Impact of smoke-free legislation among smokers – Findings from the ITC Europe Surveys Ute Mons

1. WCToH 2012, Singapore, March 2012 Impact of smoke-free legislation among smokers – Findings from the ITC Europe Surveys Ute Mons German Cancer Research Center (DKFZ) Heidelberg, Germany

2. Background Methods Findings Conclusions • Exposure to secondhand smoke (SHS) is an important health risk. Effective measures to provide protection from SHS require the total elimination of smoking in a particular space to create a smoke-free environment. • Public support for smoke-free policies are considered to be a key variable in the process of their adoption and with regards to compliance with the regulations. • Opponents of smoke-free policies have argued that such policies could lead to displacement of smoking into the private home and hence even increase SHS exposure of non-smoking family members and children.

3. Background Methods Findings Conclusions

4. Background Methods Findings Conclusions

5. Background Methods Findings Conclusions Measures: • „The last time you visited, were people smoking inside?“ (separately for bars/pubs and restaurants) • „Should smoking be allowed in all indoor areas, in some indoor areas, or not allowed indoors at all?“ (separately for bars/pubs and restaurants) • „Which of the following statements best describes smoking inside your home? Smoking is allowed anywhere inside your home, smoking is never allowed inside your home, something inbetween.“

6. Background Methods Findings Conclusions Smoking in hospitality venues and policy support among smokers

7. Background Methods Findings Conclusions ITC Europe surveys, cross-sectionalsmokersamples, weightedfigures Smoking ban March 2004

8. Background Methods Findings Conclusions ITC Europe surveys, cross-sectionalsmokersamples, weightedfigures Smoking ban March 2004

9. Background Methods Findings Conclusions ITC Europe surveys, cross-sectionalsmokersamples, weightedfigures Smoking ban Scotland March 2006 Smoking ban Rest of UK April/July 2007

10. Background Methods Findings Conclusions ITC Europe surveys, cross-sectionalsmokersamples, weightedfigures Smoking ban Scotland March 2006 Smoking ban Rest of UK April/July 2007

11. Background Methods Findings Conclusions ITC Europe surveys, cross-sectionalsmokersamples, weightedfigures Smoking ban January 2008

12. Background Methods Findings Conclusions ITC Europe surveys, cross-sectionalsmokersamples, weightedfigures Smoking ban January 2008

13. Background Methods Findings Conclusions ITC Europe surveys, cross-sectionalsmokersamples, weightedfigures Smoking ban Aug 2007 - Jul 2008 (partial bans in all states but Bavaria) April 2011 (total smoking ban comes into force in Saarland) August 2009 (Bavaria lifts total ban) August 2010 (comprehensive ban in Bavaria after successful referendum) Constitutional Court August 2008 (overturns ban in small bars)

14. Background Methods Findings Conclusions ITC Europe surveys, cross-sectionalsmokersamples, weightedfigures Smoking ban Aug 2007 - Jul 2008 (partial bans in all states but Bavaria) April 2011 (total smoking ban comes into force in Saarland) August 2009 (Bavaria lifts total ban) August 2010 (comprehensive ban in Bavaria after successful referendum) Constitutional Court August 2008 (overturns ban in small bars)

15. Background Methods Findings Conclusions ITC Europe surveys, cross-sectionalsmokersamples, weightedfigures April 2011 (total smoking ban comes into force in Saarland) Smoking ban Aug 2007 - Jul 2008 (partial bans in all states but Bavaria) August 2009 (Bavaria lifts total ban) August 2010 (comprehensive ban in Bavaria after successful referendum)

16. Background Methods Findings Conclusions July 2011 (smoking ban officially lifted for small bars without employees) ITC Europe surveys, cross-sectionalsmokersamples, weightedfigures November 2010 (smoking ban unofficially lifted for small bars without employees – no fines) Smoking ban July 2008 (partial ban) July 2009 (smoking ban temporarily lifted for small bars without employees) March 2010 (Supreme court decision – ban in small bars is constitutional)

17. Background Methods Findings Conclusions ITC Europe surveys, cross-sectionalsmokersamples, weightedfigures Smoking ban July 2008 (partial ban)

18. Background Methods Findings Conclusions Conclusions • Only comprehensive policies are effective in eliminating smoking in hospitality venues • Only comprehensive policies substantially improve support once the policy is in place

19. Background Methods Findings Conclusions Displacement of smoking?

20. Background Methods Findings Conclusions ITC Europe surveys, cross-sectionalsmokersamples, weightedfigures

21. Background Methods Findings Conclusions Conclusions (contd.) • Only comprehensive policies are effective in eliminating smoking in hospitality venues • Only comprehensive policies substantially improve support once the policy is in place • No evidence of displacement of smoking into the home was found in any of the examined countries

23. Thank youfor your attention! Contact: u.mons@dkfz.de