Tobacco and Public Health - TCSC Indonesia

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IMPACT OF SMOKE-FREE BANS AND RESTRICTIONS
et al. 2002). A high level of compliance with workplace smoking bans is related to the
consultative process used with employees. The literature indicates that use of a consultative
process that involves employees is related to employee acceptance of bans and to
high compliance with them. For example, a survey of clerical workers comparing
methods of implementing workplace smoking bans found acceptance was enhanced by
providing thorough information about why the bans were required before they were
imposed and doing this in a social sensitivity manner which acknowledged the inconvenience
and difficulties for smokers. The survey also found that smokers showed the
most incremental gain in accepting bans after exposure to comprehensive information
presented in a highly sensitive manner and that all employees valued the fairness
associated with the process (Greenberg 1994). Kemp et al. (1993), in an Australian
study of pockets of non-compliance with a total indoor workplace ban, found that
non-compliance was largely due to poor management practice, not to any characteristics
of the smokers. Management support may be more important than the specific
approach used to implement smoking restrictions and bans. However, regardless of
how bans are implemented, a subgroup of smokers may require additional help in the
form of quit programmes or assistance with cravings to help them adjust to bans.
Overall, studies have consistently shown support for workplace bans and that the
level of support improves after implementation especially where compliance is high
(Borland et al. 1990a;Hocking et al. 1991; Daughton et al. 1992; Brownson et al. 2002).
There is also data from Japan that supports strong acceptance and high compliance
with bans (Mizoue et al. 1999).
Research indicates that even though heavy smokers may find it harder to comply
with bans than lighter smokers (Daughton et al. 1992), a substantial number of smokers
approve and accept bans in a context of almost universal compliance (Owen et al.
1991; Stave and Jackson 1991; Daughton et al. 1992; Emont et al. 1995). This finding is
consistent with the notion that many smokers are ambivalent about their smoking and
that they adjust attitudes in line with behaviours, even when the behaviour change is
not voluntary (Borland et al. 1990a).
The nature of the restrictions affect their effectiveness in ways that are entirely
predictable. Research indicates that smoking bans are more effective than partial
smoking restrictions in reducing ETS (Hopkins et al. 2001). Compliance is higher for
total bans (Sorensen et al. 1991; Wakefield et al. 1996) and satisfaction with smoking
regulations appear highest when employees report the least amount of exposure to
environmental tobacco smoke (Sorensen et al. 1991). This has also been found in
Germany (Brenner et al. 1997). The next most effective restriction is ventilated smoking
lounges, but is more costly and can elevate lung cancer risk in smokers. The least
effective restriction in reducing ETS being designated smoking area without ventilation
(Brownson et al. 2002). Japanese research (Mizoue et al. 1999) supports the
finding that complete bans are complied with better suggesting considerable generality
of this phenomenon. There is a tendency to support the level of restriction to which