Rigotti N A, Stoto M A, Schelling T C
Institute for the Study of Smoking Behavior and Policy, John F. Kennedy School of Government, Harvard University, Boston, Massachusetts.
Prev Med. 1994 Mar;23(2):223-9. doi: 10.1006/pmed.1994.1030.
Many states and cities have adopted laws restricting smoking in public places. Health departments generally regard the laws as self-enforcing, implying little need for monitoring or enforcement. Whether this achieves good compliance at the workplace, a major site of passive smoke exposure, is not known.
We assessed workplace compliance with a no-smoking ordinance in Cambridge, Massachusetts, by conducting telephone surveys of two stratified random samples of city businesses, 3 and 24 months after the law took effect. Response rates were 76% at 3 months (n = 312) and 79% at 24 months (n = 317).
Employers' awareness and approval of the law were initially high. Approval remained high, but awareness declined over 2 years, from 92 to 73% (P < 0.0001), and employers' knowledge of the law's requirements was incomplete. Eighty percent of companies restricted smoking 3 and 24 months after the law, but only half of businesses fully complied with the law at either time. On multivariate analysis, compliance was significantly better in businesses that were aware of the law, in favor of it, and whose owners were nonsmokers. One fifth of firms with smoking policies cited the law as a reason for policy adoption.
A self-enforcement approach to implementing a no-smoking law achieved high levels of awareness and intermediate levels of compliance in a city's businesses. Awareness of the law declined over 2 years without reinforcement. The law was popular with employers and was associated with a high level of smoking restrictions in city businesses, but further efforts are needed to maximize compliance with a no-smoking law and reduce workplace smoke exposure.
许多州和城市都通过了限制在公共场所吸烟的法律。卫生部门通常认为这些法律可自行实施，意味着几乎无需监督或执行。但在工作场所这一被动吸烟的主要场所，该法律是否能实现良好的遵守情况尚不清楚。
我们通过对马萨诸塞州剑桥市的两类分层随机抽取的城市企业样本进行电话调查，评估了工作场所对一项无烟条例的遵守情况，调查分别在该法律生效后的3个月和24个月进行。3个月时的回应率为76%（n = 312），24个月时为79%（n = 317）。
雇主对该法律的知晓度和认可度最初很高。认可度一直保持较高水平，但知晓度在2年中有所下降，从92%降至73%（P < 0.0001），而且雇主对法律要求的了解并不完整。80%的公司在法律生效3个月和24个月后都限制了吸烟，但在这两个时间点，只有一半的企业完全遵守了法律。多变量分析显示，知晓该法律、支持该法律且企业主为非吸烟者的企业，其遵守情况明显更好。五分之一制定了吸烟政策的公司将该法律作为制定政策的一个理由。
实施无烟法律的自行实施方法在该市企业中实现了较高的知晓度和中等水平的遵守情况。在没有强化措施的情况下，对该法律的知晓度在2年中有所下降。该法律受到雇主欢迎，并与该市企业的高水平吸烟限制相关，但仍需要进一步努力，以最大限度地提高对无烟法律的遵守情况，并减少工作场所的烟雾暴露。
