Article Text

Download PDFPDF
The impact of Michigan's Dr Ron Davis smoke-free air law on levels of cotinine, tobacco-specific lung carcinogen and severity of self-reported respiratory symptoms among non-smoking bar employees
  1. Teri Wilson,
  2. Farid Shamo,
  3. Katherine Boynton,
  4. Janet Kiley
  1. Michigan Department of Community Health, Tobacco Control Program, Lansing, Michigan, USA
  1. Correspondence to Dr Teri Wilson, MDCH, Tobacco Section, 109W. Michigan Avenue, 8th Floor, Lansing, Michigan 48913, USA, scorciawilsont{at}


Objective To determine the impact on bar employee's health and exposure to secondhand smoke (SHS) before and after the implementation of Michigan's Dr Ron Davis smoke-free air law that went into effect on 1 May 2010, prohibiting smoking in places of work, including bars.

Methods This study used a pre/postintervention experimental design. The setting was bars in 12 Michigan counties. Subjects were bar employees, recruited through flyers and individual discussions with local health department staff. Participants completed a screening questionnaire to determine eligibility. A total of 40 eligible employees completed a demographic survey, provided urine samples for analysis of cotinine and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) and completed questionnaires on respiratory and general health status 6 weeks before and 6–10 weeks after the law went into effect. The main outcome measures were urine samples for total cotinine and total NNAL and data from a self-administered respiratory and general health status questionnaire collected during the pre-law and post-law study periods.

Results There was a significant decrease in the mean cotinine levels from 35.9 ng/ml to a non-quantifiable value (p<0.001), and there was a significant reduction in the mean NNAL level from 0.086 pmol/ml to 0.034 pmol/ml (p<0.001) 2 months after implementation of the law. There was also a significant improvement in all six self-reported respiratory symptoms (p<0.001) and general health status (p<0.001).

Conclusions The reduction in the SHS biomarkers cotinine and NNAL and reported improvement in respiratory health demonstrates that the Michigan smoke-free workplace law is protecting bar employee health.

  • Tobacco smoke pollution
  • public policy
  • workplace
  • cotinine
  • carcinogens
  • secondhand smoke

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Funding This study was supported in part by a cooperative agreement from CDC's Communities Putting Prevention to Work program (3U58DP001973-01S2). The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the US Department of Health and Human Services or the Centers for Disease Control and Prevention.

  • Competing interests None.

  • Ethics approval Michigan Department of Community Health Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.