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

Department of Psychology, University of Waterloo, Ватерлоо, Ontario, Canada
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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    • "Research on public perception toward the harmful effects of SHS is growing [7, 8] and studies have revealed that sociodemographic correlates may contribute to harm perception [2] and the use of noncombustible tobacco products91011. Levels of support for smoke-free public places have been shown to vary by cigarette smoking status, experience with smoke-free environments , knowledge about the harmfulness of SHS exposure , and other factors12131415161718. Changes in attitudes about the acceptability of SHS exposure and the benefits of smoke-free environments both contribute to, and are further accelerated by, the publicity, education, debate, and experiences that generally accompany the adoption of smoke-free laws [1, 19]. "
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    ABSTRACT: Background: Exposure to secondhand smoke (SHS) causes significant disease and death. We assessed the prevalence and correlates of perceptions about the health harm of SHS among U.S. adults at the national and state level. Methods: Data came from the 2009-2010 National Adult Tobacco Survey, a national landline and cellular telephone survey. Perceptions about the health harms of SHS were assessed as follows: 'not at all harmful', 'somewhat harmful', and 'very harmful'. Descriptive statistics were used to assess the prevalence of SHS harm perceptions by tobacco use and sociodemographic factors, including sex, age, race/ethnicity, education, marital status, annual household income, region, sexual orientation, children in the household, and smoke-free law coverage. Logistic regression was used to assess odds of perceiving SHS to be "very harmful" (vs. "not at all harmful" or "somewhat harmful"), adjusting for the aforementioned factors. Results: Nationally, 64.5 % of adults perceived SHS as 'very harmful' (state range: 73.5 % [Utah] to 53.7 % [Kentucky]). By tobacco use, the perception that SHS is 'very harmful' was: 76.5 % among nonusers of tobacco; 62.1 % among noncombustible only users; 47.9 % among combustible only users; and 40.8 % among dual combustible and noncombustible users. Following adjustment, the perception that SHS was 'very harmful' was higher among females, non-Hispanic minorities and Hispanics, respondents living with children, and states with 100 % smoke-free law coverage. Among current tobacco users the odds of perceiving SHS to be 'very harmful' was lower in the Midwest than the West. Conclusions: Almost two-thirds of American adults perceive SHS as 'very harmful'; however, currently only half of all Americans are protected by comprehensive state or local smoke-free laws. These findings underscore the importance of public education campaigns to increase awareness of SHS exposure harm and the benefits of smoke-free environments. Expanding comprehensive smoke-free laws could protect all Americans from SHS.
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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.
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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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