RESEARCH PAPER

Reductions in tobacco smoke pollution and increases in support for smoke-free public places following the implementation of comprehensive smoke-free workplace legislation in the Republic of Ireland: findings from the ITC Ireland/UK Survey

G T Fong¹, A Hyland², R Borland⁴, D Hammond³, G Hastings⁵, A McNeill⁶, S Anderson⁵, K M Cummings², S Allwright⁷, M Mulcahy⁸, F Howell⁹, L Clancy¹⁰, M E Thompson¹¹, G Connolly¹² and P Driezen¹³

¹ Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
² Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York, USA
³ Department of Health Studies and Gerontology, University of Waterloo, Waterloo, Ontario, Canada
⁴ Cancer Control Research Institute, The Cancer Council Victoria, Carlton, Victoria, Australia
⁵ Institute for Social Marketing and Centre for Tobacco Control Research, University of Stirling and the Open University, Stirling, UK
⁶ University College London, London, UK
⁷ Department of Public Health and Primary Care, Trinity College Centre for Health Sciences, Adelaide & Meath Hospital incorporating the National Children’s Hospital, Tallaght, Dublin, Republic of Ireland
⁸ Environmental Health Department, Health Service Executive, Western Area, The Annex, Seamus Quirke Road, Galway, Republic of Ireland
⁹ National Population Health Directorate-HSE, Department of Public Health, Railway Street, Navan, County Meath, Republic of Ireland
¹⁰ Research Institute for a Tobacco-Free Society, The Digital Depot, Dublin, Republic of Ireland
¹¹ Department of Statistics and Actuarial Sciences, University of Waterloo, Waterloo, Ontario, Canada
¹² Tobacco Control Research and Training Program, Harvard School of Public Health, Division of Public Health Practice, Boston, Massachusetts, USA
¹³ International Tobacco Control Policy Evaluation Project, Population Health Research Group, University of Waterloo, Waterloo, Ontario, Canada

Correspondence to:
Correspondence to:
Geoffrey T Fong
PhD, Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1 Canada; gfong{at}uwaterloo.ca

Objective: To evaluate the psychosocial and behavioural impact of the first ever national level comprehensive workplace smoke-free law, implemented in Ireland in March 2004.

Design: Quasi-experimental prospective cohort survey: parallel cohort telephone surveys of national representative samples of adult smokers in Ireland (n = 769) and the UK (n = 416), surveyed before the law (December 2003 to January 2004) and 8–9 months after the law (December 2004 to January 2005).

Main outcome measures: Respondents’ reports of smoking in key public venues, support for total bans in those key venues, and behavioural changes due to the law.

Results: The Irish law led to dramatic declines in reported smoking in all venues, including workplaces (62% to 14%), restaurants (85% to 3%), and bars/pubs (98% to 5%). Support for total bans among Irish smokers increased in all venues, including workplaces (43% to 67%), restaurants (45% to 77%), and bars/pubs (13% to 46%). Overall, 83% of Irish smokers reported that the smoke-free law was a "good" or "very good" thing. The proportion of Irish homes with smoking bans also increased. Approximately 46% of Irish smokers reported that the law had made them more likely to quit. Among Irish smokers who had quit at post-legislation, 80% reported that the law had helped them quit and 88% reported that the law helped them stay quit.

Conclusion: The Ireland smoke-free law stands as a positive example of how a population-level policy intervention can achieve its public health goals while achieving a high level of acceptance among smokers. These findings support initiatives in many countries toward implementing smoke-free legislation, particularly those who have ratified the Framework Convention on Tobacco Control, which calls for legislation to reduce tobacco smoke pollution.

Abbreviations: CATI, computer assisted telephone interviewing; FCTC, Framework Convention on Tobacco Control; GEE, generalised estimating equation; ITC-4, International Tobacco Control Four Country Survey; TSP, tobacco smoke pollution

Keywords: Framework Convention on Tobacco Control; FCTC; tobacco smoke pollution; environmental tobacco smoke; secondhand smoke; smoke-free laws; tobacco control policy; policy evaluation

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