title: An observational study of the secondary effects of a local smoke-free ordinance.
abstract: BACKGROUND
  The secondary, sometimes unintended effects of smoke-free ordinances have not been thoroughly evaluated. In this observational study, we evaluated the association of a local ordinance implemented in Madison, Wisconsin, with changes in public disturbances; smoking, drinking, and bar-going behaviors in the general population; and smoking and drinking behaviors among university students.
  
  
  METHODS
  We obtained data from 4 sources: police records, key informant interviews, a community survey, and an undergraduate survey. Except for interviews, which we conducted postenactment only, we compared measures before and after the ordinance was put into effect.
  
  
  RESULTS
  We found no evidence of association of the ordinance with public disturbances. We found that the ordinance was not associated with changes in smoking rates, drinking rates, or bar-going in the general population, although bar-going decreased among the 16% of the general adult population who smokes (from 84% in 2005 to 70% in 2007, P < .001). Student smoking rates also decreased (from 23% in 2005 to 16% in 2007, P < .001), but student binge drinking did not change.
  
  
  CONCLUSIONS
  The study adds unique information to the evidence base on the effect of smoke-free policies, finding little evidence of their secondary, unintended effects. With the addition of these results to existing evidence, we conclude that the potential health benefits of smoke-free ordinances outweigh the potential harms from unintended effects.
authors.affiliation: University of Wisconsin Carbone Cancer Center, 610 N. Walnut Street, Madison, WI 53726, USA. aawilliamson@uwcarbone.wisc.edu
authors.forename: Amy A
authors.initials: AA
authors.lastname: Williamson
authors.forename: Brion J
authors.initials: BJ
authors.lastname: Fox
authors.forename: Paul D
authors.initials: PD
authors.lastname: Creswell
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Kuang
authors.forename: Sudakshina L
authors.initials: SL
authors.lastname: Ceglarek
authors.forename: Aaron M
authors.initials: AM
authors.lastname: Brower
authors.forename: Patrick L
authors.initials: PL
authors.lastname: Remington
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D011050:Policy Making; D012189:Retrospective Studies; D012907:Smoking / Q000453:epidemiology / Q000331:legislation & jurisprudence*; D000074606:Smoking Prevention; D014028:Tobacco Smoke Pollution / Q000331:legislation & jurisprudence*; D014922:Wisconsin / Q000453:epidemiology
chemical_list: D014028:Tobacco Smoke Pollution