Smokefree Policies Result in High Levels of Compliance
Exposure to secondhand smoke from burning tobacco products causes disease and premature death among people who do not smoke.1 There is no risk-free level of secondhand smoke, and even brief exposure can cause immediate harm.1 Establishing a 100% smokefree environment is the only effective way to fully protect those who do not smoke from secondhand smoke.1
National and international studies have shown that comprehensive national, state, and local smokefree laws that prohibit smoking in all indoor areas of workplaces, restaurants, and bars typically result in high levels of compliance.1-2, 5-8 Studies have found that comprehensive smokefree laws are easier to enforce and achieve higher levels of compliance than smoking restrictions that contain significant exemptions (e.g., exemptions for designated smoking areas or certain types of restaurants or bars).1,7
A state smokefree law prohibiting smoking in all indoor areas of bars and restaurants, as well as in most indoor workplaces, took effect in California in 1998.
A study found that bar patron compliance with the smokefree law increased significantly over the course of 4 years.2
|California||Before Law Took Effect||4 Years After Law Took Effect|
|Patron compliance with smokefree law in bars||46%||76%|
Although California’s law was the first statewide law in the nation, and did not prohibit municipalities from enacting stronger policies, it did not meet CDC’s definition of a comprehensive smokefree law.3 The law was amended in 2016 and extended smokefree protections to all non-hospitality workplaces.3 The state of California is now considered to have a comprehensive smokefree law.
A comprehensive state smokefree law prohibiting smoking in all indoor areas of workplaces, restaurants, and bars in New York took effect in 2003.
New York statistics of compliance before and after the law
|New York||Before Law
|1 Month After Law Took Effect||1 Year After
Law Took Effect
|3 Years After
Law Took Effect
|10 Years After
Law Took Effect
|Proportion of bars that were smokefree||11.2%||86.3%||84.1%||79.0%||99.4%|
|Proportion of restaurants that were smokefree||47.7%||97.4%||98.9%||99.2%||100%|
In 2013, inspections conducted in 114 restaurants and 173 bars across all counties in New York State concluded that 100% of restaurants were smokefree, compared with 47.7% at baseline, and 99.4% of bars were smokefree, compared with 11.2% at baseline.
Separately, inspections conducted in more than 22,000 New York City bars and restaurants within 1 year after the city implemented a comprehensive municipal smokefree law in 2003 found that 97% were smokefree. In other words:5
- No patrons or workers were observed smoking.
- No ashtrays were present.
- “No smoking” signs were properly posted.
A national comprehensive smokefree law prohibiting smoking in all indoor areas of workplaces, restaurants, and bars took effect in Ireland in 2004.
A telephone survey of Irish adults found a significant decrease in observed smoking in workplaces, restaurants, and pubs within 1 year after the law took effect.5
Ireland statistics of compliance before and after the law
|Ireland||Before Law Took Effect||1 Year After Law Took Effect|
|Adults who observed smoking in workplaces||62%||14%|
|Adults who observed smoking in restaurants||85%||3%|
|Adults who observed smoking in pubs||98%||5%|
Four European Countries
Ireland and France implemented comprehensive national smokefree laws prohibiting smoking in all indoor areas of workplaces, restaurants, and bars in 2004 and 2008, respectively (with a very narrow exemption for smoking areas in bars in France). The Netherlands implemented a partial national smoking restriction in 2008. Various German states implemented partial smoking restrictions from 2007 through 2008. Among other exemptions, the Dutch and German laws allowed smoking in small bars.
An international telephone and Web survey of adults who smoke found declines in the proportion of adults who reported smoking in bars after these laws took effect.6
European statistics of compliance before and after the law
|Four European Countries||Before Law Took Effect||After Law Took Effect|
|Self-reported smoking in bars:|
|Ireland (comprehensive national law)||97%||3%|
|France (comprehensive national law)||84%||3%|
|The Netherlands (partial national law)||88%||34%|
|Germany (partial state laws)||87%||44%|
- U.S. Department of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2006 [accessed 2014 May 12].
- Weber MD, Bagwell DAS, Fielding JE, Glantz SA. Long Term Compliance with California’s Smoke-Free Workplace Law Among Bars and Restaurants in Los Angeles County. Tobacco Control 2003;12(3):269–73 [cited 2014 May 12].
- Prochaska JJ, Watts MH, Zellers L et al. Inequity in California Smokefree Workplace Laws: A Legal Epidemiological Analysis of Loophole Closuresexternal icon. Am J Preventive Med 2020;58(3):E71-78 [accessed 2020 Aug 17].
- New York State Department of Health. Statshot: Compliance with the New York State Clean Indoor Air Act (CIAA), 2003-2013pdf iconexternal icon. July 2013 [accessed 2020 Aug 17].
- New York State Department of Health. The Health and Economic Impact of New York’s Clean Indoor Air Actpdf iconexternal icon. [PDF–377.32 KB] New York: New York State Department of Health, 2006 [accessed 2014 May 12].
- New York City Department of Finance, New York City Department of Health and Mental Hygiene, New York City Department of Small Business Services, New York City Economic Development Corporation. The State of Smoke-Free New York City: A One-Year Reviewpdf iconexternal icon. New York: New York State Department of Health, 2006 [accessed 2014 May 12].
- Fong GT, Hyland A, Borland R, Hammond D, Hastings G, McNeill A, et al. Reductions in Tobacco Smoke Pollution and Increases in Support for Smoke-Free Public Places Following the Implementation of Comprehensive Smoke-Free Workplace Legislation in the Republic of Ireland: Findings from the ITC Ireland/UK Survey. Tobacco Control 2006;15(Suppl III):iii51–iii58 [cited 2014 May 12].
- Nagelhout GE, Mons U, Allwright S, Guignard R, Beck F, Fong GT, de Vries H, Willemsen MC. Prevalence and Predictors of Smoking in “Smoke-Free” Bars. Findings from the International Tobacco Control (ITC) Europe Surveys. Social Science & Medicine 2011; 72:1643–51 [cited 2014 May 12].
For Further Information
Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion
Office on Smoking and Health
Media Inquiries: Contact CDC’s Office on Smoking and Health press line at 770-488-5493.