Maastricht University, CAPHRI, The Netherlands.
Soc Sci Med. 2011 May;72(10):1643-51. doi: 10.1016/j.socscimed.2011.03.018. Epub 2011 Mar 30.
National level smoke-free legislation is implemented to protect the public from exposure to second-hand tobacco smoke (SHS). The first aim of this study was to investigate how successful the smoke-free hospitality industry legislation in Ireland (March 2004), France (January 2008), the Netherlands (July 2008), and Germany (between August 2007 and July 2008) was in reducing smoking in bars. The second aim was to assess individual smokers' predictors of smoking in bars post-ban. The third aim was to examine country differences in predictors and the fourth aim was to examine differences between educational levels (as an indicator of socioeconomic status). This study used nationally representative samples of 3147 adult smokers from the International Tobacco Control (ITC) Europe Surveys who were surveyed pre- and post-ban. The results reveal that while the partial smoke-free legislation in the Netherlands and Germany was effective in reducing smoking in bars (from 88% to 34% and from 87% to 44%, respectively), the effectiveness was much lower than the comprehensive legislation in Ireland and France which almost completely eliminated smoking in bars (from 97% to 3% and from 84% to 3% respectively). Smokers who were more supportive of the ban, were more aware of the harm of SHS, and who had negative opinions of smoking were less likely to smoke in bars post-ban. Support for the ban was a stronger predictor in Germany. SHS harm awareness was a stronger predictor among less educated smokers in the Netherlands and Germany. The results indicate the need for strong comprehensive smoke-free legislation without exceptions. This should be accompanied by educational campaigns in which the public health rationale for the legislation is clearly explained.
国家层面的禁烟立法旨在保护公众免受二手烟（SHS）的侵害。本研究的首要目的是调查爱尔兰（2004 年 3 月）、法国（2008 年 1 月）、荷兰（2008 年 7 月）和德国（2007 年 8 月至 2008 年 7 月）的禁烟餐饮业立法在减少酒吧吸烟方面的成功程度。其次是评估个人吸烟者在禁烟令后的酒吧吸烟预测因素。第三个目的是检验国家间预测因素的差异，第四个目的是检验不同教育水平（作为社会经济地位的指标）之间的差异。本研究使用了来自国际烟草控制（ITC）欧洲调查的具有全国代表性的 3147 名成年吸烟者样本，这些吸烟者在禁烟前后都接受了调查。结果表明，尽管荷兰和德国的部分禁烟立法在减少酒吧吸烟方面是有效的（分别从 88%降至 34%和从 87%降至 44%），但效果远低于爱尔兰和法国的全面禁烟立法，这两项立法几乎完全消除了酒吧吸烟现象（分别从 97%降至 3%和从 84%降至 3%）。禁烟立法更受支持、对 SHS 危害认识更深刻、对吸烟持负面看法的吸烟者，在禁烟令后更不可能在酒吧吸烟。在德国，对禁烟立法的支持是一个更强的预测因素。在荷兰和德国，受教育程度较低的吸烟者中，对 SHS 危害的认识是一个更强的预测因素。结果表明，需要制定没有例外的强有力的全面禁烟立法。这应辅以教育活动，明确解释立法的公共卫生依据。
