Effect of smoking regulations in local restaurants on smokers' anti-smoking attitudes and quitting behaviours.

OBJECTIVE

To examine the effect of smoking regulations in local restaurants on anti-smoking attitudes and quitting behaviours among adult smokers.

DESIGN

Hierarchical linear modelling (HLM) was used to assess the relationship between baseline strength of town-level restaurant smoking regulation and follow-up (1) perceptions of the social acceptability of smoking and (2) quitting behaviours.

SETTING

Each of the 351 Massachusetts towns was classified as having strong (complete smoking ban) or weak (all other and no smoking restrictions) restaurant smoking regulations.

SUBJECTS

1712 adult smokers of Massachusetts aged > or = 18 years at baseline who were interviewed via random-digit-dial telephone survey in 2001-2 and followed up 2 years later.

MAIN OUTCOME MEASURES

Perceived social acceptability of smoking in restaurants and bars, and making a quit attempt and quitting smoking.

RESULTS

Among adult smokers who had made a quit attempt at baseline, living in a town with a strong regulation was associated with a threefold increase in the odds of making a quit attempt at follow-up (OR = 3.12; 95% CI 1.51 to 6.44). Regulation was found to have no effect on cessation at follow-up. A notable, although marginal, effect of regulation was observed for perceiving smoking in bars as socially unacceptable only among smokers who reported at baseline that smoking in bars was socially unacceptable.

CONCLUSIONS

Although local restaurant smoking regulations did not increase smoking cessation rates, they did increase the likelihood of making a quit attempt among smokers who had previously tried to quit, and seem to reinforce anti-social smoking norms among smokers who already viewed smoking in bars as socially unacceptable.