Structured Abstract on Provided article

Students will be called on for summaries or key ?take away? points from readings assigned attached article. Use the provided format to complete the paper
This unit is Public Finance in Health Care
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Context: Smokefree legislation is a powerful public health intervention. Despite progress in smokefree
legislation, over half of U.S. adults remain unprotected by comprehensive smokefree legislation.
Evidence acquisition: This paper reviews the scientific literature on health and economic outcome
studies of smokefree legislation from the past decade, 2000 to early 2010, using MEDLINE and
key search terms: smoking, smoking cessation, smoking/legislation and jurisprudence, smoking cessation/
legislation and jurisprudence, and health policy.
Evidence synthesis: There is a wealth of research showing the health benefits to entire populations
when communities implement comprehensive smokefree laws and/or regulations. These laws
improve the health of hospitality workers and the general population by improving indoor air
quality, reducing acute myocardial infarctions and asthma exacerbations, and improving infant and
birth outcomes. Some studies report reduced smoking prevalence and cigarette consumption and
improved cessation outcomes after smokefree legislation. In aIDition to the health benefits, economic
studies confirm that smokefree laws do not adversely affect business revenues or operating
costs.
Conclusions: While there is an abundance of smokefree policy outcomes research showing both
the health and economic impacts of smokefree legislation, these outcomes may have more to do with
implementation effectiveness than adoption, especially among subpopulations. An emerging body of
literature documents not only that disparities in health protections remain among subpopulations,
but that health outcomes of smokefree legislation may vary by gender, race/ethnicity, SES, and age.
Further research is needed on implementation effectiveness of smokefree legislation and differential
effects on subpopulations.
(Am J Prev Med 2010;39(6S1):S66 –S76) © 2010 American Journal of Preventive Medicine
Introduction
Smokefree legislation is a powerful public health intervention.
1 There is a wealth of research showing
the health benefits to entire populations when communities
implement smokefree laws and/or regulations.
Exposure to secondhand smoke (SHS) decreases, indoor
air quality improves, workers are protected, adult and
youth smoking levels decrease, smokers are more likely to
quit, acute myocardial infarctions (AMI) and asthma exacerbations
decline, and infant/birth outcomes may improve.
In aIDition to health benefits, economic studies
confirm that smokefree laws do not hurt business revenues
or operating costs.
Smokefree laws reduce exposure to SHS. After Scotland’s
smokefree legislation was implemented, there was
a 39% reduction in salivary cotinine among nonsmoking
primary schoolchildren, especially among those with
nonsmoking parents,2 and a similar reduction in adults.3
Similarly, adults in Spain self-reported an overall 22%
reduction in exposure to SHS following their smokefree
law, with the greatest reductions in the workplace.4 A
New Zealand study recruited volunteer patrons and measured
salivary cotinine before and after a 3-hour visit to a
bar, and reported a 90% reduction after the smokefree
legislation.5 Further, the more extensive the smokefree
law, the lower the serum cotinine among nonsmoking
adults.6 Massachusetts adults living in a town with strong
restaurant and bar smoking restrictions self-reported
lower exposure to SHS compared to those living in towns
that allowed smoking in restaurants and bars.7
From the Kentucky Center for Smoke-Free Policy, College of Nursing and
College of Public Health, University of Kentucky, Lexington, Kentucky
AIDress correspondence to: Ellen J. Hahn, PhD, RN, Director, Tobacco
Policy Research Program, Kentucky Center for Smoke-Free Policy, University
of Kentucky, 751 Rose Street, Lexington KY 40536-0232. E-mail:
ejhahn00@email.uky.edu.
0749-3797/$17.00
doi: 10.1016/j.amepre.2010.08.013
S66 Am J Prev Med 2010;39(6S1):S66–S76 © 2010 American Journal of Preventive Medicine • Published by Elsevier Inc.