Article Text
PDF
Statistics from Altmetric.com
Editor,—The introduction of non-smoking areas into public places is one of the key recommendations of the white paper “Smoking Kills”.1 However, despite the findings of surveys conducted within the USA and Australia which have shown no adverse economic impact on restaurants after smoking restrictions were implemented,2-5 pro-tobacco groups have asserted that the introduction of non-smoking areas in public houses (pubs) is commercially untenable and unpopular with customers.
Eleven pubs in Staffordshire, England volunteered to establish non-smoking areas for at least 2–3 months during which the effect on trade would be monitored, and a survey undertaken of customer perceptions. Between 6–12 weeks after implementation, the pubs were visited and a questionnaire distributed to all customers. The questionnaire requested brief demographic details and customers' views on the non-smoking areas. Information on sales at each pub were requested from landlords, and income before the intervention compared with that in the following months.
One pub dropped out after a few weeks claiming the policy unpopular with its predominantly young customers. Three pubs declined to provide financial information but participated in the customer questionnaire.
Three hundred and seventeen customers responded to the questionnaire. Approximately one third of respondents were current smokers, and three quarters described themselves as a “regular” at the pub. Only 25 (8%) respondents described the introduction of non-smoking areas as a “bad” or “very bad” idea, with the majority (234, 74%) stating it to be a “very good” or “good” idea.
Figure 1 shows the monthly sales for pubs C, D, E, F, G, and H. The trend data do not suggest that the introduction of non-smoking areas had an adverse affect on trade. Pub B provided aggregated data for the period April–June 1999 (£42 979, approximately $62 300) which showed a 10% increase on similar period in previous year (£38 937, approximately $56 500).
Trends in financial trade at pubs C, D, E, F, G, and H. Arrows indicate when non-smoking area was introduced. Data not available from Pub H for May period.
The results of this study suggest that the introduction of non-smoking areas into pubs has the support of the majority of customers and presents no adverse financial impact to landlords. These findings concur with other reports in the literature.2-5
The conduct of the study was dependent entirely upon the goodwill of the small number of pub landlords who were prepared both to risk the introduction of a non-smoking area into their premises, and also to permit researchers to question customers and analyse confidential and commercially sensitive financial information. Although such self-selection will not impact on the internal validity of the findings, the generalisability of our observations may be limited if landlords only chose to participate if they believed that such an intervention was unlikely to upset their particular customers and/or reduce trade.
No attempt was made to quantify the number of customers in each pub during the conduct of the questionnaire, and thus it has not been possible to estimate a response rate for each pub. It is possible that only customers in favour of the introduction of non-smoking areas responded to the questionnaire. However, a deliberate attempt to minimise the impact of response bias was made by the project worker who endeavoured to ensure that all customers were given, and returned, a questionnaire.
It is possible that the high levels of satisfaction and the effects on trade reported reflect not so much an acceptance of the introduction of non-smoking areas by the existing customer base, but a change in the customer population itself. If this has occurred, and new non-smoking customers have “moved in”, then the intervention has achieved greater consumer choice, although any impact on overall health gain may be negated.
No attempt was made to gain an objective measure of the “smokiness” of the atmosphere, and thus the integrity of the non-smoking areas was not formally assessed. It has been suggested that non-smoking areas will not be respected, and that at weekends and other times when public houses get very busy, it is possible that non-smoking areas could be infringed as smokers seek seating accommodation. However, comments from landlords and staff suggested this not to be the case.
No attempt was made to survey the impact on bar staff who may be adversely effected by the introduction of non-smoking areas.6-8 Adverse effects might be mediated both through the need to “police” the areas, and also through possible increased exposure to smoke—the latter arising as a consequence of bar/serving areas remaining as smoking areas when seating areas are designated “non-smoking”. The use of quantitative techniques to assess exposure and to validate the integrity of the non-smoking areas are required. The utility of ventilation systems as an adjunct to designated non-smoking areas also requires consideration.
References
In Lebanon, the WHO “Bob, I've got cancer” poster has been placed around the country and mass distributed to households in packs of Lebanese bread. Photos by Youssef Bassim, Tobacco Control Program, Lebanon.