Evaluation of Scotlands Smokefree Legislation

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Evaluation of Scotlands Smokefree Legislation
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Scotlands comprehensive smokefree legislation
has

• Become self policing with very high levels of
  compliance
• Dramatically improved air quality in pubs
• Reduced secondhand smoke exposure in the general
  population

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Within a year measurable health gains

• A dramatic reduction in hospital admissions for
  acute heart attack
• Improvement in the respiratory health of bar
  workers

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Legislation accompanied by

• Increasing support for the legislation among both
  non-smokers and smokers.
• Change in social norms about smoking behaviour
  and exposing others to secondhand smoke

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Evaluation Strategy
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Primary Outcome Areas

• Compliance
• Knowledge attitudes
• Exposure to SHS
• Smoking prevalence and tobacco consumption
• Short and longer term health impacts
• Economic impact
• Health inequalities

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National Surveys
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Health Impacts
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Qualitative Studies
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Evaluation Findings
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Observed Smoking in Different Locations

Rest of UK
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Observed Smoking in Different Locations
Scotland
Rest of UK
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Observed Smoking in Different Locations
Scotland
Rest of UK
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Observed Smoking in Different Locations
Scotland
Rest of UK
Source ITC Ireland/UK Scotland Study
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Air Quality

• 106 (53 pre and 53 post) visits made to 41
  randomly selected bars
• TSI Sidepak aerosol sampler measured particulate
  matter less than 2.5 mm in size (PM2.5)

Source Barworkers Health ETS Exposure
(BHETSE)
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Source Barworkers Health ETS Exposure
(BHETSE)
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Cotinine Concentrations in Adult Non-smokers
Source Health Education Population Survey (HEPS)
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Cotinine Concentrations in Adult Non-smokers
39 reduction in mean cotinine
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STOPIT Results

• 17 reduction in heart attack admitted to 9 major
  Scottish hospitals.
• Average reduction of 3 per year in Scottish
  heart attack admissions in the 10 years leading
  up to the ban

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Support for Legislation
Legislation
Source Health Education Population Survey (HEPS)
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Smoking Restrictions in Homes

Non-smokers
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Smoking Restrictions in Homes

Non-smokers
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Smoking Restrictions in Homes
Smokers
Non-smokers
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Smoking Restrictions in Homes
Smokers
Non-smokers
Source Health Education Population Survey (HEPS)
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In Summary

• High level of compliance with legislation
• 86 improvement in air quality in bars
• 39 reduction in SHS exposure in non-smoking
  adults and children.
• Improvements in respiratory health of barworkers
• 17 reduction in heart attack admissions
• High level of support for legislation in
  non-smokers and increasing support post ban
  amongst smokers
• Evidence of change in acceptability of smoking in
  the home for both non-smokers and smokers
• Evidence of changing social norms about smoking
  behaviour.

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Clean-air Legislation Evaluation (CLEAN)
Collaboration
Sally Haw, Health Scotland (Coordinator) Laurence
Gruer, Health Scotland Colin Fischbacher, ISD
Scotland Diane Stockton, ISD Scotland Calum
Scott, Scottish Executive STOPIT Jill Pell,
University of Glasgow (PI) Stuart Cobbe, Glasgow
Royal Infirmary John Rodgers, Glasgow Royal
Infirmary Frank Dunn Stobhill Hospital Anne
Wright, Stobhill Hospital Nat Hawkins, Stobhill
Hospital Tim Gilbert, Hairmyres Hospital Jim
Young, Hairmyres Hospital Paul MacIntyre, Royal
Alexandra Hosp Jacqui Dougall, Royal Alexandra
Hosp
Dave Murdoch, Southern General Hosp Anne Andrews,
Southern General Hosp Dave Newby, Royal Infirmary
Edinburgh Sharon Cameron, Royal Infirmary
Edin Keith Oldroyd, Western Infirmary Glas Joanne
Kelly, Western Infirmary Glas Fiona Stevenson,
Western Infirmary Glas Alastair Pell Monklands
Hospital Judith Anderson, Monklands
Hospital Stuart Pringle, Ninewells Hospital Helen
Marshall, Ninewells Hospital BHETSE Jon Ayres,
University of Aberdeen (PI) Sean Semple,
University of Aberdeen Anne Ludbrook, University
of Aberdeen Fintan Hurley, IOM, Edinburgh
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Clean-air Legislation Evaluation (CLEAN)
Collaboration
Graeme Hughson, IOM Edinburgh Mark Petticrew,
MRC, Glasgow CHETS Candace Currie, CAHRU
(PI) Patricia Akhtar, CAHRU Dorothy Currie,
CAHRU HEPS Sally Malam, BMRB Ruth
Gosling Qualitative Bar Study Gerard Hastings,
Stirling University (PI) Douglas Eadie,
University of Stirling Susan MacAskill,
University of Stirling Derek Heim, University of
Strathclyde John Davies, University of
Strathclyde Alastair Ross, University of
Strathclyde
Qualitative Community Study Claudia Martin,
Scottish Centre for Social Research (PI) Amanda
Amos, University of Edinburgh Deborah Ritchie,
University of Edinburgh ITC Gerard Hastings,
Stirling University (PI) Louise Hassan, Stirling
University
Welcome Trust Research Lab, Edinburgh
Gordon Hill ABS Labs, London
Colin Fereyband
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Contender for Collins Dictionary?

• To smirt smirting (vb)
• Definition Flirting while smoking outside
  enclosed or partially enclosed public places
  where smoking is prohibited.

Source Professor Luke Clancy