The population impact of smoke-free workplace and hospitality industry legislation on smoking behaviour. Findings from a national population survey

Abstract

Aims: To study the impact of implementing smoke-free workplace and hospitality industry legislation on smoking behaviour.

Design, setting and participants: A cross-sectional population survey from 2001 to 2008 (n ≈ 18,000 per year) was used to assess trends and seasonal patterns in smoking and quitting, and to examine whether changes could be observed after the workplace smoking ban in the Netherlands in 2004 and the hospitality industry ban in 2008.

Measurements: Outcome measures were smoking prevalence, quit attempts and successful quit attempts. Interactions with educational level (socio-economic status) and bar visiting (exposure to the hospitality industry ban) were tested.

Findings: The workplace ban was followed by a decrease in smoking prevalence (OR = 0.91, P < 0.001), but the hospitality industry ban was not (OR = 0.96, P = 0.127). Both bans, especially the workplace ban, were followed by an increase in quit attempts and successful quit attempts: workplace ban, OR = 1.31, P < 0.001; OR = 1.49, P < 0.001; hospitality industry ban, OR = 1.13, P = 0.013; OR = 1.44, P < 0.001. The workplace ban had a larger effect on successful quitting among higher-educated (OR = 0.35, P < 0.001) than on lower-educated respondents (OR = 0.74, P = 0.052). The hospitality industry ban had a larger effect on quit attempts among frequent bar visitors (OR = 1.48, P = 0.003) than on non-bar visitors (OR = 0.71, P = 0.014).

Conclusions: A workplace smoking ban in the Netherlands was followed by more changes in smoking and quitting than a hospitality industry ban. The hospitality industry ban only appeared to have an impact on quit attempts, and not on smoking prevalence.