摘要：Objectives. We examined the association of local restaurant and bar regulations with self-reported exposure to environmental tobacco smoke among adults. Methods. Data were derived from a telephone survey involving a random sample of Massachusetts households. Results. Compared with adults from towns with no restaurant smoking restrictions, those from towns with strong regulations had more than twice the odds of reporting nonexposure to environmental tobacco smoke (odds ratio [OR]=2.74; 95% confidence interval [CI]=1.97, 3.80), and those from towns with some restrictions had 1.62 times the odds of reporting nonexposure (OR=1.62; 95% CI=1.29, 2.02). Bar smoking bans had even greater effects on exposure. Conclusions. Strong local clean indoor air regulations were associated with lower levels of reported exposure to environmental tobacco smoke in restaurants and bars. Environmental tobacco smoke (ETS) exposure has been shown to cause respiratory illnesses, including lung cancer, childhood asthma, and lower respiratory tract infections, as well as having developmental and cardiovascular effects. 1– 3 Exposure to ETS is unevenly distributed across the US working population. Food service workers—waiters, waitresses, cooks, bartenders, and counter help—are the least likely group to be covered by smoke-free policies. 4, 5 To protect restaurant patrons and employees, many communities have adopted regulations restricting smoking in bars and restaurants. These restrictions vary from less stringent policies to total bans in which smoking is prohibited with no exceptions. Intermediate policies include restriction of smoking to enclosed, separately ventilated areas. Importantly, provisions exist that provide loopholes in these policies, such as variances from regulations and exemptions for particular circumstances. 6 In our study, we sought to (1) examine the association of local clean indoor air regulations with adult exposure to ETS in Massachusetts restaurants and bars and (2) specify the relation between the strength of local regulations and exposure in these establishments. To the best of our knowledge, this is the first investigation to quantitatively examine the effects of local restaurant and bar smoking regulations on exposure to ETS through the use of a representative state sample.
