Clinical Review ABC of smoking cessation

Population strategies to prevent smoking

BMJ 2004; 328 doi: http://dx.doi.org/10.1136/bmj.328.7442.759 (Published 25 March 2004) Cite this as: BMJ 2004;328:759
  1. Konrad Jamrozik, professor of primary care epidemiology
  1. Imperial College, London, and visiting professor in public health, School of Population Health, University of Western Australia, Perth

    Introduction

    Interventions targeted at individual smokers are only part of the much broader spectrum of strategies to reduce the prevalence of smoking. This article summarises the population strategies that can make substantial contributions to smoking cessation and help to prevent people from taking up smoking. Ten important initiatives are used or have been proposed for reducing tobacco use at population level. Nine initiatives are discussed here; the tenth (the use of proved treatments) is covered in previous articles in this series.

    View this table:

    Ten point plan for tobacco control

    Public places and workplaces

    Policies that ban smoking in public places are effective in reducing passive smoking among non-smokers generally. They also protect vulnerable groups such as children and infants, adults with cardiac or respiratory disease, and pregnant women against the adverse effects of environmental tobacco smoke. Smoke-free policies in public places also send a clear message to young people about non-smoking being the norm, and they reduce the numbers of adults that young people see smoking.

    In the workplace, smoke-free policies lead to some staff quitting—typically about 4% of the workforce—and reduce daily consumption among continuing smokers. Each extension of a smoke-free policy to a setting in which smoking was previously permitted requires both careful consideration of public opinion and systematic planning for the change. It is good practice to offer existing smokers in an organisation help in quitting during the lead-up to the introduction of a smoke-free policy, but most of those who quit in response to the change do so without special help.

    Support for smoke-free restaurants in South Australia (smoke-free policy introduced in January 1999). Adapted from Miller et al (Aust N Z J Public Health 2002;26: 38-44

    Support for smoke-free policies typically increases among smokers and non-smokers alike once the policies are introduced, and in the state of South Australia, for example, the …

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