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
G T Fong1,
A Hyland2,
R Borland4,
D Hammond3,
G Hastings5,
A McNeill6,
S Anderson5,
K M Cummings2,
S Allwright7,
M Mulcahy8,
F Howell9,
L Clancy10,
M E Thompson11,
G Connolly12,
P Driezen13
1Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
2Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York, USA
3Department of Health Studies and Gerontology, University of Waterloo, Waterloo, Ontario, Canada
4Cancer Control Research Institute, The Cancer Council Victoria, Carlton, Victoria, Australia
5Institute for Social Marketing and Centre for Tobacco Control Research, University of Stirling and the Open University, Stirling, UK
6University College London, London, UK
7Department of Public Health and Primary Care, Trinity College Centre for Health Sciences, Adelaide & Meath Hospital incorporating the National Children's Hospital, Tallaght, Dublin, Republic of Ireland
8Environmental Health Department, Health Service Executive, Western Area, The Annex, Seamus Quirke Road, Galway, Republic of Ireland
9National Population Health Directorate-HSE, Department of Public Health, Railway Street, Navan, County Meath, Republic of Ireland
10Research Institute for a Tobacco-Free Society, The Digital Depot, Dublin, Republic of Ireland
11Department of Statistics and Actuarial Sciences, University of Waterloo, Waterloo, Ontario, Canada
12Tobacco Control Research and Training Program, Harvard School of Public Health, Division of Public Health Practice, Boston, Massachusetts, USA
13International Tobacco Control Policy Evaluation Project, Population Health Research Group, University of Waterloo, Waterloo, Ontario, Canada
Correspondence to:
Geoffrey T Fong
PhD, Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1 Canada; gfong{at}uwaterloo.ca
Objective: To evaluate the psychosocial and behavioural impact of the first ever national level comprehensive workplace smoke-free law, implemented in Ireland in March 2004.
Design: Quasi-experimental prospective cohort survey: parallel cohort telephone surveys of national representative samples of adult smokers in Ireland (n = 769) and the UK (n = 416), surveyed before the law (December 2003 to January 2004) and 8–9 months after the law (December 2004 to January 2005).
Main outcome measures: Respondents' reports of smoking in key public venues, support for total bans in those key venues, and behavioural changes due to the law.
Results: The Irish law led to dramatic declines in reported smoking in all venues, including workplaces (62% to 14%), restaurants (85% to 3%), and bars/pubs (98% to 5%). Support for total bans among Irish smokers increased in all venues, including workplaces (43% to 67%), restaurants (45% to 77%), and bars/pubs (13% to 46%). Overall, 83% of Irish smokers reported that the smoke-free law was a "good" or "very good" thing. The proportion of Irish homes with smoking bans also increased. Approximately 46% of Irish smokers reported that the law had made them more likely to quit. Among Irish smokers who had quit at post-legislation, 80% reported that the law had helped them quit and 88% reported that the law helped them stay quit.
Conclusion: The Ireland smoke-free law stands as a positive example of how a population-level policy intervention can achieve its public health goals while achieving a high level of acceptance among smokers. These findings support initiatives in many countries toward implementing smoke-free legislation, particularly those who have ratified the Framework Convention on Tobacco Control, which calls for legislation to reduce tobacco smoke pollution.
CATI, computer assisted telephone interviewing
FCTC, Framework Convention on Tobacco Control
GEE, generalised estimating equation
ITC-4, International Tobacco Control Four Country Survey
TSP, tobacco smoke pollution
Framework Convention on Tobacco Control
FCTC
smoke-free laws
tobacco control policy
policy evaluation
http://dx.doi.org/10.1136/tc.2005.013649
↵* We use the term "tobacco smoke pollution" although other terms, such as "environmental tobacco smoke", "secondhand smoke", and "passive smoke" have been used.
↵† For the proportions in figs 1 and 2, approximate sampling standard errors may be computed by taking the simple random sampling (unweighted) standard error (square root of (p(1–p)/n), where p is the observed proportion, and n is 769 in Ireland and 416 in the UK) and then multiplying by a factor of 1.2 to account for the variation in the sampling weights.
Funding for this study was provided by grants from the National Cancer Institute of the USA (through R01 CA 90955 and through the Roswell Park Transdisciplinary Tobacco Use Research Center, P50 CA111236), Cancer Research UK, Flight Attendants' Medical Research Institute (012525), Research Institute for a Tobacco-Free Society, Dublin, and unrestricted grants from Glaxo Smith Kline and from Pfizer. The funding sources had no role in the study design, in the collection, analysis, and interpretation of data, in the writing of the report, and in the decision to submit the paper for publication.
Competing interest statement: All authors declare that the answer to the questions on your competing interest form www.bmj.com/cgi/content/full/317/7154/291/DC1 are all "No" and therefore have nothing to declare.
Ethics approval: As indicated in the manuscript, the study protocol was reviewed and cleared by the Research Ethics Board of the University of Waterloo.
Copyright 2006 Tobacco Control