Abstract
Indoor smoking bans have often been associated with reductions in smoking prevalence. However, few studies have evaluated their association with within-person changes in smoking behaviors. We linked longitudinal data from 5,105 adults aged 18-30 years at baseline from the Coronary Artery Risk Development in Young Adults (CARDIA) Study (1985-2011) to state, county, and local policies mandating 100% smoke-free bars and restaurants by census tract. We used fixed-effects models to examine the association of smoking bans with within-person change in current smoking risk, smoking intensity (smoking ≥10 cigarettes/day on average vs. <10 cigarettes/day), and quitting attempts, using both linear and nonlinear adjustment for secular trends. In models assuming a linear secular trend, smoking bans were associated with a decline in current smoking risk and smoking intensity and an increased likelihood of a quitting attempt. The association with current smoking was greatest among participants with a bachelor's degree or higher. In models with a nonlinear secular trend, pooled results were attenuated (confidence intervals included the null), but effect modification results were largely unchanged. Findings suggest that smoking ban associations may be difficult to disentangle from other tobacco control interventions and emphasize the importance of evaluating equity throughout policy implementation.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1250-1258 |
| Number of pages | 9 |
| Journal | American journal of epidemiology |
| Volume | 187 |
| Issue number | 6 |
| DOIs | |
| State | Published - Jun 1 2018 |
Bibliographical note
Funding Information:The Coronary Artery Risk Development in Young Adults (CARDIA) Study is supported by National Institutes of Health contracts HHSN268201300025C, HHSN268201300026C, HHSN268201300027C, HHSN268201300028C, HHSN268201300029C, and HHSN268200900041C from the National Heart, Lung, and Blood Institute (NHLBI), by the Intramural Research Program of the National Institute on Aging (NIA), and by an intraagency agreement between the NIA and the NHLBI (agreement AG0005). Additional funding was provided by contracts R01HL114091 from the NHLBI, P2CHD050924 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, P30DK56350 from the National Institute of Diabetes and Digestive and Kidney Diseases, and P30ES010126 from the National Institute of Environmental Health Sciences. All analyses, interpretations, or conclusions reached are those of the authors and not of the National Institutes of Health. Conflict of interest: none declared.
Funding Information:
The Coronary Artery Risk Development in Young Adults (CARDIA) Study is supported by National Institutes of Health contracts HHSN268201300025C, HHSN268201300026C, HHSN268201300027C, HHSN268201300028C, HHSN268201300029C, and HHSN268200900041C from the National Heart, Lung, and Blood Institute (NHLBI), by the Intramural Research Program of the National Institute on Aging (NIA), and by an intraagency agreement between the NIA and the NHLBI (agreement AG0005). Additional funding was provided by contracts R01HL114091 from the NHLBI, P2CHD050924 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, P30DK56350 from the National Institute of Diabetes and Digestive and Kidney Diseases, and P30ES010126 from the National Institute of Environmental Health Sciences.
Publisher Copyright:
© The Author(s) 2018. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved.
Keywords
- fixed-effects models
- smoke-free policies
- smoking
- smoking bans
- tobacco use