A study on teenagers in the US state of Massachusetts suggests that smoke-free restaurant laws designed to protect non-smokers have had an unexpected benefit: they may be stopping a significant number of teenagers becoming established smokers.

The study is the work of Dr Michael Siegel, professor in social and behavioral sciences at Boston University’s School of Public Health, and colleagues, and was published last week in the Archives of Pediatrics & Adolescent Medicine.

The main purpose of the study was to assess the effect of laws banning smoking in restaurants on the numbers of teenagers starting to experiment with cigarettes, and also if they started experimenting, whether they progressed to established smoking.

Siegler and colleagues enrolled over 3,800 Massachusetts teenagers who were aged from 12 to 17 at the start of the study from January 2001 to June 2002 (baseline), and followed them for 4 years, carrying out three waves of interviews altogether.

All the youths were interviewed at baseline, over 70 per cent of them were re-interviewed after two years, and nearly 60 per cent interviewed again after 4 years, including some who had not responded to interview requests in the second wave.

A total of 301 Massachusetts communities were involved, and the researchers used the strength of local restaurant smoking regulations in participants’ town of residence at the start of the study as a primary predictor of starting to experiment with smoking and also of moving from experimenting to established smoking.

The researchers took into account three measures: moving from non-smoker to experimenting, moving from experimenting to established smoker (having smoked 100 or more cigarettes in one’s lifetime), and overall progression to established smoker.

The results showed that:

  • Teenagers in towns with strong restaurant smoking bans at the start of the study were 40 per cent less likely to progress overall to established smoker status, compared to those living in towns where the bans were weaker.
  • The observed link between strong restaurant smoking bans and overall rate of teenagers becoming established smokers was “entirely due to an effect on the transition from experimentation to established smoking”, wrote the authors.

The researchers concluded that:

“Local smoke-free restaurant laws may significantly lower youth smoking initiation by impeding the progression from cigarette experimentation to established smoking.”

Siegel told the press that the local restaurant smoking bans were effectively sending out the message that it was no longer socially acceptable to smoke in public.

“I think that decreases the appeal of smoking to adolescents,” said Siegel in a report in the LA Times.

“Kids’ perceptions of how many people are smoking is a major factor in whether they decide to smoke,” said Siegel, who added that around half of the states in the US have introduced smoking bans in restaurants, and that this has had a greater effect than media campaigns and taxes on tobacco.

“Local Restaurant Smoking Regulations and the Adolescent Smoking Initiation Process: Results of a Multilevel Contextual Analysis Among Massachusetts Youth.”
Michael Siegel; Alison B. Albers; Debbie M. Cheng; William L. Hamilton; Lois Biener.
Arch Pediatr Adolesc Med, May 2008; 162: 477 – 483.

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Source: journal article, LA Times.

Written by: Catharine Paddock, PhD