Changes in Georgia restaurant and bar smoking policies from 2006 to 2012

Impact of US Smoke-free Air Laws on Restaurant and Bar Employment, 1990-2015

INTRODUCTION

Secondhand smoke exposure is responsible for an estimated 50000 deaths per year among nonsmokers in the United States. Smoke-free air laws reduce secondhand smoke exposure but often encounter opposition over concerns about their economic impact. Expansion of these laws has stagnated and efforts to weaken existing laws may exacerbate existing disparities in exposure. Studies at the state and local levels have found that smoke-free air laws do not generally have an adverse effect, but there are no recent estimates of the impact of these laws nationally.

METHODS

Employment and sales are two measures commonly used to estimate the economic impact of smoke-free air laws. Sales data are gathered by state and local taxing authorities but not uniformly across jurisdictions. Dynamic panel models are used to estimate a population-weighted national average treatment effect of smoke-free air laws on restaurant and bar employment using data from the Quarterly Census of Employment and Wages for 1990 to 2015.

RESULTS

A one-percentage point increase in population covered by a restaurant smoke-free air law is associated with a small increase (approximately 0.01%) in restaurant employment (b = .0001, p < .001). The percentage of state population covered by a bar smoke-free air law was not associated with bar employment.

DISCUSSION

Smoke-free air laws are a powerful tool for protecting hospitality workers and patrons from the dangers of secondhand smoke. Using data from over more than two decades, these results suggest that smoke-free air laws in the United States do not generally have any meaningful effect on restaurant and bar employment.

IMPLICATIONS

Smoke-free air laws are associated with reductions in negative health outcomes and decreased smoking prevalence. Despite this clear public health argument and strong public support, passage of new laws has stagnated and exemptions are being used to weaken existing laws. The ability to make both a health and business case in support of existing laws may also bolster the case for expansion. This study provides an updated look at the economic impact of smoke-free air laws nationally through 2015. The lack of adverse findings provides additional support for these laws as public health win-win.

Impact of US smoke-free air laws on restaurants and bars by employer size: a panel study

OBJECTIVES

Thirty states have smoke-free air laws that ban smoking in restaurants and bars, covering nearly two-thirds of the US population. It is well established that these laws generally have a null or positive economic impact on restaurants and bars. However, all establishments in a geographic area are usually treated as a homogeneous group without considering the potential for differential effects by establishment characteristics. This study uses variation in smoke-free air laws over time to estimate their impact on employment in restaurants and bars with a focus on potential differences by employer size (number of employees). A two-pronged approach with a national-level and state-level analysis is used to take advantage of more granular data availability for a single state (North Carolina).

DESIGN

Observational study using panel data.

SETTING

1) US, 2) North Carolina INTERVENTIONS: Smoke-free air laws.

OUTCOME MEASURES

State-level accommodation and food services employment for all 50 states and District of Columbia from 1990 through 2014 (Quarterly Census of Employment and Wages); county-level restaurant and bar employment in North Carolina from 2001 through 2014 (North Carolina Department of Commerce).

RESULTS

There is no evidence of a redistributive effect of smoke-free air laws on restaurant and bar employment by employer size.

CONCLUSION

The lack of a redistributive effect is an important finding for policy-makers considering implementation or expansion of a smoke-free air law to protect employees and patrons from the dangers of exposure to secondhand smoke.

The importance of continued engagement during the implementation phase of tobacco control policies in a middle-income country: the case of Costa Rica

OBJECTIVE

To analyse the process of implementing and enforcing smoke-free environments, tobacco advertising, tobacco taxes and health warning labels from Costa Rica's 2012 tobacco control law.

METHOD

Review of tobacco control legislation, newspaper articles and interviewing key informants.

RESULTS

Despite overcoming decades of tobacco industry dominance to win enactment of a strong tobacco control law in March 2012 consistent with WHO's Framework Convention on Tobacco Control, the tobacco industry and their allies lobbied executive branch authorities for exemptions in smoke-free environments to create public confusion, and continued to report in the media that increasing cigarette taxes led to a rise in illicit trade. In response, tobacco control advocates, with technical support from international health groups, helped strengthen tobacco advertising regulations by prohibiting advertising at the point-of-sale (POS) and banning corporate social responsibility campaigns. The Health Ministry used increased tobacco taxes earmarked for tobacco control to help effectively promote and enforce the law, resulting in high compliance for smoke-free environments, advertising restrictions and health warning label (HWL) regulations. Despite this success, government trade concerns allowed, as of December 2015, POS tobacco advertising, and delayed the release of HWL regulations for 15 months.

CONCLUSIONS

The implementation phase continues to be a site of intensive tobacco industry political activity in low and middle-income countries. International support and earmarked tobacco taxes provide important technical and financial assistance to implement tobacco control policies, but more legal expertise is needed to overcome government trade concerns and avoid unnecessary delays in implementation.