Partial Smoking Ban and Secondhand Smoke Exposure in Japan.

Sen Zeng,Haruko Noguchi,Satoru Shimokawa

doi:10.3390/ijerph16152804

Sen Zeng, Haruko Noguchi + Show 1 more

Open Access

https://doi.org/10.3390/ijerph16152804

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Abstract

Implementing smoking bans is a worldwide common practice for tobacco control. However, if the policy prohibits smoking partially rather than comprehensively, it may increase nonsmokers’ exposure to secondhand smoke (SHS) in nonprohibited places. This paper investigates how a partial smoking ban affected nonsmokers’ SHS exposure (measured by frequency of having exposure to SHS in days per month) in households, workplaces, and restaurants by examining the case of a partial smoking ban introduced in a large Japanese prefecture in 2013. Using data from the National Health and Nutrition Survey (NHNS) in 2010, 2013, and 2016 (n = 30,244) and the Comprehensive Survey of Living Conditions (CSLC) from 2001 to 2016 (n = 2,366,896), this paper employs a difference-in-differences (DID) approach. We found that the partial smoking ban significantly increased their SHS exposure in households and workplaces by 2.64 days and 4.70 days per month, respectively, while it did not change nonsmokers’ SHS exposure in restaurants. The results imply that the smoking ban displaced smokers from public places to private places. We also found that neither smokers’ smoking status nor smoking intensity changed significantly after implementing the partial smoking ban. Comprehensive smoking bans are needed to better protect nonsmokers from SHS exposure.

Highlights

Exposure to secondhand smoke (SHS) may cause serious illnesses, such as lung cancer, heart disease, and respiratory disease
We found that the partial smoking ban significantly increased their SHS exposure in households and workplaces by 2.64 days and 4.70 days per month, respectively, while it did not change nonsmokers’ SHS exposure in restaurants
To complement the literature on the effectiveness of partial smoking bans, this paper investigates the impact of a partial smoking ban in Hyogo Prefecture on nonsmokers’ SHS exposure in both public and private places using data from Japan

Summary

Introduction

Exposure to secondhand smoke (SHS) may cause serious illnesses, such as lung cancer, heart disease, and respiratory disease. To prevent exposure to SHS, many countries have implemented the legislation of smoking bans in public places (e.g., Ireland, England, New Zealand, Netherlands, Malaysia, and Korea). A partial smoking ban (smoking ban with exemptions or designated smoking rooms, e.g., under the partial smoking in Japan, restaurants, bars, and leisure facilities could choose either to prohibit smoking or introduce smoking separation, some small restaurants were even exempted from the ban) might have adverse impacts because smokers can change their smoking locations from public places (e.g., transport facilities, restaurants, bars) to private places (e.g., homes) without curbing their tobacco consumption. Several studies have examined how legislative smoking bans influence SHS exposure in public places. In other studies, smoking bans have been found to be associated with reduced SHS exposure and improved health [3,4,5,6,7], and they have improved smoking behaviors in workplaces [8,9] and in bars and

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