On Jan. 1, 2008, Illinois will join a growing list of U.S. states that ban cigarette smoking in public places. The Illinois Smoke-Free Act prohibits smoking inside workplaces, restaurants and bars, as well as within 15 feet of entrances to public establishments. Tom O'Rourke, an emeritus professor of community health, recently analyzed data for a study that considered the extent to which smoke-free ordinances and cigarette taxes affect people's smoking behavior. He recently discussed research results with News Bureau Applied Health Sciences Editor Melissa Mitchell.
It seems as though fewer people are lighting up already these days - in public or in private. True?
There have been significant declines in smoking nationwide. In 1965, half of the men and one third of the women were smokers. By 2003, that number was 23 percent of the men and 19 percent of women. Among the states today, there are wide ranges in smoking rates - from a low of Utah, at about 11 percent, to a high of 28 percent in Kentucky. The average across the country is 21 percent of the adult population, that is, people 18 and over.
It's easy to understand how hikes in cigarette taxes, passed along to the consumer through higher per-pack prices, would ultimately cause some people to quit smoking. Does smoke-free legislation results in similar reductions?
We found that both taxes and smoke-free ordinances seem to have an impact. Taxes appear to have more of an impact. Taxes and smoke-free combined have an additive impact. Smoke-free is not geared to reduce the number of smokers but to protect people from the effects of second-hand smoke. However, by reducing the opportunities to smoke, it may encourage some smokers to quit. In that sense, I call it a synergistic effect. The social norms, the social pressure, the reduced opportunity plus the money ... it makes sense that one's going to add onto the other.
Do states see a noticeable reduction in the smoking rate when cigarette taxes are boosted or when bans are implemented?
There are higher smoking rates in low-tax states, and lower smoking rates in high tax states. Similarly, but not as apparent, smoke-free legislation has an effect, but not as strong. For example, if you take low-tax states and look at it, there is a difference of about 4 ½ percentage points in the percent of people who smoke. But that translates into a 17 percent drop in the smoking rate when you compare states that have low taxes and low smoke-free to low taxes and high smoke-free. So smoke-free appears to have an impact. But where you see the major impact is if you look at low taxes and low smoke-free states compared to those with high taxes and high smoke-free policies. You'll see a difference of about 6 ½ percent of the smoking population. But that translates into a 24 percent reduction in the overall smoking rate.
By Jan. 2008, how many states will have state-wide smoking bans on the books?
This is a moving target. All 50 states and the District of Columbia have laws/policies restricting smoking in certain places. By Jan. 2008, 19 states, including Illinois and D.C., will be 100 percent smoke-free. That is, they prohibit smoking in almost all public places and workplaces, including restaurants and bars. Montana and Utah prohibit smoking in most public places and workplaces, including restaurants; bars will go smoke-free in 2009.
The overall trend is clear. Expect more states to go 100 percent smoke-free or, at least, to strengthen their smoke-free laws/policies. Also, interestingly, no state that has gone 100 percent smoke-free has gone back in the other direction. Smoke-free policies enjoy widespread public support - usually by a substantial number of smokers.
Does the legislation differ much from state to state?
Yes. For example, besides the 19 smoke-free states, four - Florida, Idaho, Louisiana and Nevada - prohibit smoking in most public places and workplaces, including restaurants, but exempt stand-alone bars. Fifteen states partially or totally preempt local communities from passing smoke-free air ordinances stronger than the statewide law. Across the country now (end of 2007), 60 percent of the population is protected by some smoke-free ordinance. That works out to about 42 percent of workplaces, 56 percent of restaurants and 44 percent of bars.
Opponents of smoke-free legislation frequently protest that the laws cause businesses to suffer or even go under. Is there any validity to that claim?
Not really. There have been numerous studies regarding the economic impact of smoke-free ordinances. In some cases, there has been a slight drop immediately, but within three, or certainly six, months, there's nothing to indicate that sales are down. Often, as measured by food and beverage sales tax receipts, there is a positive effect - they're doing more business. Opponents point to the fact that some businesses like bars or restaurants go out of business, but they don't show that some bars or businesses are going to go out of business anyway.