Table 1—

Impact of smoke-free workplace legislation on exposure, health and attitudes

First author [ref.], country, yearLegislationStudy populationEffect on exposureEffect on health/attitudes
Heloma 12, Finland, 2003 1) Weber 14, California, USA; 2) Elsner 15, California, USA, 1998March 1995 reformed tobacco-control legislation in Finland implemented nationally smoke-free workplaces (prohibition or designated, separately ventilated smoking spaces); legislation on smoke-free bars and restaurants came into effect in 2000 January 1995 statewide, smoke-free workplace legislation in California, USA; January 1998 statewide legislation on smoke-free bars and favernsNine large or middle-sized workplaces representing industry, service sector and offices in both private and public sectors; 880 employees in 1994–1995 (before new act), 940 in 1995–1996 (1 yr after law) and 659 in 1993 (3 yrs after law, eight workplaces) 1) Annual cross-sectional survey since 1998 of 8–10% of the 9,000 Los Angeles County bars and restaurants with an alcohol licence; 2) Fifty-three bartenders in San Francisco bars or taverns examined 1 month before and after the 1998 law came into effectDaily ETS at work                          Exposed %Preferred smk policy at workSupporters %
1994–19951995–19961998
No1994–1995 1995–1996 1998Nonsmokers Complete ban36.040.751.5
<1 h20.7 54.2 70.7 Designated smk areas only54.251.744.4
1–4 h28.8 28.6 17.5 Allowed/no restrictions 9.87.6 (p<0.0001)4.0
>4 h17.7 9.0 8.4Smokers
32.9 8.2 3.4 Complete ban6.98.815.3
 Designated smk areas only58.561.373.3
(p<0.0001) Allowed/no restrictions;34.629.9 (p<0.0001)11.3
1) Compliance with nonsmoking law %19982002p-value2)BaselineFollow-up
Bars/restaurantsUpper respiratory symptoms %#7432
Employees96.599.2<0.0047Lower respiratory symptoms %#7719
Patrons92.598.5<0.0001FEV1 L·s-13.383.42
Freestanding bars Employees Patrons 2) Median self-reported ETS exposure at work declined from 28 h to 2 h·week-1 (p<0.01)86.2 45.794.7 75.8<0.003 <0.001FVC L #4.434.62
Sargent 16, Montana, USA, 2004Smoke-free workplace legislation in Helena, MT, USA, from June 5 to December 3, 2002. Helena is a geographically isolated community with a population of 68140.Comparison of the number of monthly hospital admissions for acute myocardial infarction during the law (June–November 2002) with admissions during a similar 6-month period before (1998–2001) and after (2003) the law in Helena. Also comparison with admissions in communities outside Helena.No direct assessment of exposure. The city-county health department reported that all but two businesses complied with the law in Helena.Admissions for acute myocardial infarction during June–November
HelenaOutside Helena
Ordinance in 20022418
Other years(1998–2001, 2003)4012.4
Difference (95% CI)-16 (-31.7– -0.3)5.6 (-5.2–16.4)
Helena difference–not Helena difference-21.6 (-40.6– -2.6)
Allwright 17, Republic of Ireland (RI), 2005March 2004 national smoke-free workplace legislation, including pubs and restaurants; no allowance for designated smoking spaces249 bar staff (including 158 nonsmokers) recruited from three areas in RI and one area in Northern Ireland (NI), who gave saliva sample and answered a questionnaire pre-legislation (September 2003–March 2004) and post-legislation (September 2004–March 2005)        Pre-lawPost-lawp-valueAdjusted rate ratios (95% CI)
Salivary cotinine nmol·L-1Pre-lawPost-law
 RI29.05.1<0.001Respiratory symptoms
 NI25.320.40.05 RI#1.33 (1.14–1.54)0.98 (0.83–1.16)
Hours exposed at work in 7 days NI0.67 (0.39–1.17)0.83 (0.50–1.36)
 RI400<0.001Sensory symptoms
 NI42400.02 RI#1.19 (1.02–1.39)0.69 (0.57–0.85)
Hours exposed outside work in 7 days NI1.09 (0.75–1.56)0.65 (0.44–0.97)

  • ETS: environmental tobacco smoke; smk: smoking; FEV1: forced expiratory volume in one second; FVC: forced vital capacity; CI: confidence interval. #: statistically significant; : nonsignificant.