Abstract
Indiana recently implemented a statewide smoke-free indoor air law that has prohibited smoking in both restaurants and non-hospitality workplaces. Evidence for the effectiveness of the recent statewide smoke-free indoor law may persuade 14 states that do not have any statewide smoke-free laws to enact such laws. We evaluated the effectiveness of Indiana’s State Smoke-Free Air Law, implemented July 2012, in reducing adult smoking prevalence. We analyzed samples of U.S. adults using a nonequivalent control group design with multi-year, cross-sectional data from the 2011–2016 Behavioral Risk Factor Surveillance System ( N= 2,259,014). Four state groups with different levels of comprehensiveness in regard to statewide smoke-free indoor air laws in 2011–2016 served as the comparison groups, namely those with: (1) no law; (2) a partial law (prohibiting smoking in either one or two of these three settings, namely non-hospitality workplaces, restaurants, and bars); (3) a comprehensive law (prohibiting smoking in all non-hospitality workplaces, restaurants, and bars); and (4) those that changed from a partial to a comprehensive law. We used a difference-in-differences approach with multiple logistic regressions to assess the net effect of the policy with a secular trend removed. The decline rate of cigarette smoking in Indiana was steeper, from 21.2% in 2011–2012 to 17.8% in 2013–2016, than in states in our four comparison groups, which suggests a significant reduction in adult cigarette smoking prevalence above and beyond the downward secular trend observed. All the comparison groups showed higher odds of cigarette smoking than Indiana (adjusted odds ratios range from 1.08 to 1.16). Although a long-term effect of Indiana’s State Smoke-Free Air Law has yet to be evaluated, current data indicate that such a policy appears to be effective in reducing smoking prevalence. The implementation of statewide smoke-free indoor air laws in all restaurants and non-hospitality workplaces may help reduce smoking rates in the 14 states that still do not have any statewide smoke-free indoor air laws.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Alcalá, H. E., Sharif, M. Z., & Albert, S. L. (2016). Social cohesion and the smoking behaviors of adults living with children. Addictive Behavior,53, 201–205. https://doi.org/10.1016/j.addbeh.2015.10.022.
American Nonsmokers’ Rights Foundation. (2018). Summary of 100% Smokefree State Laws and Population Protected by 100% U.S. Smokefree Laws. Retrieved September 6, 2018 from: https://no-smoke.org/wp-content/uploads/pdf/SummaryUSPopList.pdf.
Becker, C. M., Lee, J. G., Hudson, S., Hoover, J., & Civils, D. (2017). A 14-year longitudinal study of the impact of clean indoor air legislation on state smoking prevalence, USA, 1997–2010. Preventive Medicine,99, 63–66. https://doi.org/10.1016/j.ypmed.2017.01.016.
Callinan, J. E., Clarke, A., Doherty, K., & Kelleher, C. (2010). Legislative smoking bans for reducing secondhand smoke exposure, smoking prevalence and tobacco consumption. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD005992.pub2.
Campaign for Tobacco-free Kids. (2018a). State cigarette excise tax rate & rankings. Retrieved September 12, 2018 from https://www.tobaccofreekids.org/assets/factsheets/0097.pdf.
Campaign for Tobacco-free Kids. (2018b). Cigarette tax increases by state per year 2000–2018. Retrieved September 12, 2018 from https://www.tobaccofreekids.org/assets/factsheets/0275.pdf.
Castellan, R. M., Chosewood, L. C., Trout, D., Wagner, G. R., Weissman, D. N., Caruso, C. C., Mazurek, J. & McCrone, S. H. (2015). Promoting health and preventing disease and injury through workplace tobacco policies. In Current intelligence bulletin 67. Morgantown: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health.
Centers for Disease Control and Prevention. (2010). Vital signs: Current cigarette smoking among adults aged > or = 18 years—United States, 2009. Morbidity and Mortality Weekly Report,59(35), 1135–1140.
Centers for Disease Control and Prevention. (2014a). Behavioral risk factor surveillance system overview: BRFSS 2013. Retrieved September 12, 2018 from https://www.cdc.gov/brfss/annual_data/2013/pdf/overview_2013.pdf.
Centers for Disease Control and Prevention. (2014b). Behavioral risk factor surveillance system 2013 codebook report. Retrieved September 12, 2018 from https://www.cdc.gov/brfss/annual_data/2013/pdf/CODEBOOK13_LLCP.pdf.
Centers for Disease Control and Prevention. (2015). National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health. BRFSS Prevalence & Trends Data [online]. Retrieved September 12, 2018 from http://www.cdc.gov/brfss/brfssprevalence/.
Centers for Disease Control and Prevention. (2016). Cigarette smoking among adults—United States, 2005-2015. Morbidity and Mortality Weekly Report,65(44), 1205–1211.
Dwyer-Lindgren, L., Mokdad, A. H., Srebotnjak, T., Flaxman, A. D., Hansen, G. M., & Murray, C. J. (2014). Cigarette smoking prevalence in US counties: 1996–2012. Population Health Metrics,12(1), 1–13. https://doi.org/10.1186/1478-7954-12-5.
Fichtenberg, C. M., & Glantz, S. A. (2002). Effect of smoke-free workplaces on smoking behaviour: Systematic review. BMJ,325(7357), 188. https://doi.org/10.1136/bmj.325.7357.188.
Frazer, K., Callinan, J. E., McHugh, J., van Baarsel, S., Clarke, A., Doherty, K., et al. (2016). Legislative smoking bans for reducing harms from secondhand smoke exposure, smoking prevalence and tobacco consumption. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD005992.pub3.
Frieden, T. R., Mostashari, F., Kerker, B. D., Miller, N., Hajat, A., & Frankel, M. (2005). Adult tobacco use levels after intensive tobacco control measures: New York City, 2002–2003. American Journal of Public Health,95(6), 1016–1023. https://doi.org/10.2105/AJPH.2004.058164.
Hamilton, W. L., Biener, L., & Brennan, R. T. (2007). Do local tobacco regulations influence perceived smoking norms? Evidence from adult and youth surveys in Massachusetts. Health Education Research,23(4), 709–722. https://doi.org/10.1093/her/cym054.
Homa, D. M., Neff, L. J., King, B. A., Caraballo, R. S., Bunnell, R. E., Babb, S. D., et al. (2015). Vital Signs: Disparities in nonsmokers’ exposure to secondhand smoke—United States, 1999–2012. Morbidity and Mortality Weekly Report,64(4), 103–108.
Hopkins, D. P., Razi, S., Leeks, K. D., Kalra, G. P., Chattopadhyay, S. K., Soler, R. E., et al. (2010). Smokefree policies to reduce tobacco use: A systematic review. American Journal of Preventive Medicine,38(2), S275–S289. https://doi.org/10.1016/j.amepre.2009.10.029.
Hyland, A., Barnoya, J., & Corral, J. E. (2012). Smoke-free air policies: Past, present and future. Tobacco Control,21(2), 154–161. https://doi.org/10.1136/tobaccocontrol-2011-050389.
Jamal, A., Phillips, E., Gentzke, A. S., Homa, D. M., Babb, S. D., King, B. A., et al. (2018). Current cigarette smoking among adults—United States, 2016. Morbidity and Mortality Weekly Report,67(2), 53. https://doi.org/10.15585/mmwr.mm6702a1.
King, B. A., Dube, S. R., & Tyan, M. A. (2012). Current tobacco use among adults in the United States: Findings from the National Adult Tobacco Survey. American Journal of Public Health,102(11), e93–e100. https://doi.org/10.2105/AJPH.2012.301002.
Miyakado-Steger, H., & Seidel, S. (2019). Using the Behavioral Risk Factor Surveillance System to assess mental health, Travis County, Texas, 2011–2016. Preventing Chronic Disease. https://doi.org/10.5888/pcd16.180449.
Osinubi, O. Y., Sinha, S., Rovner, E., Perez-Lugo, M., Jain, N. J., Demissie, K., et al. (2004). Efficacy of tobacco dependence treatment in the context of a “smoke-free grounds” worksite policy: A case study. American Journal of Industrial Medicine,46(2), 180–187. https://doi.org/10.1002/ajim.20020.
Puhani, P. A. (2012). The treatment effect, the cross difference, and the interaction term in nonlinear “difference-in-differences” models. Economics Letters,115(1), 85–87. https://doi.org/10.1016/j.econlet.2011.11.025.
Sallis, J. F., Owen, N., & Ficher, E. B. (2008). Ecological models of health behavior. In K. Glanz, B. K. Rimer, & K. Viswanath (Eds.), Health behavior and health education: Theory, research, and practice (4th ed., pp. 465–485). San Francisco, CA: John Wiley & Sons.
Schoenborn, C. A. (2004). Marital status and health: United States, 1999–2002 Advance data from vital and health statistics; no351. Hyattsville, MD: National Center for Health Statistics.
State of Indiana Alcohol and Tobacco Commission. (2015). Indiana’s new smoking law: frequenty asked questions—general information. Retrieved September 12, 2018 from http://www.in.gov/atc/files/Smoking_Ban_FAQ_-_updated_6_15_15.pdf.
US Department of Health and Human Services. (2004). National Institute of Alcohol Abuse and Alcoholism. NIAAA council approves definition of binge drinking. NIAAA Newsletter; US Department of Health and Human Services: Washington, DC, USA.
US Department of Health and Human Services. (2006). The health consequences of involuntary exposure to tobacco smoke: A report of the surgeon general. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.
US Department of Health and Human Services. (2010). A report of the surgeon general: How tobacco smoke causes disease: What it means to you. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.
US Department of Health and Human Services. (2014). The health consequences of smoking—50 years of progress: A report of the surgeon general. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 17.
Wang, T. W., Asman, K., Gentzke, A. S., Cullen, K. A., Holder-Hayes, E., Reyes-Guzman, C., et al. (2018). Tobacco product use among adults—United States, 2017. Morbidity and Mortality Weekly Report,67(44), 1225. https://doi.org/10.15585/mmwr.mm6744a2.
Weaver, A. M., Wang, Y., Rupp, K., & Watson, D. P. (2018). Effects of smoke-free air law on acute myocardial infarction hospitalization in Indianapolis and Marion County. Indiana. BMC Public Health,18(1), 232–240. https://doi.org/10.1186/s12889-018-5153-y.
World Health Organization. (2017). WHO report on the global tobacco epidemic, 2017: Monitoring tobacco use and prevention policies. Geneva: World Health Organization. Licence: CC BY-NC-SA 3.0 IGO.
Xu, X., Bishop, E. E., Kennedy, S. M., Simpson, S. A., & Pechacek, T. F. (2015). Annual healthcare spending attributable to cigarette smoking: An update. American Journal of Previve Medicine,48(3), 326–333. https://doi.org/10.1016/j.amepre.2014.10.012.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
The authors declare that they have no conflict of interest.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Cho, BY., Lin, HC. & Seo, DC. Effectiveness of Indiana’s Statewide Smoke-Free Indoor Air Law in Reducing Prevalence of Adult Cigarette Smoking. J Primary Prevent 41, 87–103 (2020). https://doi.org/10.1007/s10935-020-00579-z
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10935-020-00579-z