Key Researchers

  • Compliance with smoke-free regulations is usually high. Launching a comprehensive and carefully planned educational effort well in advance of the implementation date facilitates compliance by providing both the public and business owners with information on the purpose of the law and how to avoid violations (Sorensen 1991; Hyland et al. 1999b; Weber et al. 2003; Skeer et al. 2004; Howell 2005).

    Actual implementation of smoke-free regulations is often accompanied by a period of anxiety. Some business owners are concerned that they will be required to spend a lot of money to comply with the law and that many will ignore the regulations. Some enforcement agencies are concerned that they will be unable to adequately enforce the regulations and/or that enforcement will divert funding and staff from other areas.

    However, the literature indicates that most establishments and individuals willingly obey the new regulations, meaning that compliance is usually widespread and enforcement is neither costly nor a drain on human resources.

    The best smoke-free policies, those that pose the least burden on business and offer the greatest public health benefits, are comprehensive (Sorensen 1991). Policies that create variances for some establishments make both compliance and enforcement more difficult and undermine the rationale for adopting smoke-free regulations. Businesses may have a hard time understanding the exemptions. Meanwhile, there is no health basis for the variances because secondhand smoke is dangerous regardless of whether the exposure occurs in a bar or in a hospital. Examples of variances include the following:
    - exempting certain types of establishments such as bars
    - allowing businesses that suffer financial hardship to apply for a waiver
    - allowing establishments to permit smoking if they install a special smoking room or ventilation equipment
    - allowing establishments to permit smoking if minors are not allowed on premises
    - allowing establishments to permit smoking if they pay an extra fee

    The research shows that businesses typically comply with simple, comprehensive smoke-free regulations with relative ease, although there is an adjustment period. When restaurants first went smoke-free in New York City in 1995, for example, there was a surge in complaints to the Health Department about the regulations in the first two months after they took effect. Protests then leveled off, though they increased again following the one-year anniversary. However, after two years the level of complaints dropped below what it had been when the law was merely under consideration. In other words, despite initial opposition, the regulations eventually were accepted.

    Few business owners built special smoking rooms, the majority complied without spending any money, and the vast majority of restaurant owners reported their dining rooms were smoke-free (Hyland et al. 1999b).

    In Los Angeles, compliance inspections were done after bars were required to become smoke-free by state law in 1998. The percentage of bars that were observed to be smoke-free increased from 46% in 1998 to 76% in 2002, while in restaurants the compliance rate increased from 92% to 99% over the same period (Weber et al. 2003).

    In Boston, a pre-implementation outreach and educational campaign was implemented before bars and restaurants were required to go smoke-free. Unlike the results from Los Angeles, the rate of compliance increased much more quickly. In the three months after the law took effect, the percentage of bars observed with smoking patrons decreased from 100% before the law to 2.5% (Skeer et al. 2004).

    Ireland became the first nation to adopt a comprehensive national policy that requires all indoor public places, including bars and restaurants, to become smoke-free. This policy captured a tremendous amount of media attention in the months leading up to the implementation date, offering a long, sustained opportunity to educate the public about the dangers of secondhand smoke and the issues involved in the debate. As a result, the Irish public became more knowledgeable about secondhand smoke. The implementation of the Irish smoke-free law was a tremendous success with a 94% compliance rate. Complaints peaked one month after the law went into effect but quickly subsided (Howell 2005).

    In summary, comprehensive smoke-free policies are simplest to implement and they are largely self-enforcing, which means that relatively few resources are needed to assure compliance. Communities that have made strong efforts to educate the public and business communities about the purpose of the smoke-free regulations have experienced the easiest and shortest transition periods.



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