Impact of smoke-free legislation among smokers – Findings from the

ITC Europe SurveysUte Mons

German Cancer Research Center (DKFZ) Heidelberg, Germany

WCToH 2012, Singapore, March 2012

Background Methods Findings Conclusions

• Exposure to secondhand smoke (SHS) is an important health risk. Effective measures to provide protection from SHS require the total elimination of smoking in a particular space to create a smoke-free environment.

• Public support for smoke-free policies are considered to be a key variable in the process of their adoption and with regards to compliance with the regulations.

• Opponents of smoke-free policies have argued that such policies could lead to displacement of smoking into the private home and hence even increase SHS exposure of non-smoking family members and children.

Background Methods Findings Conclusions

Background Methods Findings Conclusions

Background Methods Findings Conclusions

Measures:1) „The last time you visited, were people smoking

inside?“ (separately for bars/pubs and restaurants)2) „Should smoking be allowed in all indoor areas, in

some indoor areas, or not allowed indoors at all?“ (separately for bars/pubs and restaurants)

3) „Which of the following statements best describes smoking inside your home? Smoking is allowed anywhere inside your home, smoking is never allowed inside your home, something inbetween.“

Smoking in hospitality venuesand policy support among smokers

Background Methods Findings Conclusions

Background Methods Findings Conclusions

Smoking banMarch 2004

ITC

Euro

pe su

rvey

s, c

ross

-sec

tiona

l sm

oker

sam

ples

, wei

ghte

d fig

ures

Background Methods Findings Conclusions

Smoking banMarch 2004

ITC

Euro

pe su

rvey

s, c

ross

-sec

tiona

l sm

oker

sam

ples

, wei

ghte

d fig

ures

Background Methods Findings Conclusions

Smoking ban Rest of UKApril/July 2007

Smoking ban ScotlandMarch 2006

ITC

Euro

pe su

rvey

s, c

ross

-sec

tiona

l sm

oker

sam

ples

, wei

ghte

d fig

ures

Background Methods Findings Conclusions

Smoking ban ScotlandMarch 2006

Smoking ban Rest of UKApril/July 2007

ITC

Euro

pe su

rvey

s, c

ross

-sec

tiona

l sm

oker

sam

ples

, wei

ghte

d fig

ures

Background Methods Findings Conclusions

Smoking banJanuary 2008

ITC

Euro

pe su

rvey

s, c

ross

-sec

tiona

l sm

oker

sam

ples

, wei

ghte

d fig

ures

Background Methods Findings Conclusions

Smoking banJanuary 2008

ITC

Euro

pe su

rvey

s, c

ross

-sec

tiona

l sm

oker

sam

ples

, wei

ghte

d fig

ures

Background Methods Findings Conclusions

Smoking banAug 2007 - Jul 2008

(partial bans in all states but Bavaria)

Constitutional CourtAugust 2008

(overturns ban in small bars)

August 2009(Bavaria lifts total ban)

August 2010(comprehensive ban in Bavaria

after successful referendum)

April 2011(total smoking ban comes

into force in Saarland)

ITC

Euro

pe su

rvey

s, c

ross

-sec

tiona

l sm

oker

sam

ples

, wei

ghte

d fig

ures

Background Methods Findings Conclusions

Smoking banAug 2007 - Jul 2008

(partial bans in all states but Bavaria)

Constitutional CourtAugust 2008

(overturns ban in small bars)

August 2009(Bavaria lifts total ban)

August 2010(comprehensive ban in Bavaria

after successful referendum)

April 2011(total smoking ban comes

into force in Saarland)

ITC

Euro

pe su

rvey

s, c

ross

-sec

tiona

l sm

oker

sam

ples

, wei

ghte

d fig

ures

Background Methods Findings Conclusions

Smoking banAug 2007 - Jul 2008

(partial bans in all states but Bavaria)

August 2009(Bavaria lifts total ban)

April 2011(total smoking ban comes

into force in Saarland)

August 2010(comprehensive ban in Bavaria

after successful referendum)

ITC

Euro

pe su

rvey

s, c

ross

-sec

tiona

l sm

oker

sam

ples

, wei

ghte

d fig

ures

Background Methods Findings Conclusions

July 2009(smoking ban temporarily lifted

for small bars without employees)

November 2010(smoking ban unofficially

lifted for small bars without employees – no fines)

March 2010(Supreme court decision – ban in small bars is constitutional)

Smoking banJuly 2008(partial ban)

ITC

Euro

pe su

rvey

s, c

ross

-sec

tiona

l sm

oker

sam

ples

, wei

ghte

d fig

ures

July 2011(smoking ban officially lifted for small bars without employees)

Background Methods Findings Conclusions

Smoking banJuly 2008(partial ban)

ITC

Euro

pe su

rvey

s, c

ross

-sec

tiona

l sm

oker

sam

ples

, wei

ghte

d fig

ures

Background Methods Findings Conclusions

Conclusions• Only comprehensive policies are effective

in eliminating smoking in hospitality venues

• Only comprehensive policies substantially improve support once the policy is in place

Displacement of smoking?

Background Methods Findings Conclusions

Background Methods Findings Conclusions

ITC

Euro

pe su

rvey

s, c

ross

-sec

tiona

l sm

oker

sam

ples

, wei

ghte

d fig

ures

Background Methods Findings Conclusions

Conclusions (contd.)• Only comprehensive policies are effective

in eliminating smoking in hospitality venues

• Only comprehensive policies substantially improve support once the policy is in place

• No evidence of displacement of smoking into the home was found in any of the examined countries

Thank youfor your attention!

Contact:u.mons@dkfz.de