Paper
Saturday, July 14, 2007
Effect of a Smoke-free Law on the Community Smoking Rate
Ellen J. Hahn, RN, DNS, Mary Kay Rayens, PhD, and Mei Zhang, MSN, MPH, RN. College of Nursing, University of Kentucky, Lexington, KY, USA
| Learning Objective #1: discuss the context of the smoke-free law that was enacted in one community in April 2004. |
| Learning Objective #2: analyze the effect of a smoke-free law on adult smoking rates compared to residents in similar communities without smoke-free ordinances. |
Background: Restrictions on smoking in public places reduce smoking prevalence and average daily cigarette consumption among smokers and increase cessation attempts.
Purpose: Evaluate whether there was a change in the rate of adult smoking in Lexington-Fayette County, Kentucky, following the enactment of a 100% smoke-free public places ordinance in April 2004.
Methods: Behavioral Risk Factor Surveillance Survey (BRFSS) data from 2001-05 were used to test whether smoking rates changed significantly in Fayette County from the pre- to post-law period, relative to the degree of change during the same timeframe in five Kentucky counties with similar demographic characteristics. The sample consisted of 3,457 BRFSS respondents: 2,334 pre-law and 1,123 post-law.
Results: The smoking rate for Fayette County pre-law was 25.7% (CI: 21.2-20.1), and this declined to 17.5% (CI: 11.8-23.1) post-law, a decrease of 31.9%. In the five counties without a law (Control group), the rates at pre-law and post-law were 27.6% (CI: 24.7-30.5) and 27.6% (CI: 23.3-31.8), respectively, indicating no change. With gender, age, education and month of interview included as control variables, the interaction between Time (pre- vs. post-law) and Group (Fayette vs. controls) was significant (Wald χ2 = 4.0, p = .05). While Fayette and the Control counties did not differ in smoking rate during the pre-law period, Fayette had a significantly lower rate during post-law. The degree of decrease over time in Fayette was significant; there was not a significant change from pre- to post-law in the Control counties. It is estimated that there were 16,467 fewer smokers in Fayette during the post-law period compared to pre-law.
Discussion: While smoke-free legislation is typically enacted to protect nonsmokers from secondhand smoke, this study provides evidence that smoke-free laws also positively affect the health of future and current smokers by providing an environment conducive to preventing initiation and promoting quitting.