http://bmj.com/cgi/content/abstract/325/7357/188
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respiratory medicine Drugs:
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Caroline M Fichtenberg
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
Correspondence to: S A Glantz
glantz@medicine.ucsf.edu
Objective: To quantify the effects of smoke-free workplaces
on smoking in employees and compare these effects to those achieved
through tax increases.
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,
and Germany.
Participants: Employees in unrestricted and totally smoke-free
workplaces.
Main outcome measures: Daily cigarette consumption (per smoker and
per employee) and smoking prevalence.
Results: Totally smoke-free workplaces are associated with
reductions in prevalence of smoking of 3.8% (95% confidence interval
2.8% to 4.7%) and 3.1 (2.4 to 3.8) fewer cigarettes smoked per day
per continuing smoker. Combination of the effects of reduced
prevalence and lower consumption per continuing smoker yields a mean
reduction of 1.3 cigarettes per day per employee, which corresponds
to a relative reduction of 29%. To achieve similar reductions the tax
on a pack of cigarettes would have to increase from $0.76 to $3.05 (
0.78
to 3.14) in the United States and from £3.44 to
£6.59 (5.32 to 10.20) in the United
Kingdom. If all workplaces became smoke-free, consumption per capita
in the entire population would drop by 4.5% in the United States and
7.6% 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 reduce consumption.
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What is already known on this topic What this study adds 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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