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The effects of smokefree legislation: The Scottish experience
Sally Haw, Principal Public Health Adviser, NHS Health Scotland, UK
Abstract
A comprehensive ban on smoking in public places was implemented in Scotland on 26th March 2006. The legislation was regarded as one of the most important public health interventions for a generation and so a complex evaluation was developed to assess its impacts on the Scottish population.
The evaluation strategy was based on a logic model which proposes causal pathways that linked the implementation of the legislation with short-term, intermediate and long-term health, behavioural, social and economic outcomes. Using a ‘before and after’ design the evaluation focused on eight key outcome areas – compliance with the legislation; secondhand smoke exposure; smoking prevalence and tobacco consumption; tobacco-related morbidity and mortality; knowledge and attitudes; socio-cultural adaptation; economic impacts on the hospitality sector; and health inequalities. Assessment of each of the outcome areas was based on a combination of secondary analysis of the routine datasets and results from a portfolio of 8 research studies designed to address specific questions.
This paper will outline the evaluation strategy; present data on the primary outcomes associated with the first year of the Scottish smoke-free legislation; and discuss the implications of the findings for Article 8 of the WHO Framework Convention on Tobacco Control.
The evaluation represents the most comprehensive yet developed to assess the impact of smoking bans and the combined results have make a significant contribution to our understanding of the health effects of exposure to second-hand smoke and the broader social, cultural and economic impacts of smoke-free legislation.
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About the presenter
Sally Haw is Principal Public Health Adviser with NHS Health Scotland, the national agency for health improvement. Based in the Evidence for Action (EfA) division of the Public Health Science Directorate she leads the topics team who are responsible for the development of evidence-based advice and guidance to inform both the development of policy and practice. Sally’s own specialist area is Substance Misuse (Tobacco, Alcohol and Drugs). Sally was a member of the Prevention Working Group of the Advisory Council on the Misuse of Drugs (ACMD) that reported recently on Pathways to Problems.
She also led the development of an alcohol research strategy which was published last year. A major part of her work over the last 3 years has been the development and coordination of the national evaluation of Scotland’s smoke-free legislation which is being conducted by the Clean-air Legislation Evaluation (CLEAN) collaboration. In September 2007 she was winner of International Network of Women Against Tobacco (INWAT) Europe 2007 Outstanding Contribution Award for the work.
Members of the Clean-air Legislation Evaluation (CLEAN) Collaboration who conducted the smokefree evaluation also received the British Occupational Hygiene Society (BOHS) 2007 Peter Isaacs Award for outstanding contributions to the reduction of ill-health at work, in May this year.
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