Smoking Ban

Smoke-free laws, sometimes colloquially referred to as “smoking bans” are key tobacco control public policies, including criminal laws and occupational safety and health regulations, which prohibit tobacco smoking in workplaces and/or other public spaces. Legislation may also define smoking as more generally being the carrying or possessing of any lit tobacco product.[1]

Rationale

The rationale for smoke-free laws posits that smoking is optional, whereas breathing is not. Therefore, smoke-free laws exist to protect breathing people from the effects of second-hand smoke, which include an increased risk of heart diseasecanceremphysema, and other diseases.[2][3] Laws implementing bans on indoor smoking have been introduced by many countries in various forms over the years, with some legislators citing scientific evidence that shows tobacco smoking is harmful to the smokers themselves and to those inhaling second-hand smoke.

In addition, such laws may reduce health care costs,[4] improve work productivity, and lower the overall cost of labour in the community thus protected, making that workforce more attractive for employers. In the US state of Indiana, the economic development agency included in its 2006 plan for acceleration of economic growth encouragement for cities and towns to adopt local smoke-free workplace laws as a means of promoting job growth in communities.

Additional rationales for smoking restrictions include reduced risk of fire in areas with explosive hazards; cleanliness in places where food, pharmaceuticals, semiconductors, or precision instruments and machinery are produced; decreased legal liability; potentially reduced energy use via decreased ventilation needs; reduced quantities of litter; healthier environments; and giving smokers incentive to quit[5].

The World Health Organization considers smoke-free laws to have an influence to reduce demand for tobacco by creating an environment where smoking becomes increasingly more difficult and to help shift social norms away from the acceptance of smoking in everyday life. Along with tax measures, cessation measures, and education, smoke-free regulations are viewed by public health experts as an important element in reducing smoking rates and promoting positive health outcomes. When effectively implemented they are seen as an important element of policy to support behaviour change in favour of a healthy lifestyle[6].

Medical and scientific basis for smoking restrictions

Main article: Passive smoking

Research has generated evidence that second-hand smoke causes the same problems as direct smoking, including lung cancercardiovascular disease, and lung ailments such as emphysema,bronchitis, and asthma.[7] Specifically, meta-analyses show that lifelong non-smokers with partners who smoke in the home have a 20–30% greater risk of lung cancer than non-smokers who live with non-smokers. Non-smokers exposed to cigarette smoke in the workplace have an increased lung cancer risk of 16–19%.[8]

A study issued in 2002 by the International Agency for Research on Cancer of the World Health Organization concluded that non-smokers are exposed to the same carcinogens on account of tobacco smoke as active smokers.[9] Sidestream smoke[10] contains 69 known carcinogens, particularly benzopyrene[11] and other polynuclear aromatic hydrocarbons, and radioactive decay products, such aspolonium 210.[12] Several well-established carcinogens have been shown by the tobacco companies’ own research to be present at higher concentrations in second-hand smoke than in mainstream smoke.[13]

Scientific organisations confirming the effects of second-hand smoke include the U.S. National Cancer Institute,[14] the U.S. Centers for Disease Control and Prevention (CDC),[15] the U.S. National Institutes of Health,[16] the Surgeon General of the United States,[17] and the World Health Organization.[18]

Air quality

Restrictions upon smoking in bars and restaurants can substantially improve the air quality in such establishments. For example, one study listed on the website of the U.S. Centers for Disease Control and Prevention states that New York’s statewide law to eliminate smoking in enclosed workplaces and public places substantially reduced RSP (respirable suspended particles) levels in western New York hospitality venues. RSP levels were reduced in every venue that permitted smoking before the law was implemented, including venues in which only second-hand smoke from an adjacent room was observed at baseline.[19] The CDC concluded that their results were similar to other studies which also showed substantially improved indoor air quality after smoke-free regulations were instituted.

A 2004 study showed New Jersey bars and restaurants had more than nine times the levels of indoor air pollution of neighbouring New York City, which had already enacted its smoke-free law.[20]

Research has also shown that improved air quality translates to decreased toxin exposure among employees.[21] For example, among employees of the Norwegian establishments that enacted smoking restrictions, tests showed improved (i.e. decreased) levels of nicotine in the urine of both smoking and non-smoking workers (as compared with measurements prior to going smoke-free).[22]

Public Health Law Research

In 2009, the journal Public Health Law Research published an evidence brief summarising the research assessing the effect of a specific law or policy on public health. They stated that “There is strong evidence supporting smoking bans and restrictions as effective public health interventions aimed at decreasing exposure to secondhand smoke.”[23]

History

One of the world’s earliest smoke-free ordinances was a 1575 Mexican ecclesiastical council regulation which forbade the use of tobacco in any church in Mexico and Spanish colonies in the Caribbean. The Ottoman Sultan Murad IV prohibited smoking in his empire in 1633.[24] The Pope also banned smoking in the Church, Pope Urban VII in 1590[25] and Urban VIII in 1624.[24] Pope Urban VII in particular threatened to excommunicate anyone who “took tobacco in the porchway of or inside a church, whether it be by chewing it, smoking it with a pipe or sniffing it in powdered form through the nose”.[26] The earliest citywide European smoking bans were enacted shortly thereafter. Such bans were enacted in Bavaria, Kursachsen, and certain parts of Austria in the late 17th century. Smoking was banned in Berlin in 1723, in Königsberg in 1742, and in Stettin in 1744. These bans were repealed in the revolutions of 1848.[27] The first building in the world to have a smoke-free policy was the Old Government Building in Wellington, New Zealand in 1876. This was over concerns about the threat of fire, as it is the second largest wooden building in the world.[28]

The first modern attempt at restricting smoking was imposed by the then German government in every university, post office, military hospital, and Nazi Party office, under the auspices of Karl Astel’s Institute for Tobacco Hazards Research, created in 1941 under orders from Adolf Hitler.[29] Major anti-tobacco campaigns were widely broadcast by the Nazis until the demise of the regime in 1945.[30]

In the latter part of the 20th century, as research on the risks of second-hand tobacco smoke became public, the tobacco industry launched “courtesy awareness” campaigns. Fearing reduced sales, the industry created a media and legislative programme that focused upon “accommodation”. Tolerance and courtesy were encouraged as a way to ease heightened tensions between smokers and those around them, while avoiding smoking bans. In the USA, states were encouraged to pass laws providing separate smoking sections.[31]

In 1975, the US state of Minnesota enacted the Minnesota Clean Indoor Air Act, making it the first state to restrict smoking in most public spaces. At first, restaurants were required to have No Smoking sections, and bars were exempt from the Act.[32] As of 1 October 2007, Minnesota enacted a ban on smoking in all restaurants and bars statewide, called the Freedom to Breathe Act of 2007.[33]

The resort town of Aspen, Colorado, became the first city in the country to restrict smoking in restaurants, in 1985.[34]

On April 3, 1987, the City of Beverly Hills, California, initiated an ordance to restrict smoking in most restaurants, in retail stores and at public meetings. It exempted restaurants in hotels – City Council members reasoned that hotel restaurants catered to large numbers of visitors from abroad, where smoking is more acceptable than in the United States.

In 1990, the city of San Luis Obispo, California, became the first city in the world to restrict indoor smoking in all public places, including bars and restaurants.[35]

In America, the success of the smoke-free law enacted by the state of California in 1998 encouraged other states such as New York to implement similar regulations. California’s smoke-free law included a controversial restriction upon smoking in bars, extending the statewide workplace smoke-free ordinance enacted in 1994. As of April 2009 there were 37 states with some form of smoke-free provision.[36] Some areas in California began making entire cities smoke-free, which would include every place except residential homes. More than 20 cities in California enacted park and beach smoking restrictions.

Since December 1993, in Peru, it is illegal to smoke in any public enclosed places and any public transport vehicles (according to Law 25357 issued on Nov 27, 1991 and its regulations issued on Nov 25, 1993 by decree D.S.983-93-PCM). There is also legislation restricting publicity, and it is also illegal (Law 26957 May 21, 1998) to sell tobacco to minors or directly advertise tobacco within 500m of schools (Law 26849 Jul 9, 1997).

On 3 December 2003, New Zealand passed legislation to progressively implement a smoke-free law in schools, school grounds, and workplaces by December 2004[37]. On 29 March 2004, the Republic of Ireland implemented a smoke-free workplace law. In Norway similar legislation was put into force on 1 June the same year.

The whole of the United Kingdom achieved smoke-free workplaces in 2007, when England became the final region to have the legislation come into effect (the age limit for buying tobacco was also raised from 16 to 18 on 1 October 2007).

On July 15, 2007, Chandigarh became the first city in India to endeavour to become smoke-free. Smoking was restricted in public indoor venues in Victoria, Australia on 1 July 2007. Nepal announced a restriction upon smoking in public places, as well as by those under age 16 in June 2010.[38] On 31 May 2011 Venezuela introduced a restriction upon smoking in enclosed public and commercial spaces.[39]

Smoking was first restricted in schools, hospitals, trains, buses and train stations in Turkey in 1996. In 2008, a more comprehensive smoke-free law was implemented, covering all all public indoor venues.

Smoking has been restricted at a French beach – the Plage Lumière in La Ciotat, France, became the first beach in Europe[40] to restrict smoking, from August 2011, in an effort to encourage more tourists to visit the beach.

Cigarette advertising

In several parts of the world, tobacco advertising and sponsorship of sporting events is prohibited. The bar upon tobacco advertising and sponsorship in the European Union in 2005 prompted Formula One Management to look for venues that permit display of the livery of tobacco sponsors, and led to some of the races on the calendar being cancelled in favor of more ‘tobacco-friendly’ markets. As of 2008, only one Formula One team, Scuderia Ferrari, received sponsorship from a tobacco company. Marlboro branding appeared on its cars in two races; Monaco and China, as neither restricts tobacco advertising. Despite the EU prohibition from 2005, advertising bill-boards for tobacco were still in use in Germany as of 2011.

MotoGP team Ducati Marlboro received sponsorship from Marlboro, its branding appearing at races in Qatar and China. On 1 July 2009 Ireland prohibited the advertising and display of tobacco products in all retail outlets; when fully implemented, this will mean that shops will have to store cigarettes in closed containers out of sight of customers.

Public support for smoke-free laws

A 2007 Gallup poll found that 54% of Americans favoured completely smoke-free restaurants, 34% favoured completely smoke-free hotel rooms, and 29% favoured completely smoke-free bars[41].

Another Gallup poll, of over 26,500 Europeans, conducted in December 2008, found that “a majority of EU citizens support smoke-free public places, such as offices, restaurants and bars.” The poll further found that “support for workplace smoking restrictions is slightly higher than support for such restrictions in restaurants (84% vs. 79%). Two-thirds support smoke-free bars, pubs and clubs.” The support is highest in countries which have implemented clear smoke-free laws: “Citizens in Italy are the most prone to accept smoking restrictions in bars, pubs and clubs (93% – 87% “totally in favour”). Sweden and Ireland join Italy at the higher end of the scale with approximately eight out of 10 respondents supporting smoke-free bars, pubs and clubs (70% in both countries is totally in favor).”[42]

Effects of smoke-free regulations

Effects upon health

Several studies have documented health and economic benefits related to smoke-free regulations. In the first 18 months after Pueblo, Colorado enacted a 2003 smoke-free law, hospital admissions for heart attacks dropped by 27% while admissions in neighbouring towns without smoke-free regulations showed no change. The decline in heart attacks was attributed to the smoke-free law, which reduced exposure to second-hand smoke.[43] A similar study in Helena, Montana found a 40% reduction in heart attacks following the imposition of a smoke-free law.[44] However, a 2010 study comparing US nationwide data suggested that smoke-free regulations may not associated with statistically significant short-term declines in mortality or hospital admissions for myocardial infarction or other diseases.[45]

Researchers at the University of Dundee found significant improvements in bar workers’ lung function and inflammatory markers attributed to the introduction of smoke-free workplaces; the benefits were particularly pronounced for bar workers with asthma.[46] The Bar Workers’ Health and Environment Tobacco Smoke Exposure (BHETSE) study found the percentage of all workers reporting respiratory symptoms, such as wheezing, shortness of breath, cough and phlegm production, fell from 69% to 57%.[47] A group of researchers from Turin, Italy found that smoking restrictions had significantly reduced heart attacks in the city, and attributed most of the reduction to decreased second-hand smoke exposure.[48] A comprehensive smoke-free law in New York was found to have prevented 3,813 hospital admissions for heart attacks in 2004, and to have saved $56 million in health-care costs for the year.[49]

A study in England estimated a 2.4% reduction in heart attack emergency admissions to hospital (or 1,200 fewer admissions) in the 12 months following the introduction of smoke-free workplace regualtions.[50][51]

Effects upon tobacco consumption

Smoke-free laws bans are generally acknowledged to reduce rates of smoking; smoke-free workplaces reduce smoking rates among workers,[52] and restrictions upon smoking in public places reduce general smoking rates through a combination of stigmatisation and reduction in the social cues for smoking.[53] However, reports in the popular press after smoke-free laws have been enacted often present conflicting accounts as regards perceptions of effectiveness.

One report stated that cigarette sales in Ireland and Scotland increased after a smoke-free laws were introduced.[54] In contrast, another report states that in Ireland, cigarette sales fell by 16% in the six months after the introduction of smoke-free workplaces.[55] In the UK, cigarette sales fell by 11% during July 2007, the first month of nation-wide smoke-free workplaces, compared with July 2006.[56]

A 1992 document from Phillip Morris summarised the tobacco industry’s concern about the effects of smoke-free legislation: “Total prohibition of smoking in the workplace strongly effects [sic] tobacco industry volume. Smokers facing these restrictions consume 11%–15% less than average and quit at a rate that is 84% higher than average.”[57]

In the United States, the CDC reported a levelling-off of smoking rates in recent years despite a large number of ever more comprehensive smoke-free laws and large tax increases. It has also been suggested that a “backstop” of hardcore smokers has been reached: those unmotivated and increasingly defiant in the face of further legislation.[58]

In Sweden, use of snus, as an alternative to smoking, has risen steadily since the introduction of smoke-free workplaces.[59]

Smoking restrictions may make it easier for smokers to quit. A survey suggests 22% of UK smokers may have considered quitting in response to the introduction of smoke-free workplaces.[60]

Restaurant smoking restrictions may help to stop young people from becoming habitual smokers. A study of Massachusetts youths, found that those in towns with smoke-free regulations were 35 percent less likely to be habitual smokers.[61][62]

Effects upon businesses

Many studies have been published in the health industry literature on the economic effect of smoke-free policies. The majority of these government and academic studies have found that there is no negative economic impact associated with smoking restrictions and many findings that there may be a positive effect on local businesses.[63] A 2003 review of 97 such studies of the economic effects of a smoking ban on the hospitality industry found that the “best-designed” studies concluded that smoking bans did not harm businesses.[64]

Studies funded by the bar and restaurant associations have sometimes claimed that smoke-free legislation has a negative effect on restaurant and bar profits. Such associations have also criticised studies which found that such legislation had no impact.[65]

The following are some examples: the Dallas Restaurant Association funded a study that showed a $11.8 million decline in alcohol sales ranging from 9 to 50% in Denton, Texas. A 2004 study by Ridgewood Economic Associates LTD funded by the Empire State Restaurant and Tavern Association found a loss of 2000 jobs, $28.5 million dollar loss in wages, and a loss of $37 million in New York State product.[66] A 2004 study for the National Restaurant Associationof the United States conducted by Deloitte and Touche found a significant negative impact. The restaurant Association of Maryland found sales tax receipts for establishments falling 11% in their study. Carroll and Associates found bars sales decreased by 18.7% to 24.3% in a number of Ontario markets following the introduction of smoke-free bars.[67] The Buckeye Liquor Permit Holders Association reported that liquor sales were down over $67 million dollars while sales for home consumption increased and asked for the smoke-free regulations to be amended in Ohio.[68]

Australia

A government survey in Sydney found that the proportion of the population attending pubs and clubs rose after the introduction of a smoke-free enclosed places.[69]However, a ClubsNSW report in August 2008 blamed the smoke-free law for New South Wales clubs suffering their worst fall in income ever, amounting to a decline of $385 million. Income for clubs was down 11% in New South Wales. Sydney CBD club income fell 21.7% and western Sydney clubs lost 15.5%.[70]

Germany

Smoking restrictions were introduced in German hotels, restaurants, and bars in 2008 and early 2009. The restaurant industry has claimed that some businesses in the states which introduced a smoke-free law in late 2007 (Lower SaxonyBaden-Württemberg, and Hessen) experienced reduced profits. The German Hotel and Restaurant Association (DEHOGA) claimed that the smoke-free law deterred people from going out for a drink or meal, stating that 15% of establishments that adopted a smoke-free law in 2007 saw turnover fall by around 50%.[71] Smoking is not permitted in any public transit or in or around railway stations except for the locations expressly indicated for smoking. Smoking on trains itself was prohibited completely by the Deutsche Bahn AG in 2007, and there was a permanent reduction of smoking compartments on all trains in 2000.[72] Smoking has restricted in airports and all Lufthansa planes since the late 1990s[73].

In 2008, Bavaria was the first federal state of Germany to restrict smoking in every bar and restaurant. After this restriction was criticised as being “too hard” by some members of the governing party CSU, it was relaxed one year later. Supporters of smoke-free regulations then brought about a public referendum on the issue, which led to even firmer restrictions than the initial smoke-free law. Thereafter a more comprehensive smoke-free law was introduced in 2010[74].

Ireland

In the Republic of Ireland, the main opposition was from publicans. Ireland was the world’s first country to introduce fully smoke-free workplaces. The Irish workplace smoke-free law was introduced with the intention of protecting workers from second-hand smoke and to discourage smoking in a nation with a high percentage of smokers. Many pubs introduced “outdoor” arrangements (generally heated areas with shelters). It was speculated by opponents that the smoke-free workplaces law would increase the amount of drinking and smoking in the home, but recent studies showed this was not the case.[75]

Ireland’s Office of Tobacco Control website indicates that “an evaluation of the official hospitality sector data shows there has been no adverse economic effect from the introduction of this measure (the March 2004 national introduction of smoke-free in bars, restaurants, etc). It has been claimed that the smoke-free law was a significant contributing factor to the closure of hundreds of small rural pubs, with almost 440 fewer licences renewed in 2006 than in 2005.[76]

Isle of Man

Smoke-free restrictions came into effect in the Isle of Man on 30 March 2008.

United Kingdom

Smoke-free regulations came into effect in Scotland on 26 March 2006,[77] in Wales on 2 April 2007, in Northern Ireland on 30 April 2007 and in England on 1 July 2007.[78] Six months after implementation in Wales, the Licensed Victuallers Association (LVA), which represents pub operators across Wales, claimed pubs had lost up to 20% of their trade. The LVA says some businesses were on the brink of closure, others had already closed down, and there was little optimism trade would eventually return to previous levels.[79]

The British Beer and Pub Association (BBPA), which represents some pubs and breweries across the UK claimed that beer sales were at their lowest level since the 1930s, ascribing a fall in sales of 7% during 2007 to the smoke-free reasgulations.[80]

According to a survey conducted by pub and bar trade magazine The Publican, the anticipated increase in sales of food following intrduction of smoke-free workplaces has not occurred. The trade magazine’s survey of 303 pubs in the United Kingdom found the average customer spent £14.86 on food and drink at dinner in 2007, virtually identical to 2006.[81]

A survey conducted by BII (formerly British Institute of Innkeeping) and the Federation of Licensed Victuallers’ Associations (FLVA) concluded that sales had decreased by 7.3% in the 5 months since the introduction of smoke-free workplaces on 1 July 2007. Of the 2,708 responses to the survey, 58% of licensees said they had seen smokers visiting less regularly, while 73% had seen their smoking customers spending less time at the pub.[82]

United States

In the USA, smokers and hospitality businesses initially argued that businesses would suffer from smoke-free laws. However, a 2006 review by the U.S. Surgeon Generalfound that smoking restrictions were unlikely to harm businesses in practice, and that many restaurants and bars might see increased business.[83][84]

In 2003, New York City amended its smoke-free law to include all restaurants and bars, including those in private clubs, making it, along with the California smoke-free law, one of the toughest in the United States. The city’s Department of Health found in a 2004 study that air pollution levels had decreased sixfold in bars and restaurants after the restrictions went into effect, and that New Yorkers had reported less second-hand smoke in the workplace. The study also found the city’s restaurants and bars prospered despite the smoke-free law, with increases in jobs, liquor licenses, and business tax payments. The President of the New York nightlife association remarked that the study was not wholly representative, as by not differentiating between restaurants and nightclubs, the reform may have caused businesses like nightclubs and bars to suffer instead.[85] A 2006 study by the New York State Department of Health found similar results: “(…) the CIAA has not had any significant negative financial effect on restaurants and bars in either the short or the long term.”[86]

Effects upon musical instruments

Bellows-driven instruments – such as the accordionconcertinamelodeon and Uilleann (or Irish) bagpipes – reportedly need less frequent cleaning and maintenance as a result of the Irish smoke-free law.[87]

Effects of prison smoking restrictions

Prisons are increasingly restricting tobacco smoking.[88] In the United States, some states with smoke-free prison policies only prohibit indoor smoking whereas others disallow smoking on the entire prison grounds.[89] In July 2004 the Federal Bureau of Prisons adopted a smoke-free policy for its facilities.[90] A 1993 Supreme Court ruling acknowledged that a prisoner’s exposure to second-hand smoke could be regarded as cruel and unusual punishment (which would be in violation of the Eighth Amendment).[91] A 1997 ruling in Massachusetts established that prison smoking bans do not constitute cruel and unusual punishment.[92] Many officials view prison smoking bans as a means of reducing health-care costs.[93]

Prison officials and guards are sometimes worried due to previous events in other prisons concerning riots, fostering a cigarette black market within the prison, and other problems resulting from total prison smoking restrictions. Prisons have experienced riots when placing smoking restrictions into effect resulting in prisoners setting fires, destroying prison property, persons being assaulted, injured, and stabbed. One prison in Canada had some guards reporting breathing difficulties from the fumes of prisoners smoking artificial cigarettes made from nicotine patches lit by creating sparks from inserting metal objects into electrical outlets.[94][95] For example in 2008, the Orsainville Detention Centre near Quebec City, withdrew its smoke-free provision following a riot. But the feared increase in tension and violence expected in association with smoking restrictions has generally not been experienced in practice.[92]

Compliance

The introduction of smoking restrictions occasionally generates protests[96] and predictions of widespread non-compliance, and media stories regarding the rise of clandestine smokeasies, including in New York City,[97] Northern Ireland,[98][99] Germany,[100] Illinois,[101] the United Kingdom,[102] Utah,[103] and Washington, D.C.[104]

In reality, however, high levels of compliance with smoke-free laws (in excess of 90 per cent) have been reported in most jurisdictions including New York,[105] Ireland,[106] Italy[107] and Scotland.[108]Poor compliance was reported in Kolkata.[109]

Criticism of smoke-free laws

Smoke-free regulations and ordinances have been criticised on a number of grounds.

Government interference with personal lifestyle

Critics of smoke-free provisions, including musician Joe Jackson,[110] and political essayist Christopher Hitchens,[111][112] have claimed that regulation efforts are misguided. Typically, such arguments are based upon an interpretation of John Stuart Mill‘s harm principle which perceives smoke-free laws as an obstacle to tobacco consumption per se, rather than a bar upon harming other people.

Such arguments, which usually refer to the notion of personal liberty, have themselves been criticised by Nobel Prize-winning economist Amartya Sen who defended smoke-free regulations on several grounds.[113] Among other things, Sen argued that while a person may be free to acquire the habit of smoking, they thereby restrict their own freedom in the future given that the habit of smoking is hard to break.[113] Sen also pointed out the heavy costs that smoking inevitably imposes on every society which grants smokers unrestricted access to public services (which, Sen noted, every society that is not “monstrously unforgiving” would do).[113] Arguments which invoke the notion of personal liberty against smoke-free laws are thus incomplete and inadequate, according to Sen[113].

Property rights

Some critics of smoke-free laws emphasise the property rights of business owners, drawing a distinction between nominally public places (such as government buildings) and privately-owned establishments (such as bars and restaurants). Citing economic efficiency, some economists suggest that the basic institutions of private property rights and contractual freedom are capable of resolving conflicts between the preferences of smokers and those who seek a smoke-free environment, without government intrusion.[114]

Legality of smoke-free regulations

Businesses affected by smoke-free regulations have filed lawsuits claiming that these are unconstitutional or otherwise illegal. In the United States, some cite unequal protection under the law while others cite loss of business without compensation, as well as other types of challenges. Some localities where hospitality businesses filed lawsuits against the State or local government include,NevadaMontanaIowaColoradoKentucky, New York, South Carolina, and Hawaii.[115][116][117][118][119][120][121][122] Such lawsuits have generally been unsuccessful.

Smoke-free laws may move smoking elsewhere

Restrictions upon smoking in offices and other enclosed public places often result in smokers going outside to smoke, frequently congregating outside doorways. Many jurisdictions that have restricted smoking in enclosed public places have extended provisions to cover areas within a fixed distance of entrances to buildings[123].

The former British Secretary of State for Health John Reid claimed that restrictions upon smoking in public places may lead to more smoking at home.[124] However, both the House of Commons Health Committee and the Royal College of Physicians disagreed, with the former finding no evidence to support Reid’s claim after studying Ireland,[124] and the latter finding that smoke-free households increased from 22% to 37% between 1996 and 2003.[125]

In January 2010, the mayor of Boston, Massachusetts, Thomas Menino, proposed a restriction upon smoking inside public housing apartments under the jurisdiction of the Boston Housing Authority.[126][127]

Connection to DUI fatalities

In May 2008, research published by Adams and Cotti in the Journal of Public Economics examined statistics of drunken-driving fatalities and accidents in areas where smoke-free laws have been implemented in bars and found that fatal drunken-driving accidents increased by about 13 percent, or about 2.5 such accidents per year for a typical county of 680,000. They speculate this could be caused by smokers driving farther away to jurisdictions without smoke-free laws or where enforcement is lax. No evidence is presented for jurisdictions where smoke-free laws and enforcement thereof are consistent.[128]

Effects of funding on research literature

As in other areas of research, the effect of funding on research literature has been discussed with respect to smoke-free laws. Most commonly, studies which found few or no positive and/or negative effects of smoke-free laws and which were funded by tobacco companies have been delegitimised because they were seen as biased in favor of their funders.[129]

Professor of Economics at the California State Polytechnic University-San Luis Obispo, Michael L. Marlow, defended “tobacco-sponsored” studies arguing that all studies merited “scrutiny and a degree of skepticism,” irrespective of their funding. He wished for the basic assumption that every author were “fair minded and trustworthy, and deserves being heard out” and for less attention to research funding when evaluating the results of a study. Marlow suggests that studies funded by tobacco companies are viewed and dismissed as “deceitful,”[130] i.e. as being driven by (conscious) bad intention.

Alternatives to smoke-free laws

Incentives for voluntarily smoke-free establishments

During the debates over the Washington, DC, smoke-free law, city council member Carol Schwartz proposed legislation that would have enacted either a substantial tax credit for businesses that chose to voluntarily restrict smoking or a quadrupling of the annual business license fee for bars, restaurants and clubs that wished to allow smoking. Additionally, locations allowing smoking would have been required to install specified high-performance ventilation systems.[131]

Ventilation

Critics of smoke-free laws have suggested that ventilation is a means of reducing the harmful effects of second-hand smoke. A tobacco industry-funded study conducted by the School of Technology of the University of Glamorgan in Wales, published in the Building Services Journal suggested that “ventilation is effective in controlling the level of contamination”, although “ventilation can only dilute or partially displace contaminants and occupational exposure limits are based on the ‘as low as reasonably practicable’ principle”.[132] [133]

Some hospitality organisations have claimed that ventilation systems could bring venues into line with smoke-free restaurant ordinances. A study published by the American Society of Heating, Refrigerating and Air-Conditioning Engineers and funded by the Robert Wood Johnson Foundation found one establishment with lower air quality in the non-smoking section, due to improperly installed ventilation systems. They also determined that even properly functioning systems “are not substitutes for smoking bans in controlling environmental smoke exposure.”[134]

The tobacco industry has focused on proposing ventilation as an alternative to smoke-free laws, though this approach has not been widely adopted in the U.S. because “in the end, it is simpler, cheaper, and healthier to end smoking.”[135] The Italian smoke-free law ban permits dedicated smoking rooms with automatic doors and smoke extractors. Nevertheless, few Italian establishments are creating smoking rooms due to the additional cost.[136]

A landmark report from the U.S. Surgeon General found that even the use of elaborate ventilation systems and smoking rooms fail to provide protection from the health hazards of second-hand smoke, since there is “no safe level of second-hand smoke”.[137]

Preemption

A number of states in the United States have “preemption clauses” within state law which block local communities from passing smoke-free ordinances more strict than the state laws on the books. The rationale is to prevent local communities from passing smoke-free ordinances which are viewed as excessive by that state’s legislature. Other states have “anti-preemption clauses” that allow local communities to pass smoking ban ordinances that their legislature found unacceptable.[138]

Hardship exemptions

In Wauwatosa, Wisconsin, three restaurants received short-term exemptions from a local smoke-free ordinance in restaurants when they managed to demonstrate financial suffering because of it.[139]

References

Check—> References

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