Do Smoking Bans Work?

Research Blogging / by Dave Munger /

Municipal bans on smoking in restaurants and bars are highly controversial, but history shows they can also be highly effective. But are all smoking bans equally successful?

Credit: Flickr user Jram23

The barkeep and blogger who writes as “Scribbler50” was outraged when, in 2003, New York City enacted one of the first comprehensive smoking bans in bars and restaurants: “How can a guy and some board just kick us in the teeth like this? This smacks of fascism.” If people are aware of the consequences of smoking (or visiting places with lots of secondhand smoke), should the government really have to tell us what to do? Won’t people just vote with their feet and smoke even more when they’re at home and away from restrictions?

Scribbler50’s post inspired the physician who blogs as PalMD last week to look up the research on the effectiveness of smoking bans. He found several studies showing that not only did workers in restaurants and bars show improved health shortly after the bans were put in place, but smokers themselves also reduced the number of cigarettes they smoked. While long-time smokers’ risk of lung cancer probably isn’t diminished after quitting smoking, their risk of heart disease death does decline rapidly—and heart disease is a greater danger to smokers than cancer.

Overall, however, smoking rates remain persistently high, despite now nearly-ubiquitous workplace smoking bans. Can other government measures help these smokers live healthier lives, or at least prevent people from taking up the habit?

In the US, warning messages have been in place on cigarette packages for decades. But the messages are rather clinical, for example: “Smoking Causes Lung Cancer, Heart Disease, Emphysema, And May Complicate Pregnancy.” What if packages contained more dramatic warnings? In January, psychologist and science writer Christian Jarrett looked at a small study of smokers’ reactions to cigarette warnings. The researchers measured self-esteem in student smokers, then showed them cigarette packages with either death-related warnings (“smokers die earlier”) or esteem-related warnings (“smoking makes you unattractive”). Students who derived self-esteem from smoking and saw the death-related warnings later viewed smoking more positively than those who saw the esteem-related warnings. For students whose smoking wasn’t motivated by self-esteem, the effect was reversed. The research was published in the Journal of Experimental Social Psychology.

So not all anti-smoking messages are equal: Depending on who the message is directed at, a morbid warning on a cigarette label may actually backfire.

Do media efforts to reduce smoking always go wrong? University of Michigan child psychologist Nestor Lopez-Duran wrote last year about a study of smoking behavior in 1,791 kids aged 10 to 14. The research, led by Madeline Dalton and published in Pediatrics, asked the children which movies they had seen (from a list of 50). They analyzed the smoking content of the movies, and contacted the study participants seven to eight years later. Respondents who, as children, had seen more movies where actors were depicted smoking, were significantly more likely to become smokers themselves. Even after controlling for other possible influences such as peer smoking and parental disapproval, the kids who had the most exposure to smoking in movies were nearly twice as likely to take up smoking as kids who had seen the fewest movies with smoking. In fact, smoking in movies was a stronger influence on smoking behavior than having a friend or parent who smokes.


So clearly the depiction of smoking in the media does have a large influence on smoking behavior in kids. Lopez-Duran says US teenage smoking declined dramatically in the late-1990s, and many attribute this decline at least in part to the removal of 1980s “Joe Camel” cartoon ads and other tobacco-industry media strategies targeting children. Perhaps additional regulation of smoking depicted in media could bring about further declines.

Scribbler50, for his part, is now a convert favoring smoking restrictions, at least in his narrow purview as a bartender. His patrons who haven’t quit smoking say they smoke a lot less now that they have to go outside to get a nicotine fix. He doesn’t miss emptying ashtrays, or the holier-than-thou customers who griped every time a fellow patron lit up, or working in a smoke-filled bar all night and going home “smelling like you put out a three-alarm.”

Would it be right to enact even more restrictions on smoking in the interest of public health? It’s hard to deny that banning smoking in public, indoor spaces has been a huge success. Why not try out some stronger smoking bans? Parents in some areas are already restricted from smoking in cars with children, but I haven’t seen a study that evaluates the success of those measures. Perhaps a state or municipality could try extending the ban to homes, with provisions for studying the results. It’s also possible that stronger measures would be counter-productive, like the stronger warnings on cigarette labels. Maybe we’ll decide that at some level deciding whether or not to smoke should still be an individual choice.  Or maybe in a few generations, it won’t be necessary to regulate smoking: There won’t be any smokers left.

Dave Munger is editor of ResearchBlogging.org, where you can find thousands of blog posts on this and myriad other topics. Each week, he writes about recent posts on peer-reviewed research from across the blogosphere. See previous Research Blogging columns »

 

Originally published October 27, 2010

Tags behavior health policy

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