Smokefree Policies Reduce Smoking

The primary purpose of smokefree laws and policies is to protect people who do not smoke from secondhand smoke.1 However, smokefree laws can also motivate and help tobacco users quit and prevent initiation of tobacco use. Studies have shown that the implementation of smokefree laws and policies can increase cessation and reduce smoking prevalence among workers and the general population1-6 and may also reduce smoking initiation among youth.1,7

Reviews

U.S. Surgeon General

In 2014, the U.S. Surgeon General concluded that smokefree laws in workplaces and communities help smokers quit and reduce tobacco use. In addition, smokefree workplaces and communities make youth and young adults less likely to start smoking due to a number of factors, including lower visibility of people who smoke, fewer opportunities to smoke alone or with others, and reduced social acceptability for smoking. The implementation of smokefree laws also increase the adoption of voluntary smokefree rules in homes, which can further protect those who do not smoke—especially those most vulnerable that are exposed to secondhand smoke in the home, such as children.1

Residents of multi-unit housing, like apartments or condos, are particularly likely to be exposed to secondhand smoke. Approximately 25% of the U.S. population lives in public or private multi-unit housing.8,9 In 2016, the U.S. Department of Housing and Urban Development finalized a rule requiring public housing authorities to prohibit smoking in their buildings, including in residents’ units. The policy was combined with promotion of tobacco cessation and cessation resources. Promoting cessation services together with smokefree policies in multi-unit housing could help motivate those who smoke to quit, and may encourage more private multi-unit facilities to adopt smokefree policies.10

Task Force on Community Preventive Services

In 2010, a systematic review by the Task Force on Community Preventive Services reported that:2

  • Eleven studies found that smokefree laws and policies in workplaces were associated with a median 6.4% increase in tobacco use cessation.
  • Twenty-one studies found that these laws and policies were associated with a median 3.4% decrease in tobacco use prevalence.

International Agency for Research on Cancer

In 2009, a report by the International Agency for Research on Cancer on the effects of smokefree laws concluded that:3

  • There is sufficient evidence (the highest level of evidence under the report’s rating scale) that smokefree workplaces reduce cigarette consumption among people who continue to smoke.
  • There is strong evidence (the second highest level of evidence) that smokefree workplaces lead to increased successful cessation among people who smoke.
  • There is strong evidence that smokefree policies reduce tobacco use among youth.

Cochrane Review

In 2010, a Cochrane review of 23 studies of smokefree laws reporting measures of active smoking reported:4

  • There was no consistent evidence of a reduction in smoking prevalence attributable to these laws.
  • However, total tobacco consumption was reduced in studies where smoking prevalence decreased.

Selected Studies on Reduced Smoking

Adults

Effects of Reduced Smoking Among Adults

Effects of Reduced Smoking Among Adults
Studies in: Found that:
Ireland, France, The Netherlands, Germany (2011)
20 U.S. and 2 Canadian communities (2005)5
Employees who worked in places that maintained or implemented smokefree policies were nearly twice as likely to stop smoking as employees who worked in places that allowed smoking everywhere.
Australian, Canadian, German, and U.S. communities (2002)6 A smokefree workplace policy:
  • Reduces smoking prevalence by 3.8% among employees who smoke
  • Reduces daily smoking by 3.1 cigarettes (per person) among employees who continue to smoke

 

Youth

Effects of Reduced Smoking Among Youth

Effects of Reduced Smoking Among Youths
Studies in: Found that:
Massachusetts (2008)7 Youth living in towns with laws making restaurants smokefree were less likely to progress to established smoking than youth who lived in towns with weak smoking restrictions (odds ratio: 0.60, 95% confidence interval: 0.42–0.85).

This effect was found to be entirely due to a reduced likelihood of progressing from experimentation with smoking to established smoking.

References

  1. U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014. [Accessed 2020 Sep 8]].
  2. Hopkins DP, Razi S, Leeks KD, Priva Kalra G, Chattopadhyay SK, Soler RE, et al. Task Force on Community Preventive Services. Smoke-Free Policies to Reduce Tobacco Use: A Systematic Review. American Journal of Preventive Medicine 2010;38(2 Suppl):S275–89 [cited 2014 Apr 25].
  3. International Agency for Research on Cancer (IARC). IARC Handbooks of Cancer Prevention, Tobacco Control, Volume 13: Evaluating the Effectiveness of Smoke-Free Policiespdf iconexternal icon[PDF–2.67 MB]. Lyon, France: WHO, 2009 [accessed 2014 Apr 25].
  4. Callinan JE, Clarke A, Doherty K, and Kelleher C. Legislative Smoking Bans for Reducing Secondhand Smoke Exposure, Smoking Prevalence and Tobacco Consumption (Review)external icon[PDF–1.11 MB]. The Cochrane Library 2010; Issue 6 [accessed 2020 Aug 18].
  5. Bauer JE, Hyland A, Li Q, Steger C, Cummings KM. A Longitudinal Assessment of the Impact of Smoke-Free Worksite Policies on Tobacco Use. American Journal of Public Health 2005;95(6):1024–9 [cited 2014 Apr 25].
  6. Fichtenberg CM, Glantz SA. Effect of Smoke-Free Workplaces on Smoking Behaviour: Systematic Review. British Medical Journal 2002;325(7357):188–94 [cited 2014 Apr 25].
  7. Siegel M, Albers AB, Cheng DM, Biener L, Rigotti NA. Local Restaurant Smoking Regulations and the Adolescent Smoking Initiation Process: Results of a Multilevel Contextual Analysis Among Massachusetts Youth. Archives of Pediatric and Adolescent Medicine 2008;162(5):477–83 [cited 2014 Apr 25].
  8. U.S. Department of Health and Human Services. Smoking Cessation: A Report of the Surgeon General. Atlanta: 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, 2020 [accessed 2020 Sep 10].
  9. King BA, Babb SD, Tynan MA, Gerzoff RB. National and state estimates of secondhand smoke infiltration among U.S. multiunit housing residents. Nicotine and Tobacco Research 2013a;15(7):1316–21.
  10. Levy DT, Borland R, Villanti AC, Niaura R, Yuan Z, Zhang Y, Meza R, Holford TR, Fong GT, Cummings KM, et al. The application of a decision-theoretic model to esti­mate the public health impact of vaporized nicotine product initiation in the United Statesexternal icon. Nicotine and Tobacco Research 2017;19(2): 149-159 [accessed 2020 Sep 9].

For Further Information

Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion
Office on Smoking and Health
E-mail: tobaccoinfo@cdc.gov
Phone: 1-800-CDC-INFO

Media Inquiries: Contact CDC’s Office on Smoking and Health press line at 770-488-5493.