Eateries' smoking ban is dissuading teens

Study says fewer using cigarettes

Restaurant smoking bans may be as powerful as peers or parents in the battle to keep teenagers from becoming smokers, a new study suggests.

Teenagers who lived in towns that adopted early bans on smoking in restaurants were 40 percent less likely to become smokers than their counterparts in towns with weaker restaurant smoking laws, Boston researchers report.

The study did not address how smoking bans discourage teenage smoking. But Dr. Michael Siegel of the Boston University School of Public Health said the findings bear out his hypothesis that if teens see fewer people smoking and conclude that smoking isn't socially acceptable, then they may be less likely to pick up the habit.

Writing in the Archives of Pediatric & Adolescent Medicine, Siegel reported results from three waves of phone surveys in 301 Massachusetts towns starting in 2001. Massachusetts banned smoking in all workplaces, bars, and restaurants in 2004, but 227 cities and towns in the state had rules on tobacco at work sites, including restaurants, before the law went into effect.

Siegel and his colleagues asked more than 3,800 young people who were between the ages of 12 and 17 at the beginning of the study if they had ever smoked, if they had a cigarette in the past month, and if they had smoked more than 100 cigarettes.

"Restaurant smoking bans are actually one of the most effective interventions to reduce youth smoking," Siegel said. "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 ahead of the state law, 7.9 percent of participants had smoked more than 100 cigarettes when the study began; in towns with weak laws, the rate was 9.6 percent. After adjusting for a variety of factors, such as age, race, and household income, the difference widened to 40 percent, Siegel said.

Having a parent or a close friend who smoked was a factor in whether a child tried smoking, but not in whether the child continued to smoke, he said.

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

In an earlier paper based on the same survey, Siegel found that teens living in towns that had an early smoking ban thought fewer people smoked and considered it less socially acceptable than those who lived in towns with weaker smoking laws.

According to state figures, teen smoking hit a 15-year low in 2007, dipping to 17.7 percent of high school students from 20.5 percent two years earlier. Sales to minors took an even steeper dive, with 22 percent of teens able to get cigarettes if they wanted them in 2006, compared with 13.3 percent in 2007, according to a state program that sends teens to stores to track how many businesses violate the law against selling to underage buyers.

Lois Keithly, director of the Massachusetts Tobacco Control Program, said many factors might have contributed to the substantial decline in teen cigarette use.

"Certainly the statewide workplace smoking ban was part of it," she said. "I think in a couple of years we'll be able to compare it to other factors."

Since 2006, counseling and medications to help smokers quit have been covered by MassHealth, the state's Medicaid plan, and the benefit has been used by more than 10 percent of members, she said.

Public health efforts aimed at adolescents have been reinvigorated, including the launch of the84.org, a website with antismoking ads created by teenagers and named for the 84 percent of their peers who don't smoke.

A proposed increase in the cigarette tax, should it be approved by the Legislature, could also have an effect on teen smoking rates, Keithly said.

"What I took from this study is the importance of adolescents not seeing adults whom they respect smoking," she said.