossRefGoogle Scholar
  31. 31.
    Allwright S, Paul G, Greiner B, et al. Legislation for smoke-free workplaces and health of bar workers in Ireland: before and after study. BMJ 2005 Nov 12; 331: 1117–20Google Scholar
  32. 32.
    Smith DR. Tobacco smoking by occupation in Australia and the United States: a review of national surveys conducted between 1970 and 2005. Ind Health 2008; 46: 77–89PubMedCrossRefGoogle Scholar
  33. 33.
    Pickett MS, Schober SE, Brody DJ, et al. Smoke-free laws and secondhand smoke exposure in US non-smoking adults, 1999–2002. Tob Control 2006 Aug 1; 15(4): 302–7PubMedCrossRefGoogle Scholar
  34. 34.
    Haw SJ, Gruer L. Changes in exposure of adult non-smokers to secondhand smoke after implementation of smoke-free legislation in Scotland: national cross sectional survey. BMJ 2007 Sep 15; 335(7619): 549–52PubMedCrossRefGoogle Scholar
  35. 35.
    Akhtar PC, Currie DB, Currie CE, et al. Changes in Child Exposure to Environmental Tobacco Smoke (CHETS) study after implementation of smoke-free legislation in Scotland: national cross sectional survey. BMJ 2007 Sep 15; 335(7619): 545PubMedCrossRefGoogle Scholar
  36. 36.
    Hyland A, Higbee C, Hassan L, et al. Does smoke-free Ireland have more smoking inside the home and less in pubs than the United Kingdom? Findings from the international tobacco control policy evaluation project. Eur J Public Health 2008 Feb 1; 18(1): 63–5PubMedCrossRefGoogle Scholar
  37. 37.
    Borland R, Mullins R, Trotter L, et al. Trends in environmental tobacco smoke restrictions in the home in Victoria, Australia. Tob Control 1999 Sep 1; 8(3): 266–71PubMedCrossRefGoogle Scholar
  38. 38.
    Borland R, Yong HH, Cummings KM, et al. Determinants and consequences of smoke-free homes: findings from the International Tobacco Control (ITC) Four Country Survey. Tob Control 2006 Jun 1; 15 Suppl. 3: iii42–50PubMedCrossRefGoogle Scholar
  39. 39.
    Merom D, Rissel C. Factors associated with smoke-free homes in NSW: results from the 1998 NSW Health Survey. Aust NZ J Public Health 2001 Aug; 25(4): 339–45CrossRefGoogle Scholar
  40. 40.
    Vardavas CI, Linardakis M, Kafatos AG. Environmental tobacco smoke exposure in motor vehicles: a preliminary study [letter]. Tob Control 2006; 15: 415PubMedCrossRefGoogle Scholar
  41. 41.
    Rees VW, Connolly GN. Measuring air quality to protect children from secondhand smoke in cars. Am J Prev Med 2006 Nov; 31(5): 363–8PubMedCrossRefGoogle Scholar
  42. 42.
    Schick S, Glantz S. Philip Morris toxicological experiments with fresh sidestream smoke: more toxic than mainstream smoke. Tob Control 2005 Dec 1; 14(6): 396–404PubMedCrossRefGoogle Scholar
  43. 43.
    Wakefield M, Cameron M, Inglis G, et al. Secondhand smoke exposure and respiratory symptoms among casino, club, and office workers in Victoria, Australia. J Occup Environ Med 2005 Jul; 47(7): 698–703PubMedCrossRefGoogle Scholar
  44. 44.
    Jarvis MJ, Foulds J, Feyerabend C. Exposure to passive smoking among bar staff. Br J Addict 1992; 87: 111–3PubMedCrossRefGoogle Scholar
  45. 45.
    Siegel M, Skeer M. Exposure to secondhand smoke and excess lung cancer mortality risk among workers in the “5B’s”: bars, bowling alleys, billiard halls, betting establishments, and bingo parlours. Tob Control 2003; 12: 333–8PubMedCrossRefGoogle Scholar
  46. 46.
    Pilkington PA, Gray S, Gilmore AB. Health impacts of exposure to second hand smoke (SHS) amongst a highly exposed workforce: survey of London casino workers. BMC Public Health 2007; 7: 257PubMedCrossRefGoogle Scholar
  47. 47.
    Eisner MD, Smith AK, Blanc PD. Bartenders’ respiratory health after establishment of smoke-free bars and taverns. JAMA 1998; 280: 1909–14PubMedCrossRefGoogle Scholar
  48. 48.
    Menzies D, Nair A, Williamson PA, et al. Respiratory symptoms, pulmonary function, and markers of inflammation among bar workers before and after a legislative ban on smoking in public places. JAMA 2006 Oct 11; 296(14): 1742–8PubMedCrossRefGoogle Scholar
  49. 49.
    Goodman P, Agnew M, McCaffrey M, et al. Effects of the Irish smoking ban on respiratory health of bar workers and air quality in Dublin pubs. Am J Respir Crit Care Med 2007 Apr 15; 175(8): 840–5PubMedCrossRefGoogle Scholar
  50. 50.
    Routledge HC, Ayres JG. Air pollution and the heart. Occup Med (Lond) 2005 Sep 1; 55(6): 439–47CrossRefGoogle Scholar
  51. 51.
    Maitre A, Bonneterre V, Huillard L, et al. Impact of urban atmospheric pollution on coronary disease. Eur Heart J 2006 Oct 1; 27(19): 2275–84PubMedCrossRefGoogle Scholar
  52. 52.
    Schindler C, Kunzli N, Bongard J-P, et al. Short-term variation in air pollution and in average lung function among never-smokers: the Swiss Study on Air Pollution and Lung Diseases in Adults (SAPALDIA). Am J Respir Crit Care Med 2001 Feb 1; 163(2): 356–61PubMedGoogle Scholar
  53. 53.
    Pope III CA, Burnett RT, Thun MJ, et al. Lung cancer, cardiopulmonary mortality, and long-term exposure to fine particulate air pollution. JAMA 2002 Mar 6; 287(9): 1132–41PubMedCrossRefGoogle Scholar
  54. 54.
    Moshammer H, Hutter HP, Hauck H, et al. Low levels of air pollution induce changes of lung function in a panel of school children. Eur Respir J 2006 Jun 1; 27(6): 1138–43PubMedCrossRefGoogle Scholar
  55. 55.
    Glantz SA, Parmley WW. Passive smoking and heart disease: epidemiology, physiology and biochemistry. Circulation 1991; 31: 1–12CrossRefGoogle Scholar
  56. 56.
    Glantz SA, Parmley WW. Passive smoking and heart disease. JAMA 1995; 273: 1047–53PubMedCrossRefGoogle Scholar
  57. 57.
    He J, Vupputuri S, Allen K, et al. Passive smoking and the risk of coronary heart disease: a meta-analysis of epidemiological studies. N Engl J Med 1999 Mar 25; 340(12): 920–6PubMedCrossRefGoogle Scholar
  58. 58.
    Barnoya J, Glantz SA. Cardiovascular effects of secondhand smoke help explain the benefits of smoke-free legislation on heart disease burden. J Cardiovasc Nurs 2006 Nov–Dec; 21(6): 457–62PubMedGoogle Scholar
  59. 59.
    Sargent R, Shepard R, Glantz S. Reduced incidence of admissions for myocardial infarction associated with public smoking ban: before and after study. BMJ 2004; 328(7446): 977–80PubMedCrossRefGoogle Scholar
  60. 60.
    Bartecchi C, Alsever RN, Nevin-Woods C, et al. Reduction in the incidence of acute myocardial infarction associated with a citywide smoking ordinance. Circulation 2006 Oct 3; 114(14): 1490–6PubMedCrossRefGoogle Scholar
  61. 61.
    Khuder SA, Milz S, Jordan T, et al. The impact of a smoking ban on hospital admissions for coronary heart disease. Prev Med 2007 Jul; 45(1): 3–8PubMedCrossRefGoogle Scholar
  62. 62.
    Juster HR, Loomis BR, Hinman TM, et al. Declines in hospital admissions for acute myocardial infarction in New York state after implementation of a comprehensive smoking ban. Am J Public Health 2007 Nov; 97(11): 2035–9PubMedCrossRefGoogle Scholar
  63. 63.
    Barone-Adesi F, Vizzini L, Merletti F, et al. Short-term effects of Italian smoking regulation on rates of hospital admission for acute myocardial infarction. Eur Heart J 2006 Oct; 27(20): 2468–72PubMedCrossRefGoogle Scholar
  64. 64.
    Cesaroni G, Forastiere F, Agabiti N, et al. Effect of the Italian smoking ban on population rates of acute coronary events. Circulation 2008 Mar 4; 117(9): 1183–8PubMedCrossRefGoogle Scholar
  65. 65.
    Pell JP, Haw S, Cobbe S, et al. Smoke-free legislation and hospitalizations for acute coronary syndrome. N Engl J Med 2008 Jul 31; 359(5): 482–91PubMedCrossRefGoogle Scholar
  66. 66.
    Edwards R, Bullen C, O’Dea D, et al. After the smoke has cleared: evaluation of the impact of a new smokefree law. Wellington: Ministry of Health, 2006 [online]. Available from URL: http://www.moh.govt.nz/moh.nsf/pagesmh/5599 [Accessed 2008 Sep 23]Google Scholar
  67. 67.
    Fichtenberg CM, Glantz SA. Effect of smoke-free workplaces on smoking behaviour: systematic review. BMJ 2002 Jul 27; 325(7357): 188PubMedCrossRefGoogle Scholar
  68. 68.
    Heloma A, Jaakkola MS. Four-year follow-up of smoke exposure, attitudes and smoking behaviour following enactment of Finland’s national smoke-free work-place law. Addiction 2003; 98: 1111–7PubMedCrossRefGoogle Scholar
  69. 69.
    Braverman MT, Aaro LE, Hetland J. Changes in smoking among restaurant and bar employees following Norway’s comprehensive smoking ban. Health Promot Int 2008 Mar 1; 23(1): 5–15PubMedCrossRefGoogle Scholar
  70. 70.
    Gallus S, Zuccaro P, Colombo P, et al. Smoking in Italy 2005–2006: effects of a comprehensive National Tobacco Regulation. Prev Med 2007; 45(2-3): 198–201PubMedCrossRefGoogle Scholar
  71. 71.
    Hahn EJ, Rayens MK, Butler KM, et al. Smoke-free laws and adult smoking prevalence. Prev Med 2008; 47(2): 206–9PubMedCrossRefGoogle Scholar
  72. 72.
    Office of Tobacco Control. Cigarette smoking trends [online]. Available from URL: http://www.otc.ie/research.asp#anchor2 [Accessed 2008 May 14]
  73. 73.
    Jha P, Chaloupka F. Measures to reduce the demand for tobacco. In: Jha P, editor. Curbing the epidemic: governments and the economics of tobacco control. Washington, DC: World Bank, 2000Google Scholar
  74. 74.
    Siegel M, Albers AB, Cheng DM, et al. Effect of local restaurant smoking regulations on progression to established smoking among youths. Tob Control 2005 Oct 1; 14(5): 300–6PubMedCrossRefGoogle Scholar
  75. 75.
    Farkas AJ, Gilpin EA, White MM, et al. Association between household and workplace smoking restrictions and adolescent smoking. JAMA 2000 Aug 9; 284(6): 717–22PubMedCrossRefGoogle Scholar
  76. 76.
    Dearlove JV, Bialous SA, Glantz SA. Tobacco industry manipulation of the hospitality industry to maintain smoking in public places. Tob Control 2002 Jun; 11(2): 94–104PubMedCrossRefGoogle Scholar
  77. 77.
    Glantz SA. Commentary: assessing the effects of the Scottish smokefree law. The placebo effect and the importance of obtaining unbiased data. Int J Epidemiol 2007 Feb 1; 36(1): 155–6PubMedCrossRefGoogle Scholar
  78. 78.
    Eriksen M, Chaloupka F. The economic impact of clean indoor air laws. CA Cancer J Clin 2007 Nov 1; 57(6): 367–78PubMedCrossRefGoogle Scholar
  79. 79.
    Luk R, Ferrence R, Gmel G. The economic impact of a smoke-free bylaw on restaurant and bar sales in Ottawa, Canada. Addiction 2006; 101(5): 738–45PubMedCrossRefGoogle Scholar
  80. 80.
    Smoke Free Europe Partnership. Smoke free Europe makes economic sense: a report on the economic aspects of smoke free policies. 2005 May [online]. Available from URL: http://www.smokefreepartnership.eu/IMG/pdf/Smokefree_Europe_makes_economic_sense.pdf [Accessed 2008 Sep 23]Google Scholar
  81. 81.
    Simpson D. Smoke-free laws do not harm profits: new global report. Tob Control 2005 Aug 1; 14(4): 220PubMedGoogle Scholar
  82. 82.
    Adda J, Berlinski S, Machin S. Short-run economic effects of the Scottish smoking ban. Int J Epidemiol 2007 Feb 1; 36(1): 149–54PubMedCrossRefGoogle Scholar
  83. 83.
    Scollo M, Lal A, Hyland A, et al. Review of the quality of studies on the economic effects of smoke-free policies on the hospitality industry. Tob Control 2003 Mar 1; 12(1): 13–20PubMedCrossRefGoogle Scholar
  84. 84.
    Ludbrook A, Bird S, van Teijlingen E. International review of the health and economic impact of the regulation of smoking in public places: summary report 2005. Health Scotland [online]. Available from URL: http://www.healthscotland.com/uploads/documents/InternationalReviewShortReport.pdf [Accessed 2008 Sep 23]
  85. 85.
    Proescholdbell SK, Foley KL, Johnson J, et al. Indoor air quality in prisons before and after implementation of a smoking ban law. Tob Control 2008 Apr 1; 17(2): 123–7PubMedCrossRefGoogle Scholar
  86. 86.
    American Nonsmokers’ Rights Foundation. 100% smoke free correctional facilities. 2008 Jul 1 [online]. Available from URL: http://www.no-smoke.org/pdf/100smokefreeprisons.pdf [Accessed 2008 Oct 2]Google Scholar
  87. 87.
    Patterson WJ, Daube MM, Hall SLG, et al. Non-compliance with Western Australian smoke-free legislation: a complete ban on smoking in hospitality settings is needed. Med J Aust 2007; 187(6): 370–1PubMedGoogle Scholar

Copyright information

© Adis Data Information BV 2008

Authors and Affiliations

  1. 1.Department of Public Health and Primary Care, Trinity College Dublin, Trinity College Centre for Health SciencesAdelaide & Meath Hospital incorporating the National Children’s HospitalDublinRepublic of Ireland

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