Effect of smoke-free workplaces on smoking behaviour: systematic review
Caroline M Fichtenberg, research fellow,
Stanton A Glantz, professor of medicine.
Center for Tobacco Control Research and Education, Institute for Health
Policy Studies, Cardiovascular Research Institute, University of California, San
Francisco, San Francisco, CA 94143, USA
Objective: To quantify the effects of smoke-free workplaces
on smoking in employees and compare these effects to those achieved
through taxincreases. Design: Systematic review with a random effects meta-analysis. Study selection: 26 studies on the effects of smoke-free
workplaces. Setting: Workplaces in the United States, Australia,Canada,
andGermany. Participants: Employees in unrestricted and totallysmoke-freeworkplaces. Main outcome measures: Daily cigarette consumption (per smoker andper employee) and smokingprevalence. Results: Totally smoke-free workplaces are associatedwith
reductions in prevalence of smoking of 3.8% (95% confidenceinterval
2.8% to 4.7%) and 3.1 (2.4 to 3.8) fewer cigarettes smokedper day
per continuing smoker. Combination of the effects of reduced
prevalence and lower consumption per continuing smoker yieldsa mean
reduction of 1.3 cigarettes per day per employee, whichcorresponds
to a relative reduction of 29%. To achieve similarreductions the tax
on a pack of cigarettes would have to increasefrom $0.76 to $3.05 (0.78
to 3.14) in the United States andfrom £3.44 to
£6.59 (5.32 to 10.20) in the United
Kingdom. Ifall workplaces became smoke-free, consumption per capita
in theentire population would drop by 4.5% in the United States and7.6% in the United Kingdom, costing the tobacco industry $1.7
billion and £310 million annually in lost sales. To achieve similar
reductions tax per pack would have to increase to $1.11 and £4.26. Conclusions: Smoke-free workplaces not only protect
non-smokers from the dangers of passive smoking, they also encourage
smokers to quit or to reduceconsumption.
What is already known on this topic
Smoke-free workplaces are associated with lower cigarette consumption per
continuing smoker
What this study adds
Smoke-free workplaces reduce prevalence of smoking as well as consumption
The combined effects of people stopping smoking and reducing consumption
reduces total cigarette consumption by 29%
To achieve similar results through taxation would require cigarette taxes
per pack to increase from $0.76 to $3.05 in the United States and from £3.44
to £6.59 in the United Kingdom
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