Unanticipated consequences of California’s smoke-free workplace law in this study primarily occurred when bars did comply with the law and smokers went outside the bar to smoke, particularly when smokers stood on the street outside the bar. Although many of the negative consequences also apply to men, they were more pronounced for women who smoked outside of bars. They included threats to women’s physical safety and their public image of propriety,29,30
and added to the cumulative risk that these low-income women might already face from such factors as unstable housing, single motherhood, and lack of resources. For women living near bars, increased smoking on the street may have increased their exposure to SHS and disruptive noise. For some women, however, unanticipated negative consequences were identified with noncompliant bars. Many bar patrons noted that smokers congregated in a smaller number of bars where owners still tacitly allowed indoor smoking. Through a process of assortative distribution,31
low-SES women working in and frequenting these bars may have been exposed to increased SHS.8
For smokers, a very common unintended positive consequence of the tobacco control ordinance was increased social circulation and solidarity, as they went outside to smoke. A previous paper discussed the implications of solidarity among bar patrons as well as between bar patrons and staff as both a possible hindrance to the implementation of tobacco control policies in bars and as a possible support for the implementation of such policies: bar patrons may use their collective strength to resist management’s effort to comply with the law, but alternately bar staff may use this solidarity to leverage compliance.22
The effects of bar patron solidarity on smoking cessation or uptake are as yet unexplored. Previous studies on social cuing32
and the disinhibiting effects of alcohol33
may mean that in drinking settings where smoke is present, nonsmokers are more prone to occasional smoking, and smokers may “binge” on cigarettes.20,34
No research has been conducted on the effects on smoking from the unintended consequence of smokers clustering outside bars, yet the findings from this study indicate that just as smoky bars may function as “smoke-easies” where smokers congregate and where smoking behaviors may be reinforced,35
these doorway gatherings may function as “smoking settings” wherein smoking may well be supported and efforts to quit suppressed. The role of peers in establishing and reinforcing tobacco use has been well established for specific populations, including adolescents36,37
and ethnic minorities.38,39
Further research may be called for to investigate this effect specifically among the subgroup of smokers in bars.
Additionally and consistent with reports elsewhere,32
respondents reported quitting and attempting to quit in response to the limited smoking opportunities and increasing stigma attached to smoking following enactment of the law. The counterexample, however, of a female bartender who took up smoking to justify taking more breaks indicates the complexity of the issue. The lure of smoking to justify an outdoor break has been described for other low-SES occupations, including nurses40,41
and military workers.42
Although encouraging tobacco cessation may have been a covert intention of the tobacco control advocates who supported the smoke-free workplace law, the stated intent of the law was to protect worker health, cast within the framework of fair employment practices (workers should not have to choose between working in an unhealthy environment and quitting work, analogous to laws regarding sexual harassment). Although our description of quitting smoking as an unintended consequence may therefore be arguable depending on how one views this aspect of the law, clearly no one intended for the law to encourage workers to take up smoking.
Although there is a lengthy tradition in the social sciences of pointing out the unintended repercussions of policy, especially for less powerful social groups, recommendations for tying these outcomes to specific recommendations for policy formulation have been less common. This study’s findings suggest that as relatively weak provisions for enforcement of tobacco-free laws in bars enable some recalcitrant bar owners to permit smoking, low-SES women working in such bars may still be subjected to substantial SHS exposure.8
Therefore, implications for policymakers are clear: to be fair to women, smoke-free workplace laws need to be enacted with widely understood and readily enforceable repercussions for violations (e.g., substantial fines).24,43
The gender-neutral framing of strong smoke-free workplace policy will support level playing fields in which all employees (female and male) are not obliged to breathe tobacco smoke in order to work.
For individual bar owners, the findings of this study suggest that creating safe outdoor enclaves when possible will facilitate compliance with the smoke-free workplace policy while minimizing threats of harm to the physical safety and culturally salient reputation of women who smoke outside bars. Paradoxically, however, because an unexpected consequence of compliance with smoke-free workplace laws is social solidarity and sociability among women of low SES who smoke, further research is called for regarding how such solidarity may in fact inhibit their attempts to quit.