Restaurant smoking bans may be as powerful as
peers or parents in the battle to keep teenagers from becoming smokers, a new
study suggests.
Teenagers who lived in towns that adopted early
bans on smoking in restaurants were 40 percent less likely to become smokers
than their counterparts in towns with weaker restaurant smoking laws, Boston researchers report.
The study did not address how smoking bans
discourage teenage smoking. But Dr. Michael Siegel of the Boston University
School of Public Health said the findings bear out his hypothesis that if teens
see fewer people smoking and conclude that smoking isn't socially acceptable,
then they may be less likely to pick up the habit.
Writing in the Archives of Pediatric &
Adolescent Medicine, Siegel reported results from three waves of phone surveys
in 301 Massachusetts
towns starting in 2001. Massachusetts banned smoking in all workplaces, bars,
and restaurants in 2004, but 227 cities and towns in the state had rules on
tobacco at work sites, including restaurants, before the law went into effect.
Siegel and his colleagues asked more than 3,800
young people who were between the ages of 12 and 17 at the beginning of the
study if they had ever smoked, if they had a cigarettes in
the past month, and if they had smoked more than 100 cigarettes.
"Restaurant smoking bans are actually one
of the most effective interventions to reduce youth smoking," Siegel said.
"There are not a lot of interventions out there which can produce a 40
percent reduction in youth smoking."
In towns that banned smoking in restaurants
ahead of the state law, 7.9 percent of participants had smoked more than 100 cigarettes when the study began; in towns with weak
laws, the rate was 9.6 percent. After adjusting for a variety of factors, such
as age, race, and household income, the difference widened to 40 percent,
Siegel said.
Having a parent or a close friend who smoked
was a factor in whether a child tried smoking, but not in whether the child
continued to smoke, he said.
"Everyone talks about whether parents or
friends smoke," Siegel said. "This shows that a restaurant smoking
ban is equal in power."
In an earlier paper based on the same survey,
Siegel found that teens living in towns that had an early smoking ban thought
fewer people smoked and considered it less socially acceptable than those who
lived in towns with weaker smoking laws.
According to state figures, teen smoking hit a
15-year low in 2007, dipping to 17.7 percent of high school students from 20.5
percent two years earlier. Sales to minors took an even steeper dive, with 22
percent of teens able to get cigarettes if they wanted them in 2006, compared
with 13.3 percent in 2007, according to a state program that sends teens to
stores to track how many businesses violate the law against selling to underage
buyers.
Lois Keithly, director of the Massachusetts
Tobacco Control Program, said many factors might have contributed to the
substantial decline in teen cigarette use.
"Certainly the statewide workplace smoking
ban was part of it," she said. "I think in a couple of years we'll be
able to compare it to other factors."
Since 2006, counseling and medications to help
smokers quit have been covered by MassHealth, the state's Medicaid plan, and
the benefit has been used by more than 10 percent of members, she said.
Public health efforts aimed at adolescents have
been reinvigorated, including the launch of the84.org, a website with
antismoking ads created by teenagers and named for the 84 percent of their
peers who don't smoke.
A proposed increase in the cigarette tax,
should it be approved by the Legislature, could also have an effect on teen
smoking rates, Keithly said.
"What I took from this study is the
importance of adolescents not seeing adults whom they respect smoking,"
she said.
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