Retail stores' compliance with a city no-smoking law

Implementation of Clean Indoor Air Laws: Complaints, Citations, and Fines or Sanctions Related to Possible Violations of the Kansas Clean Indoor Air Act

OBJECTIVE

To determine how well the Kansas Clean Indoor Air Act was being observed and enforced.

DESIGN

A survey inquired about complaints, citations, and fines or sanctions after the implementation of the Kansas Clean Indoor Air Act; inquiry was also made about the law's effectiveness. Descriptive statistics and Poisson tests of statistical significance were used.

SETTING

Each of the 55 Kansas cities with more than 5000 in population.

PARTICIPANTS

Law enforcement personnel.

MAIN OUTCOME MEASURES

Monthly rates of complaints, citations, fines or sanctions, and reports of the law's effectiveness during the 30-month period after implementation of the act.

RESULTS

Responses were received from 100% of the sampled cities. The number of citizen complaints and citations decreased over time from 4.33 to 2.42 per month and from 3.17 to 0.92 per month, respectively. The number of fines or sanctions decreased from 1.67 per month to 0.50 per month. In 51 of 55 cities (92.7%), respondents reported that the Kansas Clean Indoor Act appeared to be working effectively. There was a statistically significant difference between the first and second and first and third time periods for citations and fines or sanctions. However, there was only a statistically significant difference between the first and third time periods for citizen complaints.

CONCLUSIONS

The law appears to be functioning effectively. This approach could be used to supplement measured or self-reported exposures to secondhand smoke in future studies in other jurisdictions, particularly in identifying areas with potential problems. Given the conservative nature of Kansas, adoption of such a law in the remaining states seems realistic.

Compliance of drugstores with a national smoke-free law: a pilot survey

OBJECTIVES

To examine the outcome of the recent implementation of a smoke-free policy in drugstores in Thailand, comparing participants and non-participants of the 100% smoke-free drugstore campaign promoted by the Thai Pharmacy Network for Tobacco Control (TPNTC).

STUDY DESIGN

A cross-sectional survey of 3600 drugstores in Thailand.

METHOD

Smoking prevalence on the premises, the number of stores displaying no-smoking signs, and the number of stores selling cigarettes were examined.

RESULTS

In total, 1001 questionnaires were returned (27.8% response rate). Smoking prevalences inside and outside drugstores in the past month were 26.4% and 84.7%, respectively. Seven percent of drugstores had at least one staff member who smoked tobacco. Overall, 63.3% of drugstores displayed no-smoking signs, as required by law. Compared with non-participating drugstores, those which participated in the TPNTC smoke-free campaign more frequently reported that they had asked smokers to stop smoking/leave the premises, in addition to possessing and displaying no-smoking signs.

CONCLUSION

Approximately one-third of drugstores in this survey did not meet the terms of the recent smoke-free regulation. The TPNTC campaign improved the compliance of drugstores with the law in various aspects. This study was considered a pilot study, and despite the low response rate, the findings suggest a need for further action to ensure that all drugstores comply with the law and are 100% smoke-free.

WITHDRAWN: Interventions for preventing tobacco smoking in public places

BACKGROUND

Environmental tobacco smoke is a health hazard. Reducing exposure to tobacco smoke in public places is a widespread public health goal. There is, however, considerable variation in the extent to which this goal has been achieved in different settings and societies. There is therefore a need to identify effective strategies for reducing tobacco consumption in public places.

OBJECTIVES

To evaluate the effectiveness of interventions to reduce tobacco consumption in public places.

SEARCH STRATEGY

We searched the Tobacco Addiction Review Group trials register, MEDLINE and EMBASE in March 2006. We handsearched a key journal and abstracts from international conferences on tobacco. We checked the bibliographies of identified studies and reviews for additional references.

SELECTION CRITERIA

We considered randomized and controlled trials, controlled and uncontrolled before-and-after studies and interrupted time series. The main outcome of interest was levels and measures of compliance with bans and restrictions. We considered strategies aimed at populations, including education campaigns, written material, non-smoking and warning signs, and comprehensive strategies. We also considered strategies aimed at individual smokers.

DATA COLLECTION AND ANALYSIS

Information relating to the characteristics and content of all kinds of interventions, participants, outcomes and methods of each study was abstracted by one reviewer and checked by two others. Studies were combined using qualitative narrative synthesis.

MAIN RESULTS

Twenty of 25 studies reporting information about interventions to reduce smoking in public places met all the inclusion criteria. Three were controlled before-and-after studies and 17 were uncontrolled before-and-after studies. The most effective strategies used comprehensive, multi-component approaches to implement policies banning smoking within institutions. Less comprehensive strategies, such as posted warnings and educational material, had a moderate effect. Five studies showed that prompting individual smokers had an immediate effect, but such strategies are unlikely to be acceptable as a public health intervention.

AUTHORS' CONCLUSIONS

Carefully planned and resourced, multi-component strategies effectively reduced smoking within public places. Less comprehensive strategies were less effective. Most studies were done in the USA and, despite increasing evidence from Europe, there is a need to identify ways in which these strategies can be adopted and used in countries with different attitudes to tobacco use. Future studies should also consider the use of more rigorous experimental designs.

Effect of clean indoor air laws on smokers: the clean air module of the SimSmoke computer simulation model

OBJECTIVES

To develop a simulation model to examine the effects of clean indoor air laws on prevalence rates and smoking attributable deaths.

METHODS

Based on empirical and theoretical research, the effects of clean air laws are modelled by type of law. The model considers clean air laws at the state levels between 1993 and 2000, and projects the number of smokers and smoking attributable deaths in the USA under different scenarios from 2000 onward.

RESULTS

The model predicts that comprehensive clean air laws have the potential to reduce substantially the number of smokers and smoking attributable deaths, and these effects are predicted to grow over time. The predicted impact of new worksite laws are reduced when previously implemented private and public worksite restrictions are taken into account.

CONCLUSIONS

Clean indoor air laws have the ability to reduce smoking rates substantially and save lives, but their impact is likely to depend on their comprehensiveness and prior private worksite restrictions in place.

Interventions for preventing tobacco smoking in public places

BACKGROUND

Environmental tobacco smoke is a health hazard. Reducing exposure to tobacco smoke in public places is a widespread public health goal. There is, however, considerable variation in the extent to which this goal has been achieved in different settings and societies. There is therefore a need to identify effective strategies for reducing tobacco consumption in public places.

OBJECTIVES

To evaluate the effectiveness of interventions to reduce tobacco consumption in public places.

SEARCH STRATEGY

We searched the Tobacco Addiction Review Group trials register, Medline, EMBASE, HEALTHSTAR, PAIS, and CDP File (National Centre for Chronic Disease Prevention and Health Promotion, CDC) "Smoking and Health database". We handsearched a key journal and abstracts from international conferences on tobacco. We checked the bibliographies of identified studies and reviews for additional references.

SELECTION CRITERIA

We considered randomized and controlled trials, controlled before and after studies and interrupted time series, and uncontrolled before and after studies. We considered strategies aimed at populations, including education campaigns, written material, non-smoking and warning signs, and comprehensive strategies. We also considered strategies aimed at individual smokers.

DATA COLLECTION AND ANALYSIS

Information relating to the characteristics and content of all kinds of interventions, participants, outcomes and methods of the study was abstracted by one reviewer and checked by two others. Studies were combined using qualitative narrative synthesis.

MAIN RESULTS

Eleven of 22 studies reporting information about interventions to reduce smoking in public places met all the inclusion criteria. All included studies were uncontrolled before and after studies. The most effective strategies used comprehensive, multicomponent approaches to implement policies banning smoking within institutions. Less comprehensive strategies, such as posted warnings and educational material had a moderate effect. Five studies showed that prompting individual smokers had an immediate effect, but such strategies are unlikely to be acceptable as a public health intervention.

REVIEWER'S CONCLUSIONS

Carefully planned and resourced, multicomponent strategies effectively reduced smoking within public places. Less comprehensive strategies were less effective. All the studies used relatively weak experimental designs. Most studies were done in the USA, and there is a need to identify ways in which these strategies can be adopted and used in countries with different attitudes to tobacco use. Future studies should also consider the use of more rigorous experimental designs.

Analysis of factors related to illegal tobacco sales to young people in Ontario

OBJECTIVE

To identify and to discuss factors influencing illegal merchant sales of tobacco to underage people in Ontario, Canada.

DESIGN

Results were obtained through random retail compliance checks of tobacco merchants. A multivariate analysis specified the relationship between selected independent variables and the willingness of tobacco merchants to sell to minors. The selected independent variables included retail operation type, community population size, the presence of tobacco production, signage, sex and age of volunteers, smoking prevalence rates, and enforcement rates.

PARTICIPANTS

A random, stratified sample of 438 tobacco retailers in 186 communities in Ontario.

MAIN OUTCOME MEASURE

Willingness of merchants to sell tobacco to minors.

RESULTS

Older youths and girls were more likely to be sold tobacco products. Purchase attempts carried out in tobacco-producing regions were also statistically related to illegal sales.

CONCLUSIONS

Policy efforts to control youth access to tobacco in Canada may need to invoke legislation requiring merchants to request proper identification from customers who appear to be under the age of 25, and who seek to purchase tobacco products. Further attention could also be directed at tobacco control policies and enforcement strategies that need to consider the unique challenges faced by jurisdictions where the tobacco industry is a powerful presence.

Employee and public responses to simulated violations of no-smoking regulations in Spain

OBJECTIVES

This study evaluated compliance with regulations prohibiting smoking in public places by using a new method of smoking simulation.

METHODS

Sites in Sabadell, Spain, were visited by observers who lit a cigarette, simulating the act of smoking, and noted the placement and content of signs indicating smoking restrictions.

RESULTS

A warning was given in only 17% of sites. A significant association was observed between the presence of signs banning smoking and the elicitation of a warning from people present.

CONCLUSIONS

Simulating the violation of smoking restrictions may be used as an efficient method of assessing enforcement of the prohibition of public smoking.

[Consumption and sales of tobacco in public places: evaluation of compliance with the current standards]

OBJECTIVE

To evaluate the compliance with current legislation on smoking and tobacco sale in public places in the city of Sabadell (Barcelona).

METHODOLOGY

A sample of 218 sites was randomly selected from a total of 1,224 affected by the legislation, after excluding those where direct, anonymous access was difficult. The existence of signs banning smoking, of areas reserved for smokers and the observation of an indication of smoking presence were analyzed, and also a simulation of the act of smoking was performed.

RESULTS

An indication of smoking presence was observed in 61.5% of sites visited, 85.8% and 74.8% did not have a sign banning smoking at the entrance or in the interior, respectively, excluding restaurants and cafeterias. Only 4.1% of sites complied with all requirements established by the Law. Only one restaurant (1.7%) had a nonsmoking section.

CONCLUSIONS

Our results show a low level of compliance with the legislation. The Administration should state a coherent and progressive strategy to achieve its complete application.