Longitudinal evaluation of smoke-free Scotland on pub and home drinking behavior: findings from the International Tobacco Control Policy Evaluation Project.
BACKGROUND
On 26 March 2006, Scotland implemented a smoke-free policy prohibiting smoking in indoor public venues, including bars and pubs. Drinking and smoking are highly associated behaviors, so we evaluated whether the regulations would decrease drinking behavior among smokers in public venues. We further assessed whether this effect would be more pronounced in heavier drinkers and whether decreases in drinking behavior in pubs would be offset by increased drinking in the home.


METHODS
Participants (N = 1,059) were adult smokers and nonsmokers from Scotland and from the rest of the United Kingdom, which did not have comprehensive smoke-free policies during the study period. Data were collected using a random-digit-dialed telephone survey from February to March 2006, just prior to the policy implementation in Scotland. Follow-up surveys were conducted in March 2007. Using baseline data, we categorized participants as abstainers, moderate drinkers, or heavy drinkers.


RESULTS
Overall, results demonstrated that drinking behavior did not change significantly in Scotland compared with the rest of the United Kingdom following implementation of the smoke-free policy in Scotland. However, planned comparisons examining mean changes in drinks consumed in pubs or bars following the legislation demonstrated that the smoke-free legislation was associated with reduced drinking behavior in pubs and bars among moderate- and heavy-drinking smokers in Scotland. These moderate- and heavy-drinking Scottish smokers also reduced their pub attendance following policy implementation.


CONCLUSIONS
The smoke-free Scottish law did not increase drinking in the home. These findings suggest that smoke-free policies may have additional public health benefits for those at greater risk for alcohol-related health problems.
Department of Psychiatry, Yale University School of Medicine, 2 Church St. South, Suite 109, New Haven, CT 06519, USA. sherry.mckee@yale.edu
Sherry A
SA
McKee
Cheryl
C
Higbee
Stephanie
S
O'Malley
Louise
L
Hassan
Ron
R
Borland
K Michael
KM
Cummings
Gerard
G
Hastings
Geoffrey T
GT
Fong
Andrew
A
Hyland
D000328:Adult; D016902:Air Pollution, Indoor / Q000517:prevention & control; D000428:Alcohol Drinking / Q000453:epidemiology*; D001294:Attitude to Health; D003431:Cross-Cultural Comparison; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012147:Restaurants / Q000331:legislation & jurisprudence*; D012606:Scotland / Q000453:epidemiology; D012907:Smoking / Q000453:epidemiology* / Q000331:legislation & jurisprudence; D016540:Smoking Cessation / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution / Q000331:legislation & jurisprudence / Q000517:prevention & control*; D006113:United Kingdom / Q000453:epidemiology
D014028:Tobacco Smoke Pollution