Legislative smoking bans for reducing secondhand smoke exposure ...

acted in many jurisdictions, there is also a need for research into the
extent to which exposure to SHS in non-smoking areas is a result
of smoke coming from the outdoor smoking areas. Further studies
should utilise larger sample sizes with common agreed measures
for smoking behaviour and exposure to SHS of the study population.
The lack of a reference group in many studies means that it is
difficult to differentiate between secular trends and impact of the
intervention, particularly on secondary outcomes such as active
smoking rates. The use of factorial design in research, that is a two
way comparison of interventions, utilizing randomized or quasiexperimental
allocation, would enable differentiation between the
effectiveness of a) smoking ban in comparison to a control or reference
region with no ban and b) population subjected to a smoking
ban with or without other smoking cessation intervention(s).
References to studies included in this review
Abrams 2006 {published data only}
Abrams SM, Mahoney MC, Hyland A, Cummings KM, Davis W,
Song L. Early evidence on the effectiveness of clean indoor air
legislation in New York State. American Journal of Public Health
2006;96:296–8.
Akhtar 2007 {published data only}
Akhtar PC, Currie DB, Currie CE, Haw SJ. Changes in child
exposure to environmental tobacco smoke (CHETS) study after
implementation of smoke-free legislation in Scotland:national
cross-sectional survey. BMJ 2007;335(7619):546–9.
Alcouffe 1997 {published data only}
Alcouffe J, Fabin C, Brehier M, Fleuret C, Botran-Aly C, Simonnet
M, et al. Smoking prohibition effect on tobacco habits in Paris area
small firms. Archives des Maladies Professionnelles et de Medecine du
Travail 1997;58(5):455.
Allwright 2005 {published data only}
Allwright S, Paul G, Greiner B, Mullally BJ, Pursell L, Kelly A, et
al. Legislation for smoke-free workplaces and health of bar workers
in Ireland: before and after study. BMJ 2005;331:1117–20.
Barone-Aldesi 2006 {published data only}
Barone-Aldesi F, Vizzini L, Merletti F, Richiardi L. Short-term
effects of Italian smoking regulation on rates of hospital admission
for acute myocardial infarction. European Heart Journal 2006;27:
2468–72.
Bartecchi 2006 {published data only}
Bartecchi C, Alsever RN, Nevin-Woods C, Thomas WM, Estacio
RO, Bucher Bartelson B. Reduction in the incidence of acute
myocardial infarction associated with a citywide smoking
ordinance. Circulation 2006;114:1490–96.
Biener 2007 {published data only}
Biener L, Garrett CA, Skeer M, Siegel M, Connolly G. The effects
on smokers of Boston’s smoke-free bar ordinance: a longitudinal
analysis of changes in compliance, patronage, policy support, and
smoking at home. Journal of Public Health Management and
Practice 2007;13:630–6.
R E F E R E N C E S
Such designs are feasible in large countries with federal, regional
and state level structures and preliminary evidence to date suggests
that public bans are effective but need to be contextualized
as part of wider anti-smoking policy. More research is required on
the long term impact of smoking bans on the health outcomes of
specific subgroups of the population such as the young children,
disadvantaged and minority groups.
A C K N O W L E D G E M E N T S
We wish to acknowledge support and advice from the Cochrane
Tobacco Addiction Review Group.
Bondy 2009 {published data only}
Bondy SJ, Zhang B, Kreiger N, Selby P, Benowitz N, et al. Impact
of an indoor smoking ban on bar workers’ exposure to secondhand
smoke. Journal of Occupational and Environmental Medicine 2009;
51:612–9.
Braverman 2008 {published data only}
Braverman MT, Aarø LE, Hetland J. Changes in smoking among
restaurant and bar employees following Norway’s comprehensive
smoking ban. Health Promotion International 2008;23:5–15.
Brownson 1995 {published data only}
Brownson RC, Davis JR, Jackson-Thompson J, Wilkerson JC.
Environmental tobacco smoke awareness and exposure: impact of a
statewide clean indoor air law and the report of the US
Environmental Protection Agency. Tobacco Control 1995;4:132–8.
CDC 2007 {published data only}
Pechacek T, Kaufmann R, Trosclair A, Caraballo R, Caudill S.
Reduced secondhand smoke exposure after implementation of a
comprehensive statewide smoking ban-New York, June 26, 2003-
June 30 2004. Morbidity & Mortality Weekly Report 2007;56(28):
705–8.
Cesaroni 2008 {published data only}
Cesaroni G, Forastiere F, Agabiti N, Valente P, Zuccaro P, Perucci
CA. Effect of the Italian smoking ban on population rates of acute
coronary events. Circulation 2008;117:1183–8.
Eagan 2006 {published data only}
Eagan T. Decline in respiratory symptoms in service workers five
months after a public smoking ban. Tobacco Control 2006;15:
242–6.
Eisner 1998 {published data only}
Eisner MD, Smith AK, Blanc PD. Bartenders’ respiratory health
after establishment of smoke-free bars and taverns. JAMA 1998;
280:1909–14.
Ellingsen 2006 {published data only}
Ellingsen DG, Fladseth G, Daae HL, Gjolstad M, Kjaerheim K,
Skogstad M, et al. Airborne exposure and biological monitoring of
Legislative smoking bans for reducing secondhand smoke exposure, smoking prevalence and tobacco consumption (Review)
Copyright © 2010 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
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