Restaurant Smoking Policies and Reported Exposure to ETS

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Restaurant Smoking Policies and Reported Exposure
to ETS

• The case of Massachusetts

Tandiwe Njobe National Conference on Tobacco or
Health November 2002 Research supported by MA DPH
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Introduction

• Question Do local restaurant smoking ordinances
  reduce the likelihood of exposure to ETS (for
  Massachusetts residents) when dining out?

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Background to Analysis

• Exposure to ETS is known to have adverse health
  impacts
• Studies show patrons and restaurant workers to be
  disproportionately affected by exposure to ETS
• Support for smoke free restaurants is growing in
  Massachusetts
• Few studies address the extent to which
  ordinances reduce exposure to ETS

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The Massachusetts Context

• Policies restricting exposure are enacted at the
  town level
• Local Boards of Health funded by MTCP identify
  and support the enactment of tobacco control
  policies
• By June 2001, 182 towns (out of 351) representing
  78 of MA population had a restaurant ordinance
  in effect

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Data Sources

• Massachusetts Adult Tobacco Survey (MATS)
• Random digit dial survey
• (Center for Survey Research, UMASS Boston)
• Includes fiscal years 1995 2000
• n 13,000
• MTCP Ordinance Tracking System
• Data on 26 types of ordinance provisions for 351
  towns (July 1993 June 2000)

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Methods

• Individual level analysis
• Demographics and household characteristics
• Individuals home town ordinance situation
• Survey respondents mapped to ordinance data by
  town of residence and time period of interview
• 14 six month time periods
• Ordinances coded as being in effect for a time
  period if in existence for at least 3 out of 6
  months

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Methods continued.

• Dependent variable derived from the following
  survey question
• When you eat out in restaurants how often are
  you exposed to other peoples tobacco smoke?
• Always
• Often
• Sometimes
• Rarely
• Never

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Methods continued

• Covariates
• Demographics (age, race, gender, education)
• Smoker or not
• Frequency of dining out
• Children under 12 in the household
• Number of restaurants in respondents town (2001)
• Time

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Ordinances Predictor Variable of Interest

• Status of restaurant ordinance in home town
• Ordinance in effect at time of interview 1
• No ordinance in effect at time of interview 0
• Status of restaurant ordinances in other towns in
  the state
• Percentage of towns in the state covered by an
  ordinance at the time of the interview.

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Model

• Estimated 2 models in SUDAAN to account for
  complex sample design
• Model 1 Ordered logit specification
• 5 categories for dependent variable
• More sensitive measure of exposure
• Harder to interpret coefficients

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Model

• Model 2 Dichotomous logit model specification
• 2 categories for dependent variable (yes/no)
• 5 categories collapsed as follows
• Always/ Often/ Sometimes coded Yes 1
• Rarely/ Never coded No 0
• Less sensitive measure of exposure
• Easier to interpret coefficients

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Results/ Findings

• The presence of a restaurant ordinance in a town
  reduces the likelihood of exposure to ETS in
  restaurants of that town.
• The presence of restaurant ordinances elsewhere
  in the state may reduce the likelihood of
  exposure to ETS in restaurants (marginally
  significant).

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Results/ Findings continued..
VARIABLE OF INTEREST COEFFICIENT (ordered logit specification) ODDS RATIO (dichotomous specification)
Home Ordinance -0.2283 (p lt 0.001) 0.8332 (0.7106 0.9769)
State Ordinance -1.1634 (p lt 0.10) 0.3432 (0.0791 1.4888)
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Results/ Findings continued..

• Demographics
• Age Older people less likely to report exposure
  than people under 25 years
• Race Racial/ ethnic minorities reported less
  exposure than non Hispanic Whites
• Education Gender Differences not
  statistically significant
• Time
• Reduced exposure over time

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Results/ Findings continued..

• Other respondent level variables
• High frequency of dining out greater likelihood
  of reported exposure compared to residents who
  eat out less than one a month
• Smokers More likely to report exposure than
  non-smokers
• Children Number of restaurants Not
  significantly related to exposure

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Discussion

• Local restaurant smoking restrictions lead to
  lower reported levels of exposure to ETS in
  restaurants
• Prior research shows MTCP funding to be strongly
  correlated with ordinance enactment
• MTCP funding stimulates ETS ordinance adoption
  which leads to reduced exposure to ETS

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Discussion continued

• Ordered logit versus dichotomous logit
• Consistent message is that ordinances have the
  effect of reducing risk of exposure
• State ordinance term is marginally significant
• Improve specification by including distance
• Ordinance duration -- effect of ordinance not
  significantly increased by length of time it has
  been in existence
• Limited testing -- specification may be weak.

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For more information contact

• Tandiwe Njobe
• Abt Associates Inc.
• 55 Wheeler Street
• Cambridge, MA 02138-1168
• Email Tandiwe_Njobe_at_abtassoc.com
• Analysis will be published in 2002 Annual Report
  on Independent Evaluation of the Massachusetts
  Tobacco Control Program