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RESEARCH PAPER |
1 Social and Behavioral Sciences Department, Boston University School of Public Health, Boston, Massachusetts, USA
2 Biostatistics Department, Boston University School of Public Health, Boston, Massachusetts, USA
3 Center for Survey Research, University of Massachusetts Boston, Boston, Massachusetts, USA
4 General Medicine Division and Tobacco Research and Treatment Center, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
Correspondence to:
Michael Siegel
MD, MPH, Social and Behavioral Sciences Department, Boston University School of Public Health, 715 Albany Street, TW2, Boston, Massachusetts 02118, USA; mbsiegel{at}bu.edu
Background: While smoke-free restaurant laws are intended to protect the public from secondhand smoke exposure, they may also discourage smoking among adolescents. There is no evidence from longitudinal studies to test this hypothesis.
Objective: To examine the effect of local restaurant smoking regulations on progression to established smoking among adolescents.
Design, setting, and subjects: A cohort of 2623 Massachusetts youths, ages 12–17 years at baseline, was interviewed via random digit dial telephone survey in 2001–2002 and followed up two years later. A generalised estimating equations (GEE) logistic regression analysis was used and controlled for potential individual, household, and town level confounding factors.
Main outcome measure: Progression to established smoking during the two year follow up period (defined as having smoked 100 or more cigarettes in one’s life).
Results: Compared to youths living in towns with weak regulations, those living in towns with strong regulations (complete restaurant smoking bans) had less than half the odds of progression to established smoking (odds ratio (OR) 0.39, 95% confidence interval (CI) 0.24 to 0.66). The association was stronger for youths in towns with strong regulations in effect for two or more years (OR 0.11, 95% CI 0.03 to 0.37), although it was still present for those in towns with strong regulations in effect for less than two years (OR 0.55, 95% CI 0.33 to 0.90). No relationship was found between living in a town with a medium restaurant smoking regulation (restriction of smoking to enclosed, separately ventilated areas) and rates of progression to established smoking.
Conclusions: Local restaurant smoking bans may be an effective intervention to prevent youth smoking.
Keywords: adolescent health; health policy; smoking; tobacco smoke pollution
This article has been cited by other articles:
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  M. Siegel, A. B. Albers, D. M. Cheng, W. L. Hamilton, and L. Biener Local Restaurant Smoking Regulations and the Adolescent Smoking Initiation Process: Results of a Multilevel Contextual Analysis Among Massachusetts Youth Arch Pediatr Adolesc Med, May 1, 2008; 162(5): 477 - 483. [Abstract] [Full Text] [PDF]
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 K C. Smith, M A Wakefield, Y Terry-McElrath, F J Chaloupka, B Flay, L Johnston, A Saba, and C Siebel Relation between newspaper coverage of tobacco issues and smoking attitudes and behaviour among American teens Tob. Control, January 1, 2008; 17(1): 17 - 24. [Abstract] [Full Text] [PDF]
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 A. Amos and Y. Bostock Young people, smoking and gender a qualitative exploration Health Educ. Res., December 1, 2007; 22(6): 770 - 781. [Abstract] [Full Text] [PDF]
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 M. K. Rayens, E. J. Hahn, R. E. Langley, S. Hedgecock, K. M. Butler, and L. Greathouse-Maggio Public Opinion and Smoke-Free Laws Policy Politics Nursing Practice, November 1, 2007; 8(4): 262 - 270. [Abstract] [PDF]
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W. L. Hamilton, L. Biener, and R. T. Brennan Do local tobacco regulations influence perceived smoking norms? Evidence from adult and youth surveys in Massachusetts Health Educ. Res., October 18, 2007; (2007) cym054v1. [Abstract] [Full Text] [PDF]
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L. McDermott, A. Dobson, and N. Owen Occasional tobacco use among young adult women: a longitudinal analysis of smoking transitions Tob. Control, August 1, 2007; 16(4): 248 - 254. [Abstract] [Full Text] [PDF]
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M Wakefield and J Forster Growing evidence for new benefit of clean indoor air laws: reduced adolescent smoking Tob. Control, October 1, 2005; 14(5): 292 - 293. [Full Text] [PDF]
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