Smoke-free restaurant laws linked to lower youth smoking rates

Teenagers who lived in towns that banned smoking in restaurants were 40 percent less likely to become established smokers than their peers in towns with weaker restaurant smoking laws, Boston researchers report.

Writing in the Archives of Pediatric and Adolescent Medicine, Dr. Michael Siegel of the Boston University School of Public Health presents final results from three waves of telephone surveys in 301 Massachusetts towns that began in 2001. More than 3,800 young people who were 12 to 17 years old at the beginning of the study were asked if they had ever smoked, if they had a cigarette in the past month, and if they had smoked more than 100 cigarettes.

In an earlier paper Siegel and his colleagues found that young people in towns with smoke-free restaurant laws perceived a lower level of smoking and a lower social acceptability of smoking than their peers in towns with weaker smoking laws, where smoking was restricted to designated areas in restaurants or not at all.

The current paper suggests that the anti-smoking laws may work by blocking the transition from experimenting with cigarettes to becoming established smokers. Massachusetts banned smoking in all workplaces, bars, and restaurants in 2004.

"The public health implications of this are that restaurant smoking bans are actually one of the most effective interventions to reduce youth smoking. While these policies are intended to protect workers and the public from secondhand smoke exposure, it turns out that an additional benefit of these laws is to reduce rates of youth smoking, thus making them a particularly powerful public health intervention," Siegel said in an interview. "There are not a lot of interventions out there which can produce a 40 percent reduction in youth smoking."

In towns that banned smoking in restaurants, 7.9 percent of the teenagers in the survey had smoked more than 100 cigarettes. In towns with weak laws, the rate was 9.6 percent, but after analyzing a variety of factors, such as age, race, and household income, the difference between the groups widened to 40 percent, the authors said. Having a parent who smoked was a factor in whether a child tried smoking, but not in whether the child continued to smoke, the authors said.

"Everyone talks about whether parents or friends smoke. This shows that a restaurant smoking ban is equal in power," Siegel said.