Support for and reported compliance with smoke-free restaurants and bars by smokers in four countries: Findings from the International Tobacco Control (ITC) Four Country Survey

Cancer Control Research Institute, The Cancer Council Victoria, 1 Rathdowne Street, Carlton, VIC 3053, Australia.
Tobacco control (Impact Factor: 5.93). 06/2006; 15 Suppl 3(suppl 3):iii34-41. DOI: 10.1136/tc.2004.008748
Source: PubMed


To explore determinants of support for and reported compliance with smoke-free policies in restaurants and bars across the four countries of the International Tobacco Control (ITC) Four Country Survey.
Separate telephone cross-sectional surveys conducted between October and December 2002 with broadly representative samples of over 2000 adult (>or=18 years) cigarette smokers in each of the following four countries: the United States, Canada, the United Kingdom, and Australia.
Support for smoke-free policies in restaurants and pubs/bars and reported compliance with existing policies.
Reported total bans on indoor smoking in restaurants varied from 62% in Australia to 5% in the UK. Smoking bans in bars were less common, with California in the USA being the only major part of any country with documented bans. Support for bans in both restaurants and bars was related to the existence of bans, beliefs about passive smoking being harmful, lower average cigarette consumption, and older age. Self-reported compliance with a smoking ban was generally high and was associated with greater support for the ban.
Among current cigarette smokers, support for smoking bans was associated with living in a place where the law prohibits smoking. Smokers adjust and both accept and comply with smoke-free laws. Associates of support and compliance are remarkably similar across countries given the notably different levels of smoke-free policies.

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    • "There is a body of research that describes the effectiveness of a smoke free policy in reducing the harm associated with exposure to second-hand smoke [7,35]. Increasing the awareness of the health benefits that a total campus ban on smoking provides is essential when implementing a smoke free policy [29]. Health has been found to be the main motivator for quitting smoking; followed by the cost [1]. "
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    ABSTRACT: Baseline data were collected to inform the adoption, implementation and institutionalisation phases of a completely smoke free campus policy at a large Western Australian university with a diverse student and staff community. An online survey was randomly emailed to staff and students to measure the attitudes towards and the acceptability and enforcement of the policy prior to implementation. In total, 969 respondents completed the survey. General attitudes towards smoking were negative. While smokers, ex-smokers and non-smokers were supportive of smoke free policy on campus, 65.7% of respondents felt the campus should be completely smoke free. Respondents indicated a smoke free policy should be stringently enforced. The majority of respondents reported that they had been exposed to second-hand smoke on campus (n = 768; 79.5%). Theory of Organisational Change provides a useful framework to support the implementation of the completely smoke free policy in the University setting. The implementation process needs to consider the broad range of issues associated with implementing a completely smoke free policy and address issues such as safety of smokers, ensuring smokers are not marginalised and ensuring a comprehensive program is implemented. These baseline findings can be used to advocate for the implementation of a comprehensive range of strategies that recognise the addictive nature of tobacco smoking and address attitude and behaviour change, environmental adaptations and effective implementation of the policy. Administration should consider smokers and non-smokers when policy is implemented.
    BMC Public Health 08/2013; 13(1):738. DOI:10.1186/1471-2458-13-738 · 2.26 Impact Factor
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    • "Further, while TID campaigns may be effective in instituting anti-industry beliefs among youth and adult smokers alike, smokers' attitudes towards the tobacco control groups that make these very same campaigns have not been investigated. It is now widely known that smokers hold less favorable attitudes towards tobacco control policies and that support for certain smokefree policies is inversely related to level of nicotine dependence (Borland et al., 2006; Lacchetti et al., 2001; Lam et al., 2005; Lazuras et al., 2009; Schumann et al., 2006). Interestingly, to date, smokers' attitudes towards groups that promote the anti-smoking policies and legislation have not been explored. "
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    ABSTRACT: Introduction: Tobacco industry denormalization (TID) informs the public about the tobacco industry's role in the tobacco epidemic and is an important component of a comprehensive tobacco control strategy. Although TID beliefs have been noted in adult smokers and associated with intent to quit, research has not evaluated whether they are affected by smokers' level of nicotine dependence. The present article sought to concurrently examine how attitudes towards the tobacco industry and tobacco control groups may differ among smokers of varying levels of nicotine dependence. In addition, it evaluated how these attitudes and beliefs may be associated with smokers' intentions to reduce or quit smoking. Methods: A random digit dialing telephone survey was conducted of 889 Canadian current daily smokers, 18 years and older. Results: Attitudes towards the tobacco industry were mixed among the entire cohort and differences in beliefs towards the tobacco industry were not found among smokers of varying levels of nicotine dependence. However, smokers that held strong TID beliefs were 5 times more intent to quit smoking than those without such beliefs. Compared to smokers with low level of nicotine dependence, heavy smokers were more likely to report strong overall displeasure with the tobacco control community (OR=1.98, 95% CI=1.23-3.19, p=0.005), however there were no differences with regards to future intent to quit. Conclusions: The absence of strong negative sentiment toward the tobacco industry among smokers as a whole suggests that more targeted anti-industry messages are needed, raising greater awareness of tobacco industry practices within smokers and non-smokers alike. As heavier smokers' discontent with the tobacco control community highlights increasing social disapproval and pressure to quit smoking, future educational and media strategies used for smoking cessation purposes may benefit from emphasizing more of the positive attributes associated with quitting smoking, as opposed to the negative features of smoking itself.
    Addictive behaviors 03/2013; 38(7):2273-2278. DOI:10.1016/j.addbeh.2013.03.004 · 2.76 Impact Factor
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    • "Strong ban agreement was the dependent variable in MLR ban support: stronger agreement (1), versus less or no agreement (0). MLR independent variables included those already identified in the literature [3,10,12,13,27] or significantly associated with the dependent variables in the bivarible analysis, such as: age-group, smoking status, tobacco consumption, shift work, ban support, SHS beliefs (reporting health protection as the main reason for the ban), private smoking restrictions (home and car) and participants’ norms prior the ban (allowing clients smoking in the taxi prior the ban). A backward elimination of explanatory variables at a 5% level of significance was performed. "
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    ABSTRACT: Research evaluating enforcement and compliance with smoking partial bans is rather scarce, especially in countries with relative weak tobacco control policies, such as Portugal. There is also scarce evidence on specific high risk groups such as vehicle workers. In January 2008, Portugal implemented a partial ban, followed by poor enforcement. The purpose of this study was to explore the effectiveness of a partial smoking ban in a pro-smoking environment, specifically transportation by taxi in the city of Lisbon. Ban effectiveness was generally defined by ban awareness and support, compliance and enforcement. Exploratory cross-sectional study; purposive sampling in selected Lisbon streets. Structured interviews were conducted by trained researchers while using taxi services (January 2009-December 2010). Participants: 250 taxi drivers (98.8% participation rate). Chi-square, McNemar, Man Whitney tests and multiple logistic regression were performed. Of the participants, 249 were male; median age was 53.0 years; 43.6% were current smokers. Most participants (82.8%) approved comprehensive bans; 84.8% reported that clients still asked to smoke in their taxis; 16.8% allowed clients to smoke. Prior to the ban this value was 76.9% (p < 0.001). The major reason for not allowing smoking was the legal ban and associated fines (71.2%). Of the smokers, 66.1% admitted smoking in their taxi. Stale smoke smells were detected in 37.6% of the cars. None of the taxi drivers did ever receive a fine for non-compliance. Heavy smoking, night-shift and allowing smoking prior the ban predicted non-compliance. Despite the strong ban support observed, high smoking prevalence and poor enforcement contribute to low compliance. The findings also suggest low compliance among night-shift and vehicle workers. This study clearly demonstrates that a partial and poorly-enforced ban is vulnerable to breaches, and highlights the need for clear and strong policies.
    BMC Public Health 02/2013; 13(1):134. DOI:10.1186/1471-2458-13-134 · 2.26 Impact Factor
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