Smoke-Free Laws and Hazardous Drinking: A Cross-Sectional Study among U.S. Adults.

Nan Jiang,Mariaelena Gonzalez,Pamela Ling,Stanton Glantz,Kelly Young-Wolff

doi:10.3390/ijerph14040412

Abstract

Tobacco and alcohol use are strongly associated. This cross-sectional study examined the relationship of smoke-free law coverage and smoke-free bar law coverage with hazardous drinking behaviors among a representative sample of U.S. adult drinkers (n = 17,057). We merged 2009 National Health Interview Survey data, American Nonsmokers’ Rights Foundation U.S. Tobacco Control Laws Database, and Census Population Estimates. Hazardous drinking outcomes included heavy drinking (>14 drinks/week for men; >7 drinks/week for women) and binge drinking (≥5 drinks on one or more days during past year). Chi-square tests compared hazardous drinking by sociodemographic factors. Multivariable logistic regression models were used to examine if smoke-free law and bar law coverages were associated with hazardous drinking, controlling for sociodemographics and smoking status. Subset analyses were conducted among drinkers who also smoked (n = 4074) to assess the association between law coverages and hazardous drinking. Among all drinkers, smoke-free law coverage was not associated with heavy drinking (adjusted odds ratio (AOR) = 1.22, 95% confidence interval (CI) = 0.99–1.50) or binge drinking (AOR = 1.09, 95% CI = 0.93–1.26). Smoke-free bar law coverage was also found to be unrelated to hazardous drinking. Similar results were found among those drinkers who smoked. Findings suggest that smoke-free laws and bar laws are not associated with elevated risk for alcohol-related health issues.

Highlights

The paired use of tobacco and alcohol increases the risk for a variety of diseases, including cancers of mouth, throat, and upper aerodigestive tract [1,2,3]
We examined the association between smoke-free bar law coverage and hazardous drinking behaviors
When substituting smoke-free bar law coverage for smoke-free law coverage, we found that smoke-free bar law coverage was not associated with heavy drinking (AOR = 1.14, 95% CI = 0.96–1.35, p = 0.127)

Summary

Introduction

The paired use of tobacco and alcohol increases the risk for a variety of diseases, including cancers of mouth, throat, and upper aerodigestive tract [1,2,3]. Smokers are more likely to drink alcohol than non-smokers [7,8,9,10], and more alcohol drinkers smoke cigarettes than non-drinkers [8,11,12]. Smokers are more likely to meet the DSM-IV criteria (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) for alcohol use disorders (AUD) [13], and people with AUD have a higher rate of nicotine dependence than the general population [14]. Smoke-free laws are effective in protecting non-smokers from secondhand smoke [15,16,17], reducing smoking rates and cigarette consumption [18,19,20,21,22,23], and increasing smoking cessation [22,23,24,25]. Stronger smoke-free law coverage is associated with lower odds of current (past 30-day) smoking [26,27]

Methods

Results

Discussion

Conclusion