Retrospective Worksite Surveys

Objectives. This study estimates the contribution of smoke-free workplaces to the recent national declines in cigarette consumption in Australia and the United States. Methods. Nineteen studies of the impact of smoke-free workplaces on workday cigarette consumption were reviewed. The number and cost of cigarettes forgone were calculated and extrapolated to a scenario in which all indoor work areas were smoke-free. Results. Of the 19 studies, 18 reported declines in daily smoking rates, and 17 reported declines in smoking prevalence. Smoke-free workplaces are currently responsible for an annual reduction of some 602 million cigarettes, or 1.8% of all cigarettes that might otherwise be consumed, in Australia, and an annual reduction of 9.7 billion cigarettes (2%) in the United States. Approximately 22.3% of the 2.7 billion decrease in cigarette consumption in Australia between 1988 and 1995 can be attributed to smoke-free workplaces, as can 12.7% of the 76.5 billion decrease in the United States between 1988 and 1994. Conclusions. If workplaces were universally smoke-free, the number of cigarettes forgone annually would increase to 1.14 billion (3.4%) in Australia and 20.9 billion (4.1%) in the United States. (Am J Public Health. 1999;89:1018-1023) The research literature on environmental tobacco smoke (ETS) has been dominated by concerns about the effects of ETS on the health and comfort of exposed non-smokers. However, when people cannot smoke for prolonged periods because of bans on smoking in their workplaces, on public transport, and in other public locations, such as theaters, cinemas, and shopping malls, some may be stimulated by such restrictions to attempt to quit. Many smokers might also be expected to smoke less because they have fewer hours available in which they can smoke. On the other hand, some smokers might increase their smoking rate at other times or take breaks to go to places where smoking is permitted. Such effects could reduce the benefits of forgoing cigarettes in smoke-free workplaces (SFWs). SFWs constitute the most significant restriction on what would otherwise be largely unhindered smoking opportunities. We located 19 studies that addressed questions of whether smokers working in SFWs reduce their consumption or quit smoking.(FN1-19) In this article, we summarize the findings of these studies and calculate a weighted mean daily (24-hour) workday reduction derived from the most methodologically robust study types—prospective cohort studies that compared preand postban smoking rates at worksites that had introduced prohibitions against smoking. We extrapolate this mean reduction to the indoor workforces of 2 countries (Australia and the United States), using the proportion of workplaces that are currently smoke-free and to a scenario in which all indoor workplaces are smoke-free. We also present estimates of the revenue that would be forgone by the tobacco industry, retailers, and governments if all workplaces were smoke-free. Finally, we examine data on recent declines in total and adult per capita cigarette consumption rates and estimate the proportion of these declines that may have been caused by bans on smoking in the workplace. 1