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Smoking bans don’t drive smokers to smoke more at home

Smoking bans in public/workplaces don’t drive smokers to light up more at home, suggests a study of four European countries with smoke free legislation, published online today in Tobacco Control. If anything, a ban may prompt smokers to smoke less at home, the research suggests. The authors base their findings on two waves of the International Tobacco Control Policy Evaluation Project Europe Surveys. These were carried out before and after legislation banning smoking in public places had come into force in Ireland, France, Germany and the Netherlands, and in the UK (excluding Scotland) before legislation was enacted. For the Netherlands, the research was conducted by PhD candidate Gera Nagelhout of Maastricht University (CAPHRI) in cooperation with STIVORO, the Dutch expert centre for tobacco control.

The surveys, which were conducted between 2003/4 and 2008/9, depending on when bans took effect, involved 4634 smokers in the four countries with smoke free legislation and 1080 smokers in the UK, which served as control country. Before a ban came into force, most smokers had at least partial restrictions on smoking at home, although the proportions varied significantly among all four countries, with the lowest levels in Germany and France.

The presence of a young child in the household and agreeing with a smoking ban in bars were key factors associated with choosing to restrict smoking at home. After legislation was enacted, the proportion of smokers who banned smoking at home increased significantly across the board, rising by 25% in Ireland, 17% in France, 38% in Germany and 28% in the Netherlands by the time of the second survey. In the control country UK, the proportion of smokers who restricted smoking at home also rose 22% between the two surveys, the second of which was carried out just a few months before the smoking ban came into force. After controlling for several potential confounders, the proportion of continuing smokers banning smoking at home increased significantly in all four countries, but did not significantly increase in the control country UK.

Current thinking suggests that the consequences of making it illegal to smoke in public end up either boosting the amount of smoking at home as smokers try to compensate (the displacement hypothesis) or encouraging smokers to apply the same restrictions at home (the social diffusion hypothesis).

“Opponents of workplace or public smoking bans have argued that these policies—albeit intended to protect non-smokers from tobacco smoke—could lead to displacement of smoking into the home and hence even increase the second hand smoke exposure of non-smoking family members and, most importantly, children,” write the authors. “On the contrary, our findings strongly support the premise that smoke free legislation does not lead to more smoking in smokers’ homes” and smoke free legislation “may stimulate smokers to establish total smoking bans in their homes.”

On 14 February, researcher Gera Nagelhout was interviewed by the BBC radio programme Good Morning Scotland (use this link to listen to the interview, from 53.47 - 57.35)