Are statewide restaurant and bar smoking bans associated with reduced cigarette smoking among those with mental illness?

BACKGROUND

Smoke-free air laws have effectively reduced cigarette consumption at the population level; however, the influence of these policies on smoking among those with mental illness is unclear. We examined whether associations between statewide restaurant/bar smoking bans and cigarette smoking varied by psychiatric diagnoses and gender.

METHODS

We analyzed data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC, Wave 1: 2001-2002; Wave 2: 2004-2005; n = 7,317 smokers). All analyses were stratified by gender. We examined whether tobacco cessation was associated with the interaction between ban implementation and Wave 1 psychiatric diagnoses (alcohol use disorder [AUD], anxiety disorder [AD], or mood disorder), adjusting for relevant covariates. Among those who continued to use tobacco at Wave 2, we examined associations between Wave 2 cigarettes per day (CPD) and the diagnoses × ban interactions, controlling for Wave 1 CPD and other relevant covariates.

RESULTS

Among men with an AUD and women with an AD, ban implementation was associated with 6% and 10% greater probability of tobacco cessation at Wave 2, respectively. Among men in the overall sample, ban implementation was associated with smoking 0.8 fewer CPD at Wave 2. Associations with CPD were nonsignificant among women. Interactions between ban implementation and psychiatric diagnoses were also nonsignificant when examining CPD, suggesting consistent reductions in CPD among men but not among women.

CONCLUSIONS

This study provided the first evidence that statewide restaurant/bar smoking bans may be associated with reduced smoking among those with select psychiatric conditions.