Smoking ban

Smoking bans, or smoke-free laws, are public policies, including criminal laws and occupational safety and health regulations, that prohibit tobacco smoking in certain areas, usually in enclosed workplaces and other public spaces. Such policies are usually enacted to protect people from the negative health effects of passive smoking or second-hand smoke (SHS) exposure.

An internationally recognizable "No Smoking" sign.
An internationally recognizable black "authorization to smoke" sign

Rationale

Sometimes smoking is prohibited for safety reasons related to the burning embers produced. Oily waste is piled up after the Exxon Valdez oil spill next to a small No Smoking sign.

Smoking bans are usually enacted in an attempt to protect people from the effects of second-hand smoke, which include an increased risk of heart disease, cancer, emphysema, and other diseases. Laws implementing bans on indoor smoking have been introduced by many countries and other jurisdictions as public knowledge about the health effects of second-hand smoke increased.[1][2]

In addition, such laws may reduce health care costs,[3] improve work productivity, and lower the overall cost of labour in the community thus protected, making that workforce more attractive for employers. In the US state of Indiana, the economic development agency included in its 2006 plan for acceleration of economic growth encouragement for cities and towns to adopt local smoking bans as a means of promoting job growth in communities.

Additional rationales for smoking restrictions include reduced risk of fire in areas with explosive hazards; cleanliness in places where food, pharmaceuticals, semiconductors, or precision instruments and machinery are produced; decreased legal liability; potentially reduced energy use via decreased ventilation needs; reduced quantities of litter; healthier environments; and giving smokers incentive to quit.[4]

The World Health Organization considers smoking bans to have an influence on reducing demand for tobacco by creating an environment where smoking becomes increasingly more difficult and to help shift social norms away from the acceptance of smoking in everyday life. Along with tax measures, cessation measures, and education, smoking bans are viewed by public health experts as an important element in reducing smoking rates and promoting positive health outcomes. When effectively implemented, they are seen as an important element of policy to support behaviour change in favour of a healthy lifestyle.[5]

Banning smoking in public places has helped to cut premature births by 10 percent, according to new research from the United States and Europe.[6]

Evidence basis

Research has generated evidence that second-hand smoke causes the same problems as direct smoking, including lung cancer, cardiovascular disease, and lung ailments such as emphysema, bronchitis, and asthma.[7] Specifically, meta-analyses show that lifelong non-smokers with partners who smoke in the home have a 20–30% greater risk of lung cancer than non-smokers who live with non-smokers. Non-smokers exposed to cigarette smoke in the workplace have an increased lung cancer risk of 16–19%.[8]

A study issued in 2002 by the International Agency for Research on Cancer of the World Health Organization concluded that non-smokers are exposed to the same carcinogens on account of tobacco smoke as active smokers.[9] Sidestream smoke[10] contains 69 known carcinogens, particularly benzopyrene[11] and other polynuclear aromatic hydrocarbons, and radioactive decay products, such as polonium-210.[12] Several well-established carcinogens have been shown by the tobacco companies' own research to be present at higher concentrations in second-hand smoke than in mainstream smoke.[13]

Scientific organisations confirming the effects of second-hand smoke include the U.S. National Cancer Institute,[14] the U.S. Centers for Disease Control and Prevention (CDC),[15] the U.S. National Institutes of Health,[16] the Surgeon General of the United States,[17] and the World Health Organization.[18]

Air quality in bars and restaurants

Restrictions upon smoking in bars and restaurants can substantially improve the air quality in such establishments. For example, one study listed on the website of the U.S. Centers for Disease Control and Prevention states that New York's statewide law to eliminate smoking in enclosed workplaces and public places substantially reduced RSP (respirable suspended particles) levels in western New York hospitality venues. RSP levels were reduced in every venue that permitted smoking before the law was implemented, including venues in which only second-hand smoke from an adjacent room was observed at baseline.[19] The CDC concluded that their results were similar to other studies which also showed substantially improved indoor air quality after smoking bans were instituted.

A 2004 study showed New Jersey bars and restaurants had more than nine times the levels of indoor air pollution of neighbouring New York City, which had already enacted its smoking ban.[20]

Research has also shown that improved air quality translates to decreased toxin exposure among employees.[21] For example, among employees of the Norwegian establishments that enacted smoking restrictions, tests showed decreased levels of nicotine in the urine of both smoking and non-smoking workers (as compared with measurements prior to going smoke-free).[22]

Public Health Law Research

In 2009, the Public Health Law Research Program, a national program office of the Robert Wood Johnson Foundation, published an evidence brief summarising the research assessing the effect of a specific law or policy on public health. They stated that "There is strong evidence supporting smoking bans and restrictions as effective public health interventions aimed at decreasing exposure to secondhand smoke."[23]

History

One of the world's earliest smoking bans was a 1575 Roman Catholic Church regulation which forbade the use of tobacco in any church in Mexico.[24] In 1590, Pope Urban VII moved against smoking in church buildings.[25] He threatened to excommunicate anyone who "took tobacco in the porchway of or inside a church, whether it be by chewing it, smoking it with a pipe or sniffing it in powdered form through the nose".[26] He followed by Urban VIII in 1624.[27] In 1604 King James VI and I published an anti-smoking treatise, A Counterblaste to Tobacco, that had the effect of raising taxes on tobacco. Russia banned tobacco for 70 years from 1627.[28] The Ottoman Sultan Murad IV prohibited smoking in his empire in 1633 and had smokers executed.[27] The earliest citywide European smoking bans were enacted shortly thereafter. Such bans were enacted in Bavaria, Kursachsen, and certain parts of Austria in the late 17th century. Smoking was banned in Berlin in 1723, in Königsberg in 1742, and in Stettin in 1744. These bans were repealed in the revolutions of 1848.[29] Prior to 1865 Russia had a ban on smoking in the streets.[30]

The first building in the world to ban smoking was the Old Government Building in Wellington, New Zealand in 1876. The ban related to concerns about the threat of fire, as it is the second largest wooden building in the world.[31]

The first modern attempt at restricting smoking saw Nazi Germany banning smoking in every university, post office, military hospital, and Nazi Party office, under the auspices of Karl Astel's Institute for Tobacco Hazards Research, established in 1941 under orders from Adolf Hitler.[32] The Nazis conducted major anti-tobacco campaigns until the demise of their regime in 1945.[33]

In the latter part of the 20th century, as research on the risks of second-hand tobacco smoke became public, the tobacco industry launched "courtesy awareness" campaigns. Fearing reduced sales, the industry created a media and legislative programme that focused upon "accommodation". Tolerance and courtesy were encouraged as a way to ease heightened tensions between smokers and those around them, while avoiding smoking bans. In the US, states were encouraged to pass laws providing separate smoking sections.[34]

In 1975 the U.S. state of Minnesota enacted the Minnesota Clean Indoor Air Act, making it the first state to restrict smoking in most public spaces. At first restaurants were required to have "No Smoking" sections, and bars were exempt from the Act.[35] As of 1 October 2007 Minnesota enacted a ban on smoking in all restaurants and bars statewide, called the Freedom to Breathe Act of 2007.[36]

The resort town of Aspen, Colorado, became the first city in the US to restrict smoking in restaurants, in 1985, though it allowed smoking in areas that were separately ventilated.[37]

On 3 April 1987 the city of Beverly Hills, California, initiated an ordinance to restrict smoking in most restaurants, in retail stores and at public meetings. It exempted restaurants in hotels – City Council members reasoned that hotel restaurants catered to large numbers of visitors from abroad, where smoking is more acceptable than in the United States.

In 1990 the city of San Luis Obispo, California, became the first city in the world to restrict indoor smoking in bars as well as in restaurants.[38] The ban did not include workplaces, but covered all other indoor public spaces[39] and its enforcement was somewhat limited.[40]

In the United States, California's 1998 smoking ban encouraged other states such as New York to implement similar regulations. California's ban included a controversial restriction upon smoking in bars, extending the statewide ban enacted in 1994. As of April 2009, there were 37 states with some form of smoking ban.[41] Some areas in California began banning smoking across whole cities, including every place except residential homes. More than 20 cities in California enacted park- and beach-smoking restrictions. In recent years New York City has passed administrative codes §17-502 and §17-508 forcing landlords of privately owned buildings, cooperatives, and condominiums to adopt a smoking policy into all leases. These codes oblige landlords to create provisions telling tenants the exact locations where they can or can not smoke.[42][43]

From December 1993, in Peru, it became illegal to smoke in any public enclosed places and any public transport vehicles (according to Law 25357 issued on 27 November 1991 and its regulations issued on 25 November 1993 by decree D.S.983-93-PCM). There is also legislation restricting publicity, and it is also illegal (Law 26957 21 May 1998) to sell tobacco to minors or directly to advertise tobacco within 500m of schools (Law 26849 9 Jul 1997).

On 11 November 1975 Italy banned smoking on public transit vehicles (except for smokers' rail carriages) and in some public buildings (hospitals, cinemas, theatres, museums, universities and libraries).[44] After an unsuccessful attempt in 1986, on 16 January 2003 the Italian parliament passed the Legge Sirchia, which would ban smoking in all indoor public places, including bars, restaurants, discotheques and offices from 10 January 2005.[45][46]

On 3 December 2003, New Zealand passed legislation to progressively implement a smoking ban in schools, school grounds, and workplaces by December 2004.[47] On 29 March 2004, the Republic of Ireland implemented a nationwide ban on smoking in all workplaces. In Norway, similar legislation came into force on 1 June the same year.

In Scotland, Andy Kerr, the Minister for Health and Community Care, introduced a ban on smoking in public areas on 26 March 2006. Smoking was banned in all public places in the whole of the United Kingdom in 2007, when England became the final region to have the legislation come into effect (the age limit for buying tobacco also increased from 16 to 18 on 1 October 2007).

On 12 July 1999 a Division Bench of the Kerala High Court in India banned smoking in public places by declaring "public smoking as illegal first time in the history of whole world, unconstitutional and violative of Article 21 of the Constitution". The Bench, headed by Dr. Justice K. Narayana Kurup, held that "tobacco smoking" in public places (in the form of cigarettes, cigars, beedies or otherwise) "falls within the mischief of the penal provisions relating to public nuisance as contained in the Indian Penal Code and also the definition of air pollution as contained in the statutes dealing with the protection and preservation of the environment, in particular, the Air (Prevention and Control of Pollution), Act 1981."

In 2003 India introduced a law that banned smoking in public places like restaurants, public transport or schools. The same law also made it illegal to advertise cigarettes or other tobacco products.[48]

In 2010 Nepal planned to enact a new anti-smoking bill that would ban smoking in public places and outlaw all tobacco advertising to prevent young people from smoking.[49]

On 31 May 2011 Venezuela introduced a restriction upon smoking in enclosed public and commercial spaces.[50]

Smoking was first restricted in schools, hospitals, trains, buses and train stations in Turkey in 1996. In 2008 a more comprehensive smoking ban was implemented, covering all public indoor venues.

Smoking has been restricted at a French beach – the Plage Lumière in La Ciotat, France, became the first beach in Europe[51] to restrict smoking, from August 2011, in an effort to encourage more tourists to visit the beach.

In 2012, smoking in Costa Rica became subject to some of the most restrictive regulations in the world, the practice being banned from many outdoor recreational and educational areas as well as in public buildings and vehicles.

Total tobacco bans

In 2004, Bhutan became the first country to completely outlaw the cultivation, harvesting, production, and sale of tobacco products. Penalties for violating the ban increased under the 'Tobacco Control Act of Bhutan 2010'. However, small allowances for personal possession are permitted as long as the possessor can prove that they have paid import duties.[52] In January 2016, Turkmenistan president Gurbanguly Berdymukhammedov reportedly banned all tobacco sales in the country.[53] The Pitcairn Islands had previously banned the sale of cigarettes; however, it now permits sales from a government-run store. The Pacific island of Niue hopes to become the next country to prohibit the sale of tobacco.[54] A proposal in Iceland would ban tobacco sales from shops, making it prescription-only and therefore dispensable only in pharmacies on doctor's orders.[55] New Zealand hopes to achieve being tobacco-free by 2025 and Finland by 2040. In 2012, anti-smoking groups proposed a 'smoking licence' – if a smoker managed to quit and hand back their licence, they would get back any money they paid for it. Medical students in Singapore and the Australian state of Tasmania have proposed a 'tobacco free millennium generation initiative' by banning the sale of all tobacco products to anyone born in and after the year 2000.[56][57]

In March 2012, Brazil became the world's first country to ban all flavored tobacco, including menthols. It also banned the majority of the estimated 600 additives used, permitting only eight. This regulation applies to domestic and internationally imported cigarettes. Tobacco manufacturers had 18 months to remove the non-compliant cigarettes, 24 months to remove the other forms of non-compliant tobacco.[58][59]

Public support

A 2007 Gallup poll found that 54% of Americans favoured completely smoke-free restaurants, 34% favoured completely smoke-free hotel rooms, and 29% favoured completely smoke-free bars.[60]

Another Gallup poll, of over 26,500 Europeans, conducted in December 2008, found that "a majority of EU citizens support smoking bans in public places, such as offices, restaurants and bars." The poll further found that "support for workplace smoking restrictions is slightly higher than support for such restrictions in restaurants (84% vs. 79%). Two-thirds support smoke-free bars, pubs and clubs." The support is highest in countries which have implemented clear smoking bans: "Citizens in Italy are the most prone to accept smoking restrictions in bars, pubs and clubs (93% – 87% "totally in favour"). Sweden and Ireland join Italy at the higher end of the scale with approximately 80% of respondents supporting smoke-free bars, pubs and clubs (70% in both countries is totally in favor)."[61]

Effects

Effects upon health

Several studies have documented health and economic benefits related to smoking bans. A 2009 report by the Institute of Medicine concluded that smoking bans reduced the risk of coronary heart disease and heart attacks, but the report's authors were unable to identify the magnitude of this reduction.[62][63] Also in 2009, a systematic review and meta-analysis found that bans on smoking in public places were associated with a significant reduction of incidence of heart attacks.[64] The lead author of this meta-analysis, David Meyers, said that this review suggested that a nationwide ban on smoking in public places could prevent between 100,000 and 225,000 heart attacks in the United States each year.[65]

Legislating on smoking of tobacco in public places has reduced the cause of heart disease among adults. Such legislations include banning smoking in restaurants, buses, hotels and workplaces. Institute of Medicine (IOM) convened by the Center for Disease Control (CDC) found out that there are cardiovascular effects from exposure to secondhand smoke. An epidemiology report says that the risk of coronary heart disease is increased to around 25-30% when one is exposed to secondhand smoke. The data shows that even at low levels of the smoke, there is the risk and the risks increases with more exposures.[66]

A 2012 meta-analysis found that smoke-free legislation was associated with a lower rate of hospitalizations for cardiac, cerebrovascular, and respiratory diseases, and that "More comprehensive laws were associated with larger changes in risk."[67] The senior author of this meta-analysis, Stanton Glantz, told USA Today that, with respect to exemptions for certain facilities from smoking bans, "The politicians who put those exemptions in are condemning people to be put into the emergency room."[68] A 2013 review found that smoking bans were associated with "significant reduction in acute MI [myocardial infarction] risk", but noted that "studies with smaller population in the United States usually reported larger reductions, while larger studies reported relatively modest reductions".[69]

A 2014 systematic review and meta-analysis found that smoke-free legislation was associated with approximately 10% reductions in preterm births and hospital attendance for asthma, but not with a decrease in low birth weight.[70][71] A 2016 Cochrane review found that since the previous version of that review was published in 2010, the evidence that smoking bans improved health outcomes had become more robust, especially with respect to acute coronary syndrome admissions.[72][73]

However, other studies came to the conclusion that smoking bans have little or no short-term effect on myocardial infarction rates and other diseases. A 2010 study from the US used huge nationally representative databases to compare smoking-restricted areas with control areas and found no associations between smoking bans and short-term declines in heart attack rates. The authors have also analyzed smaller studies using subsamples and revealed that large short-term increases in myocardial infarction incidence following a smoking ban are as common as the large decreases.[74]

Effects upon tobacco consumption

Smoking bans are generally acknowledged to reduce rates of smoking; smoke-free workplaces reduce smoking rates among workers,[75] and restrictions upon smoking in public places reduce general smoking rates through a combination of stigmatisation and reduction in the social cues for smoking.[76] However, reports in the popular press after smoking bans have been enacted often present conflicting accounts as regards perceptions of effectiveness.

One report stated that cigarette sales in Ireland and Scotland increased after their smoking bans were implemented.[77] In contrast, another report states that in Ireland, cigarette sales fell by 16% in the six months after implementation of the ban.[78] In the UK, cigarette sales fell by 11% during July 2007, the first month of the nationwide smoking ban, compared with July 2006.[79]

A 1992 document from Phillip Morris summarised the tobacco industry's concern about the effects of smoking bans: "Total prohibition of smoking in the workplace strongly effects [sic] tobacco industry volume. Smokers facing these restrictions consume 11%–15% less than average and quit at a rate that is 84% higher than average."[80]

In the United States, the CDC reported a levelling-off of smoking rates in recent years despite a large number of ever more comprehensive smoking bans and large tax increases. It has also been suggested that a "backstop" of hardcore smokers has been reached: those unmotivated and increasingly defiant in the face of further legislation.[81] The smoking ban in New York City was credited with the reduction in adult smoking rates at nearly twice the rate as in the rest of the country, "and life expectancy has climbed three years in a decade".[82]

In Sweden, use of snus, as an alternative to smoking, has risen steadily since that nation's smoking ban.[83]

Smoking restrictions may make it easier for smokers to quit. A survey suggests 22% of UK smokers may have considered quitting in response to that nation's smoking ban.[84]

Restaurant smoking restrictions may help to stop young people from becoming habitual smokers. A study of Massachusetts youths, found that those in towns with smoking bans were 35 percent less likely to be habitual smokers.[85][86]

Effects upon businesses

Smoking is forbidden on some streets in Japan. Smokers utilise smoking lounges, such as this one in Tokyo.
A sign stating "Please do not smoke while walking" in Taitō, Tokyo

Many studies have been published in the health industry literature on the economic effect of smoking bans. The majority of these government and academic studies have found that there is no negative economic impact associated with smoking restrictions and many findings that there may be a positive effect on local businesses.[87] A 2003 review of 97 such studies of the economic effects of a smoking ban on the hospitality industry found that the "best-designed" studies concluded that smoking bans did not harm businesses.[88] Similarly, a 2014 meta-analysis found no significant gains or losses in revenue in restaurants and bars affected by smoking bans.[89]

Studies funded by the bar and restaurant associations have sometimes claimed that smoking bans have a negative effect on restaurant and bar profits. Such associations have also criticised studies which found that such legislation had no impact.[90] Many bar and restaurant associations have relationships with the tobacco industry and are sponsored by them.[91]

Australia

A government survey in Sydney found that the proportion of the population attending pubs and clubs rose after smoking was banned inside them.[92] However, a ClubsNSW report in August 2008 blamed the smoking ban for New South Wales clubs suffering their worst fall in income ever, amounting to a decline of $385 million. Income for clubs was down 11% in New South Wales. Sydney CBD club income fell 21.7% and western Sydney clubs lost 15.5%.[93]

Germany

Some smoking restrictions were introduced in German hotels, restaurants, and bars in 2008 and early 2009. The restaurant industry has claimed that some businesses in the states which restricted smoking in late 2007 (Lower Saxony, Baden-Württemberg, and Hessen) experienced reduced profits. The German Hotel and Restaurant Association (DEHOGA) claimed that the smoking ban deterred people from going out for a drink or meal, stating that 15% of establishments that adopted a ban in 2007 saw turnover fall by around 50%.[94] However, a study by the University of Hamburg (Ahlfeldt and Maennig 2010) finds negative impacts on revenues, if any, only in the very short run. In the medium and long run, a recovery of revenues took place. These results suggest either, that the consumption in bars and restaurants is not affected by smoking bans in the long run, or, that negative revenue impacts by smokers are compensated by increasing revenues through non-smokers.[95] Smoking is not permitted in any public transit or in or around railway stations except for the locations expressly indicated for smoking. Smoking on trains was banned completely by the Deutsche Bahn AG in 2007.[96] Smoking has been restricted in airports and all Lufthansa planes since the late 1990s.[97]

The 2006 FIFA World cup which the country hosted was the last one before bans on smoking in cafes, bars and restaurants were introduced in most of the countries around the world.

In 2008, Bavaria became the first federal state of Germany to completely ban smoking in bars and restaurants. After this restriction was criticized as being "too harsh" by some members of the governing party CSU, it was relaxed one year later. Supporters of smoking bans then brought about a public referendum on the issue, which led to even firmer restrictions than the initial ban. Thereafter, a more comprehensive ban was introduced in 2010.[98]

Also in 2010, the Saarland became the second federal state with a complete ban in bars and restaurants.

In 2013, North Rhine-Westphalia, Germany's most populous federal state, became the third state with a strict ban in bars and restaurants.[99]

Smoking bans by state
Administrative bodies,
courts
Prisons Clinics Asylums Schools,
youth
houses,
kindergartens
High
schools
Gymnasiums,
indoor
pools
Museums,
theatres,
cinemas etc.
Discos Restaurants and bars Malls Airports Railway
stations
Baden-
Württemberg
1 7 6 4 5 9 1 12
Bavaria 6 10 7 10 10 10
Berlin 1 12
Brandenburg 1 1 7 6 7 6 1 1 12
Bremen 7 9 1
Hamburg 7 12
Hesse 1 1 7 1 1 1 1 1 1 1 1 12 1
Mecklenburg-
Vorpommern
1 3
Lower Saxony 6 10 7 10 10
North Rhine
Westphalia
2 6 13 14
Rhineland-Palatinate 1 2 1 7 9 1 11
Saarland 2 6 7 7 8
Saxony 1 11 12
Saxony-Anhalt 1 7 7 1 1 1 1 1 1
Schleswig-
Holstein
7 7 1 1
Thuringia 1 7 9 1
1 With exception for separated areas and marquees.
2 Smoking permitted in detention premises which are exclusively for smokers.
3 For passenger terminals of airports, ferry ports and seaports which are listed in the Act.
4 For adult students from Grade 11, and teachers' smoking zones can be established outside of school buildings.
5 Since smoking is banned in Baden-Württemberg in all public rooms where food or drinks are served for consumption on the spot, the smoking ban applies to all cinemas, as the mentioned criterion necessarily applies to cinemas. This was confirmed on request from the Government of Tübingen and by the relevant ministry.
6 Special permission for some exceptions.
7 No ban in rooms that are left for personal use.
8 Clubhouses may permit smoking during private events.
9 A side room with no dance floor can be designated for smoking.
10 Separated smoking rooms can be established.
11 Smoking allowed in owner-managed "Einraumgaststätten" (Restaurants with maximum 1 room) without permanent staff personnel.
12 In bars (which mainly serve drinks) with maximum 1 room and less than 75 square meters, smoking can be permitted if they are signed as such and minors under the age of 18 aren't permitted. It's not allowed to serve warm meals.
13 Only on public treads.
14 Only public areas.

Ireland

The Republic of Ireland was the first country to introduce fully smoke-free workplaces (March 2004). The Irish workplace smoke-free law was introduced with the intention of protecting workers from second-hand smoke and to discourage smoking in a nation with a high percentage of smokers. In Ireland, the main opposition to the ban came from publicans. Many pubs introduced "outdoor" arrangements (generally heated areas with shelters). It was speculated by opponents that the smoke-free workplaces law would increase the amount of drinking and smoking in the home, but recent studies showed this was not the case.[100]

Ireland's Office of Tobacco Control website indicates that "an evaluation of the official hospitality sector data shows there has been no adverse economic effect from the introduction of this measure (the March 2004 national introduction of smoke-free in bars, restaurants, etc). It has been claimed that the smoke-free law was a significant contributing factor to the closure of hundreds of small rural pubs, with almost 440 fewer licences renewed in 2006 than in 2005."[101]

Isle of Man

Smoke-free restrictions came into effect in the Isle of Man on 30 March 2008.

India

Chandigarh became the first city-state of India to become smoke-free in July 2007. Social activist Hemant Goswami did pioneering work to make Chandigarh smoke-free. Inspired by the success of Chandigarh, the then Union Health Minister Dr. Ambumani Ramadoss enacted the new smoke-free regulation in 2008. India banned smoking in public places on 2 October 2008. Nearly a decade earlier, on 12 July 1999, a Division Bench of the Kerala High Court in India banned smoking in public places by declaring public smoking as illegal (the first time in the world), unconstitutional, and violative of Article 21 of the constitution. The bench headed by Dr. Justice K. Narayana Kurup, held that tobacco smoking in public places (in the form of cigarettes, cigars, beedies or otherwise) falls within the mischief of the penal provisions relating to public nuisance as contained in the Indian Penal Code and within the definition of air pollution as contained in the statutes dealing with protection and preservation of environment, in particular, Prevention and Control of Pollution Act 1981. The Supreme Court in Murli S Deora vs. Union of India and Ors., recognized the harmful effects of smoking in public and also the effect on passive smokers, and in the absence of statutory provisions at that time, prohibited smoking in public places such as,1.auditoriums, 2. hospital buildings, 3. health institutions, 4. educational institutions, 5. libraries, 6. court buildings, 7. public office, 8. public conveyances, including the railways.[102]

Tobacco is universally regarded as one of the major public health hazards and is responsible directly or indirectly for an estimated eight lakh deaths annually in the country. It has also been found that treatment of tobacco related diseases and the loss of productivity caused therein cost the country almost Rs. 13,500 crores annually, which more than offsets all the benefits accruing in the form of revenue and employment generated by tobacco industry.

Supreme Court of India, Murli S. Deora vs Union of India And Ors on 2 November 2001

Philippines

The smoking ban in the Philippines is under the provisions of two laws: the Clean Air Act of 1999 and the Tobacco Regulation Act of 2003.

The Philippine Clean Air Act of 1999 prohibits smoking inside a public building or an enclosed public place including public vehicles and other means of transport or in any enclosed area outside of one’s private residence, private place of work or any duly designated smoking area.[103]

The Tobacco Regulation Act also prohibits smoking in public places, like schools, public transportation terminals, malls, and places with fire hazards, like gas stations.

Cancer survivors support the planned smoking ban in order for local government units to strictly implement the regulations set by the Tobacco Regulation Act of 2003.[104] On 16 May 2017, President Rodrigo Duterte signed an executive order for the disestablishment of public smoking areas, both indoor and outdoor, implementing a nationwide smoking ban.[105]

Poland

Smoking in public places was banned in Poland on 15 November 2010 by a change in parliamentary act "On Defending Health Against Results of Tobacco and Tobacco Products Usage" (Ustawa o ochronie zdrowia przed następstwami używania tytoniu i wyrobów tytoniowych).[106] The smoke ban includes all public places, regardless of ownership, that is restaurants, pubs, workplaces, hospitals, universities, public transport stops and stations and sports facilities (institutions of primary and secondary education had been declared smoke-free already in 1996).[106] The fine for violating the ban is up to 500 Polish złoty.[106] Owners of businesses who fail to put up no smoking signs could be penalised with a fine of up to 2000 złoty, while tobacco producers who advertise their products as "less harmful" or "healthier" could be fined with up to 200000 złoty.[106]

However, after two years in effect the ban did not affect the number of active smokers in Poland. According to a 2012 poll by CBOS, both before the ban and 2 years later the percentage of smoking Poles was exactly the same: 31.[107]

Russia

Russia was one of the last countries in the world not to have anti-smoking legislation in place. However, in October 2012, Prime Minister Dmitry Medvedev commenced an anti-tobacco strategy that has led to proposals from the Russian Health Ministry to cease advertising, increase tax on cigarette sales and ban smoking in public spaces.[108] The Prime Minister lamented the smoking death rate in the country with 400,000 citizens dying every year of smoking-related causes and this is also compounded by the fact that a pack of cigarettes in Russia typically costs around the £1 mark.[108]

A strict law aimed to protect people’s health from tobacco smoke and the consequences of smoking that introduced a ban on smoking in all closed public areas in compliance with the WHO Framework Convention on Tobacco Control took effect on 1 June 2013. At first smoking ban abusers were not fined - the mechanism was still under consideration. The law prohibits smoking at schools and universities, cultural and sporting organizations, beaches, stadiums, on playgrounds and in hospitals, in sanatoriums and at health resorts, inside the offices of public organizations and at filling stations. Smoking is banned aboard aircraft, on the subway and all kinds of public transport. From 15 November 2013 on, smoking at working places, near and within the educational, cultural, sporting and healthcare organizations, in houses' hallways, at railway stations and airports is to be punished with a fine from 500 to 1,500 roubles ($15 – 45.5). The management of organizations where the ban is violated will face tougher fines. From 1 June 2014 the list will be complemented with restaurants and bars, dormitories, hotels, long-haul trains, and the boarding platforms of suburban railway stations.[109]

United Kingdom

No-smoking regulations came into effect in Scotland on 26 March 2006,[110] in Wales on 2 April 2007, in Northern Ireland on 30 April 2007 and in England on 1 July 2007.[111] The legislation was cited as an example of good regulation which has had a favourable impact on the UK economy by the Department for Business, Innovation and Skills[112] and a review of the impact of smoke-free legislation carried out for the Department of Health concluded that there was no clear adverse impact on the hospitality industry[113] despite initial criticism from some voices within the pub trade.

Six months after implementation in Wales, the Licensed Victuallers Association (LVA), which represents pub operators across Wales, claimed that pubs had lost up to 20% of their trade. The LVA said some businesses were on the brink of closure, others had already closed down, and there was little optimism trade would eventually return to previous levels.[114]

The British Beer and Pub Association (BBPA), which represents some pubs and breweries across the UK claimed that beer sales were at their lowest level since the 1930s, ascribing a fall in sales of 7% during 2007 to the smoke-free regulations.[115]

According to a survey conducted by pub and bar trade magazine The Publican, the anticipated increase in sales of food following introduction of smoke-free workplaces did not immediately occur. The trade magazine's survey of 303 pubs in the United Kingdom found the average customer spent £14.86 on food and drink at dinner in 2007, virtually identical to 2006.[116]

A survey conducted by BII (formerly British Institute of Innkeeping) and the Federation of Licensed Victuallers' Associations (FLVA) concluded that sales had decreased by 7.3% in the 5 months since the introduction of smoke-free workplaces on 1 July 2007. Of the 2,708 responses to the survey, 58% of licensees said they had seen smokers visiting less regularly, while 73% had seen their smoking customers spending less time at the pub.[117]

United States

In the US, smokers and hospitality businesses initially argued that businesses would suffer from no-smoking laws. However, a 2006 review by the U.S. Surgeon General found that smoking restrictions were unlikely to harm businesses in practice, and that many restaurants and bars might see increased business.[118][119]

In 2003, New York City amended its smoke-free law to include virtually all restaurants and bars, including those in private clubs, making it, along with the California smoke-free law, one of the toughest in the United States. The city's Department of Health found in a 2004 study that air pollution levels had decreased sixfold in bars and restaurants after the restrictions went into effect, and that New Yorkers had reported less second-hand smoke in the workplace. The study also found the city's restaurants and bars prospered despite the smoke-free law, with increases in jobs, liquor licenses, and business tax payments. The president of the New York Nightlife Association remarked that the study was not wholly representative, as by not differentiating between restaurants and nightclubs, the reform may have caused businesses like nightclubs and bars to suffer instead.[120] A 2006 study by the New York State Department of Health found that "the CIAA has not had any significant negative financial effect on restaurants and bars in either the short or the long term".[121] In May 2011 New York City expanded the previously implemented smoking ban by banning smoking in parks, beaches and boardwalks, public golf courses and other areas controlled by the New York City Parks Department.[122][123]

Using sales and tobacco tax data from 216 cities and counties over 11 years, the researchers projected that seven of the states would have no economic impact, and West Virginia would see a 1 percent boost in restaurant jobs if a statewide smoking ban was adopted. Other benefits of smoking bans in bars and restaurants include improved lung function and a decrease in smoking rates among staff. Some data came from the Missouri Department of Revenue after smoking bans were passed in Lake Saint Louis, Kirkwood, Clayton and Ballwin.[124]

Effects upon musical instruments

Bellows-driven instruments – such as the accordion, concertina, melodeon and (Irish) Uilleann bagpipes – reportedly need less frequent cleaning and maintenance as a result of the Irish smoke-free law.[125] "Third-hand smoke", solid particulates from secondhand smoke that are adsorbed onto surfaces and later re-emitted as gases or transferred through touch, are a particular problem for musicians. After playing in smoky bars, instruments can emit nicotine, 3-ethenylpyridine (3-EP), phenol, cresols, naphthalene, formaldehyde, and tobacco-specific nitrosamines (including some not found in freshly emitted tobacco smoke), which can enter musicians' bodies through the skin, or be re-emitted as gases after they have left the smoky environment. Concern about third-hand smoke on instruments is one of the reasons many musicians, represented by the New Orleans Musicians' Clinic, supported the smoking ban there.[126]

Effects of prison smoking restrictions

Prisons are increasingly restricting tobacco smoking.[127] In the United States, 24 states prohibit indoor smoking whereas California, Nebraska, Arkansas, and Kentucky prohibit smoking on the entire prison grounds.[128] In July 2004 the Federal Bureau of Prisons adopted a smoke-free policy for its facilities.[129] A 1993 U.S. Supreme Court ruling acknowledged that a prisoner's exposure to second-hand smoke could be regarded as cruel and unusual punishment (which would be in violation of the Eighth Amendment).[130] A 1997 ruling in Massachusetts established that prison smoking bans do not constitute cruel and unusual punishment.[131] Many officials view prison smoking bans as a means of reducing health-care costs.[132]

With the exception of Quebec, all Canadian provinces have banned smoking indoors and outdoors in all their prison facilities. Prison officials and guards are sometimes worried due to previous events in other prisons concerning riots, fostering a cigarette black market within the prison, and other problems resulting from total prison smoking restrictions. Prisons have experienced riots when placing smoking restrictions into effect resulting in prisoners setting fires, destroying prison property, persons being assaulted, injured, and stabbed. One prison in Canada had some guards reporting breathing difficulties from the fumes of prisoners smoking artificial cigarettes made from nicotine patches lit by creating sparks from inserting metal objects into electrical outlets.[133][134] For example in 2008, the Orsainville Detention Centre near Quebec City, withdrew its smoke-free provision following a riot. But the feared increase in tension and violence expected in association with smoking restrictions has generally not been experienced in practice.[131]

Prison smoking bans are also in force in New Zealand, the Isle of Man and the Australian states of Victoria, Queensland, Tasmania, Northern Territory and New South Wales. The New Zealand ban was subsequently successfully challenged in court on two occasions, resulting in a law change to maintain it.[135][136]

Some prisoners are getting around the prison smoking bans by creating and smoking "teabacco", which is nicotine patches or lozenges mixed with tea leaves, and rolled up in Bible paper.[137] A forensic analysis of teabacco made from nicotine lozenges identified some potentially toxic compounds, but concluded that teabacco made from nicotine lozenges may be less harmful than traditional tobacco cigarettes.[138]

Compliance

The introduction of smoking restrictions occasionally generates protests[139] and predictions of widespread non-compliance, along with the rise of smokeasies, including in New York City,[140] Germany,[141] Illinois,[142] the United Kingdom,[143][144][145] Utah,[146] and Washington, D.C.[147]

High levels of compliance with smoke-free laws have been reported in most jurisdictions including New York,[148] Ireland,[149] Italy[150] and Scotland.[151] Poor compliance was reported in Calcutta.[152]

Criticism

Smoke-free regulations and ordinances have been criticised on a number of grounds.

Government interference with personal lifestyle

Critics of smoke-free provisions, including musician Joe Jackson,[153] and political essayist Christopher Hitchens,[154][155] have claimed that regulation efforts are misguided. Typically, such arguments are based upon an interpretation of John Stuart Mill's harm principle which perceives smoke-free laws as an obstacle to tobacco consumption per se, rather than a bar upon harming other people.

Such arguments, which usually refer to the notion of personal liberty, have themselves been criticised by Nobel Prize-winning economist Amartya Sen who defended smoke-free regulations on several grounds.[156] Among other things, Sen argued that while a person may be free to acquire the habit of smoking, they thereby restrict their own freedom in the future given that the habit of smoking is hard to break.[156] Sen also pointed out the heavy costs that smoking inevitably imposes on every society which grants smokers unrestricted access to public services (which, Sen noted, every society that is not "monstrously unforgiving" would do).[156] Arguments which invoke the notion of personal liberty against smoke-free laws are thus incomplete and inadequate, according to Sen.[156]

In New Zealand, two psychiatrist patients and a nurse took their local district health board to court, arguing a smoking ban at intensive care units violated "human dignity" as they were there for mental health reasons, not smoking-related illness.[157] They argued it was "cruel" to deny patients cigarettes.[158]

Property rights

Some critics of smoke-free laws emphasise the property rights of business owners, drawing a distinction between nominally public places (such as government buildings) and privately owned establishments (such as bars and restaurants). Citing economic efficiency, some economists suggest that the basic institutions of private property rights and contractual freedom are capable of resolving conflicts between the preferences of smokers and those who seek a smoke-free environment, without government intrusion.[159]

Effects on existing smoke-free businesses

Many critics, including a substantial number of those who oppose smoking bans on property-rights grounds, note that where no private-establishment smoking bans are in place, a subset of establishments are able to set themselves apart by catering to the market niche of patrons who prefer smoke-free establishments. Prohibiting smoking in all areas, these critics argue, would eliminate the competitive advantage of these establishments.

Legality of smoke-free regulations

Businesses affected by smoke-free regulations have filed lawsuits claiming that these are unconstitutional or otherwise illegal. In the United States, some cite unequal protection under the law while others cite loss of business without compensation, as well as other types of challenges. Some localities where hospitality businesses filed lawsuits against the state or local government include Nevada, Montana, Iowa, Colorado, Kentucky, New York, South Carolina, and Hawaii,[160][161][162][163][164][165][166][167] though none have succeeded.

Smoke-free laws may move smoking elsewhere

Restrictions upon smoking in offices and other enclosed public places often result in smokers going outside to smoke, frequently congregating outside doorways. This can result in non-smokers passing through these doorways getting exposed to more secondhand smoke rather than less. Many jurisdictions that have restricted smoking in enclosed public places have extended provisions to cover areas within a fixed distance of entrances to buildings.[168]

The former UK Secretary of State for Health John Reid claimed that restrictions upon smoking in public places may lead to more people smoking at home.[169] However, both the House of Commons Health Committee and the Royal College of Physicians disagreed, with the former finding no evidence to support Reid's claim after studying Ireland,[169] and the latter finding that smoke-free households increased from 22% to 37% between 1996-2003.[170]

In January 2010, the mayor of Boston, Massachusetts, Thomas Menino, proposed a restriction upon smoking inside public housing apartments under the jurisdiction of the Boston Housing Authority.[171]

Connection to DUI fatalities

In May 2008, research published by Adams and Cotti in the Journal of Public Economics examined statistics of drunken-driving fatalities and accidents in areas where smoke-free laws have been implemented in bars and found that fatal drunken-driving accidents increased by about 13%, or about 2.5 such accidents per year for a typical county of 680,000. They speculate this could be caused by smokers driving farther away to jurisdictions without smoke-free laws or where enforcement is lax.[172]

Effects of funding on research literature

As in other areas of research, the effect of funding on research literature has been discussed with respect to smoke-free laws. Most commonly, studies which found few or no positive and/or negative effects of smoke-free laws and which were funded by tobacco companies have been delegitimised because of the obvious conflict of interest.[173]

Professor of Economics at the California State Polytechnic University-San Luis Obispo, Michael L. Marlow, defended "tobacco-sponsored" studies arguing that all studies merited "scrutiny and a degree of skepticism", irrespective of their funding. He wished for the basic assumption that every author were "fair minded and trustworthy, and deserves being heard out" and for less attention to research funding when evaluating the results of a study. Marlow suggests that studies funded by tobacco companies are viewed and dismissed as "deceitful",[174] i.e. as being driven by (conscious) bad intention.

Alternatives

Incentives for voluntarily smoke-free establishments

During the debates over the Washington, DC, smoke-free law, city council member Carol Schwartz proposed legislation that would have enacted either a substantial tax credit for businesses that chose to voluntarily restrict smoking or a quadrupling of the annual business license fee for bars, restaurants and clubs that wished to allow smoking. Additionally, locations allowing smoking would have been required to install specified high-performance ventilation systems.[175]

Ventilation

Critics of smoke-free laws have suggested that ventilation is a means of reducing the harmful effects of second-hand smoke. A tobacco industry-funded study conducted by the School of Technology of the University of Glamorgan in Wales, published in the Building Services Journal suggested that "ventilation is effective in controlling the level of contamination", although "ventilation can only dilute or partially displace contaminants and occupational exposure limits are based on the 'as low as reasonably practicable' principle".[176][177]

Some hospitality organisations have claimed that ventilation systems could bring venues into line with smoke-free restaurant ordinances. A study published by the American Society of Heating, Refrigerating and Air-Conditioning Engineers and funded by the Robert Wood Johnson Foundation found one establishment with lower air quality in the non-smoking section, due to improperly installed ventilation systems. They also determined that even properly functioning systems "are not substitutes for smoking bans in controlling environmental smoke exposure".[178]

The tobacco industry has focused on proposing ventilation as an alternative to smoke-free laws, though this approach has not been widely adopted in the U.S. because "in the end, it is simpler, cheaper, and healthier to end smoking".[179] The Italian smoke-free law ban permits dedicated smoking rooms with automatic doors and smoke extractors. Nevertheless, few Italian establishments are creating smoking rooms due to the additional cost.[180]

A landmark report from the U.S. Surgeon General found that even the use of elaborate ventilation systems and smoking rooms fail to provide protection from the health hazards of second-hand smoke, since there is "no safe level of second-hand smoke".[181]

Preemption

A number of states in the United States have "preemption clauses" within state law which block local communities from passing smoke-free ordinances more strict than the state laws on the books. The rationale is to prevent local communities from passing smoke-free ordinances which are viewed as excessive by that state's legislature. Other states have "anti-preemption clauses" that allow local communities to pass smoking ban ordinances that their legislature found unacceptable.[182]

Hardship exemptions

In Wauwatosa, Wisconsin, three restaurants received short-term exemptions from a local smoke-free ordinance in restaurants when they managed to demonstrate financial suffering because of it.[183]

See also

General

Organizations

People

  • Douglas Eads Foster, Los Angeles, California, City Council member, 1927–29, proposed prohibition of smoking near schools
  • Evan Lewis, Los Angeles City Council member, 1925–41, opposed smoking on balconies of theaters
  • Adolf Hitler, 1889–1945, often considered to be the first national leader to advocate non-smoking
  • Patricia Hewitt introduced bans in UK
  • Nicola Roxon introduced plain packaging in Australia

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