Smoke-free Legislation In Scotland Research Articles

The relationship between workers’ self-reported changes in health and their attitudes towards a workplace intervention: lessons from smoke-free legislation across the UK hospitality industry

BackgroundThe evaluation of smoke-free legislation (SFL) in the UK examined the impacts on exposure to second-hand smoke, workers’ attitudes and changes in respiratory health. Studies that investigate changes in the health of groups of people often use self-reported symptoms. Due to the subjective nature it is of interest to determine whether workers’ attitudes towards the change in their working conditions may be linked to the change in health they report.MethodsBar workers were recruited before the introduction of the SFL in Scotland and England with the aim of investigating their changes to health, attitudes and exposure as a result of the SFL. They were asked about their attitudes towards SFL and the presence of respiratory and sensory symptoms both before SFL and one year later. Here we examine the possibility of a relationship between initial attitudes and changes in reported symptoms, through the use of regression analyses.ResultsThere was no difference in the initial attitudes towards SFL between those working in Scotland and England. Bar workers who were educated to a higher level tended to be more positive towards SFL. Attitude towards SFL was not found to be related to change in reported symptoms for bar workers in England (Respiratory, p = 0.755; Sensory, p = 0.910). In Scotland there was suggestion of a relationship with reporting of respiratory symptoms (p = 0.042), where those who were initially more negative to SFL experienced a greater improvement in self-reported health.ConclusionsThere was no evidence that workers who were more positive towards SFL reported greater improvements in respiratory and sensory symptoms. This may not be the case in all interventions and we recommend examining subjects’ attitudes towards the proposed intervention when evaluating possible health benefits using self-reported methods.

Examining smoking behaviours among parents from the UK Millennium Cohort Study after the smoke-free legislation in Scotland

ObjectivesTo investigate parental smoking behaviours between England and Scotland after the smoke-free legislation in Scotland came into effect in 2006 and examine inequalities in maternal smoking behaviours between countries.Methods5954 white...

Responding to change: how did bar workers adapt to the smoke-free legislation in Scotland?

In recent years a number of countries have implemented comprehensive smoking bans to protect workers from adverse effects of exposure to second-hand smoke. It is also well known that many key stakeholders working in hospitality settings are themselves smokers. This paper reports the findings of a longitudinal qualitative study conducted with bar workers following the implementation of smoke-free legislation in Scotland. It examines the effects of smoking prevalence and status on support for smoke-free legislation, and its impact on business and working practices as well as bar workers' smoking behaviour both in and outside of the workplace. The results highlight a need for targeted assistance for businesses serving disadvantaged communities both to adapt commercially to the legislation and to provide cessation support to workers who smoke.

Public health or social impacts? A qualitative analysis of attitudes toward the smoke-free legislation in Scotland

Introduction of smoke-free legislation presents a unique opportunity to study how population-level interventions can challenge existing smoking norms. Our study examined support and opposition to the Scottish legislation and ascertained the relative importance of social and health factors in shaping attitudes among bar customers. Repeat (pre-/post-legislation) recorded and transcribed semistructured interviews with customers (n = 67/62) of eight community bars in contrasting settings were conducted, and data were analyzed thematically. While the legislation was marketed primarily in terms of gains to public and individual health, supportive and opposing responses to the legislation tended to be framed around libertarian and practical factors. Attitudes tended to be stable across both waves of data collection. It is concluded that reasons for smoking were not challenged by promotion of the legislation. In addition to a focus on health gains, social marketing of smoke-free legislation and initiatives may therefore benefit from a stronger focus on social and contextual effects of such policies.

The impact of smokefree legislation in Scotland: results from the Scottish ITC Scotland/UK longitudinal surveys

To evaluate how Scotland's smokefree law impacted self-reported secondhand smoke (SHS) exposure in hospitality venues, workplaces and in people's homes. In addition, we examine changes in support for the law, pub and restaurant patronage, smoking cessation indicators and whether any observed changes varied by socioeconomic status. A quasi-experimental longitudinal telephone survey of nationally representative samples of smokers and non-smokers interviewed before the Scottish law (February to March 2006) and 1 year later after the law (March 2007) in Scotland (n = 705 smokers and n = 417 non-smokers) and the rest of the UK (n = 1027 smokers and n = 447 non-smokers) where smoking in public places was not regulated at the time. Dramatic declines in the observance of smoking in pubs, restaurants and workplaces were found in Scotland relative to the rest of the UK. The change in the percent of smokers reporting a smokefree home and number of cigarettes smoked inside the home in the evening was comparable in Scotland and the rest of the UK. Support for smokefree policies increased to a greater extent in Scotland than in the rest of the UK. Self-reported frequency of going to pubs and restaurants was generally comparable between Scotland and the rest of the UK; however, non-smokers in Scotland were more likely to frequent pubs more often. No differences in smoking cessation indicators were observed between countries. The Scottish smokefree law has been successful in decreasing secondhand smoke exposure while causing none of the hypothesized negative outcomes.

Bar workers’ health and environmental tobacco smoke exposure (BHETSE): symptomatic improvement in bar staff following smoke-free legislation in Scotland

Objective:To examine changes in the health of bar workers after smoke-free legislation was introduced.Design:Longitudinal study following bar workers from before legislation introduction, at 2 months after introduction and at 1...

Changes in child exposure to environmental tobacco smoke (CHETS) study after implementation of smoke-free legislation in Scotland: national cross sectional survey

Changes in child exposure to environmental tobacco smoke (CHETS) study after implementation of smoke-free legislation in Scotland: national cross sectional survey

Changes in exposure of adult non-smokers to secondhand smoke after implementation of smoke-free legislation in Scotland: national cross sectional survey

Changes in exposure of adult non-smokers to secondhand smoke after implementation of smoke-free legislation in Scotland: national cross sectional survey

Smoking in the home after the smoke-free legislation in Scotland: qualitative study

Smoking in the home after the smoke-free legislation in Scotland: qualitative study

The impact of the 2006 Scottish smoke-free legislation on sales of nicotine replacement therapy

This study used over-the-counter (OTC) sales of nicotine replacement therapy (NRT) to investigate the impact of the introduction of smoke-free legislation in Scotland in March 2006 on smoking cessation behaviour. The time series of NRT sales (units and value) in Scotland from 2004 to 2006 were compared with the same period for the rest of the UK, and analysed using an ARIMA time series model. There was a significant increase in units and value of NRT sales in Scotland in the first 6 months of 2006 (p< or =0.001), apparent from January and prior to the introduction of the smoking ban, with no comparable increase for the rest of the UK. There was no significant increase in NRT sales for the second half of 2006. These data suggest an increase in smoking cessation behaviour in the period immediately before the introduction of smoke-free legislation, but this was not sustained beyond the first few months of the post-legislation period.

Smoke-free Legislation and Acute Coronary Syndrome

To the Editor: Pell et al. (July 31 issue)1 report that smoke-free legislation in Scotland was strongly associated with a decreased risk of the acute coronary syndrome. Nested within their study is a critical and remarkable observation: smokers are also at substantial risk from exposure to secondhand smoke and benefit from its cessation. My group and others have also shown that smokers have adverse respiratory health effects from exposure to secondhand smoke.2,3 Bartenders, whether smokers or nonsmokers, have rapid improvement in their respiratory health after smoke-free–workplace legislation is instituted.4,5 This point is important, because most previous research on . . .

Observations from behind the bar: changing patrons' behaviours in response to smoke-free legislation in Scotland

Background"Smoke-Free" legislation prohibiting smoking in all enclosed public places was introduced in March 2006. This qualitative study presents insights from bar workers about their observations of the changing social bar environment, changing patrons' behaviours and challenges bar workers have faced in managing smoke-free legislation.MethodsTwelve in-depth interviews were conducted between November 2006 and January 2007 with a purposively-selected sample of bar workers, identified from a larger quantitative study evaluating the impact of the legislation in Scotland [the Bar Workers' Health and Environmental Tobacco Smoke Exposure project (BHETSE)].ResultsBar workers all spoke of the improvements the legislation had brought to their working lives and the greater comfort it appeared to offer patrons. Bar workers reported that patrons were generally quick to accept and comply with the new law, and that families had become a greater feature of pub life since the legislation. However, they expressed concerns that older men seemed to have had most difficulty adjusting to the legislation and lack of knowledge about the best practices they should adopt in order to reduce the risks of unattended drinks being spiked and of anti-social behaviour associated with patrons moving outside to smoke.ConclusionSmoke-free legislation is changing the social context of smoking in Scotland. Further research to assess the impact the legislation is having on older male smokers and on the incidence of drink spiking would be useful. More specifically, bar workers would benefit from guidance on how to manage issues arising from patrons moving outside to smoke.

Bar Workers' Exposure to Second-Hand Smoke: The Effect of Scottish Smoke-Free Legislation on Occupational Exposure

To examine changes in bar workers' exposure to second-hand smoke (SHS) over a 12-month period before and after the introduction of Scottish smoke-free legislation on the 26 March 2006. A total of 371 bar workers were recruited from 72 bars in three cities: Aberdeen, Glasgow, Edinburgh and small towns in two rural regions (Borders and Aberdeenshire). Prior to the introduction of the smoke-free legislation, we visited all participants in their place of work and collected saliva samples, for the measurement of cotinine, together with details on work patterns, self-reported exposure to SHS at work and non-work settings and smoking history. This was repeated 2 months post-legislation and again in the spring of 2007. In addition, we gathered full-shift personal exposure data from a small number of Aberdeen bar workers using a personal aerosol monitor for fine particulate matter (PM(2.5)) at the baseline and 2 months post-legislation visits. Data were available for 371 participants at baseline, 266 (72%) at 2 months post-legislation and 191 (51%) at the 1-year follow-up. The salivary cotinine level recorded in non-smokers fell from a geometric mean of 2.94 ng ml(-1) prior to introduction of the legislation to 0.41 ng ml(-1) at 1-year follow-up. Paired data showed a reduction in non-smokers' cotinine levels of 89% [95% confidence interval (CI) 85-92%]. For the whole cohort, the duration of workplace exposure to SHS within the last 7 days fell from 28.5 to 0.83 h, though some bar workers continued to report substantial SHS exposures at work despite the legislation. Smokers also demonstrated reductions in their salivary cotinine levels of 12% (95% CI 3-20%). This may reflect both the reduction in SHS exposure at work and falls in active cigarette smoking in this group. In a small sub-sample of bar workers, full-shift personal exposure to PM(2.5), a marker of SHS concentrations, showed average reductions of 86% between baseline and 2 months after implementation of the legislation. Most bar workers have experienced very large reductions in their workplace exposure to SHS as a result of smoke-free legislation in Scotland. These reductions have been sustained over a period of 1 year.

Changes in child exposure to environmental tobacco smoke (CHETS) study after implementation of smoke-free legislation in Scotland: national cross sectional survey

Objective To detect any change in exposure to secondhand smoke among primary schoolchildren after implementation of smoke-free legislation in Scotland in March 2006.Design Comparison of nationally representative, cross sectional, class...

Changes in exposure of adult non-smokers to secondhand smoke after implementation of smoke-free legislation in Scotland: national cross sectional survey

Objective To measure change in adult non-smokers' exposure to secondhand smoke in public and private places after smoke-free legislation was implemented in Scotland.Design Repeat cross sectional survey.Setting Scotland.Participants Scottish adults,...

Smoking in the home after the smoke-free legislation in Scotland: qualitative study

Objective To explore the accounts of smokers and non-smokers (who live with smokers) of smoking in their homes and cars after the Scottish smoke-free legislation; to examine the reported impact...

Expectations and changing attitudes of bar workers before and after the implementation of smoke-free legislation in Scotland

BackgroundIn Scotland on March 26, 2006 a comprehensive prohibition on smoking in all enclosed public places was introduced. This study examines bar workers' attitudes towards a smoke-free working environment.MethodsAn intervention study comparing bar workers' opinions before and after the implementation of the smoke-free legislation. Bars were randomly selected in three Scottish cities (Glasgow, Edinburgh & Aberdeen) and towns (Aberdeenshire & Borders). Bar workers were recruited from 72 bars that agreed to participate from159 approached. Pre- and post-implementation attitudes towards legislation, second-hand smoke and smoke-free working environments were compared.ResultsInitially the majority of bar workers agreed with the proposed legislation on smoking (69%) and the need for it to protect the health of workers (80%), although almost half (49%) thought the legislation would damage business. In 266 bar workers seen at both surveys, a significant positive attitudinal change towards the legislation was seen. Post-implementation, support for the legislation rose to 79%, bar workers continued to believe it was needed to protect health (81%) and concerns about the impact on business were expressed by fewer than 20%. Only the statement that the legislation would encourage smokers to quit showed reduced support, from 70% pre-implementation to fewer than 60% post-implementation. Initial acceptance was greater among younger bar workers; older workers, initially more sceptical, became less so with experience of the legislation's effects.ConclusionThis study shows that bar workers had generally positive attitudes towards the legislation prior to implementation, which became stronger after implementation. The affirmative attitudes of these key stakeholders are likely to contribute towards the creation of 'smoke-free' as the new social norm.