Publication Date: 
Friday, December 20, 2019

The Problem: Tobacco use is a source of chronic and fatal illnesses for users and people exposed to tobacco smoke. Second-hand smoke exposure contributes to 41,000 deaths among non-smoking adults, and 400 infants annually. Second-hand exposure can lead to stroke, lung cancer and coronary heart disease. Children exposed to second-hand smoke are at increased risk for slowed lung growth, asthma, acute respiratory infections, middle ear infections and sudden infant death syndrome. CDC: Secondhand Smoke

The Law: Smoking bans prohibit smoking in specified areas. These restrictions aim to eliminate or reduce exposure to second-hand smoke. Smoking bans are found in state and local laws as well as regulations governing workplace safety. For examples of Smoke-Free laws, see Mo. Rev. Stat. §191.767 (Missouri), D.C. Code §7-742 (District of Columbia), N.Y. Pub. Health L. §1399-n (New York), and N.J. Stat. Ann. §26:3D-55 et seq. (New Jersey)

The Evidence: An expert panel at the Community Guide systematically reviewed studies assessing the effect of smoke-free policies on tobacco use and secondhand smoke exposure at national, state and local levels. Reviewers identified 82 studies that evaluated the relationship between smoke-free policy implementation, and tobacco use and secondhand smoke exposure outcomes. Study designs included cross-sectional population comparisons between groups exposed and not exposed to smoke-free policies, interrupted time series and other designs including longitudinal follow-up. Results showed that smoke-free policies were associated with decreases in secondhand smoke exposure; tobacco use prevalence among young people and adults; and adverse health effects. Results showed a median relative reduction of 50% in secondhand smoke biomarkers in study participants, and a 2.7% median reduction in tobacco use prevalence. Additionally, asthma morbidity decreased by a median 20.1% and cardiovascular events were reduced by a median of 5.1%. The reviewers found the evidence of the effectiveness of smoke-free policies to be strong.

Bottom Line: According to the reviewers of a Community Guide systematic review, there is sufficient evidence that smoke-free policies are effective in reducing tobacco use and secondhand smoke exposure.

Impact: Effective