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This study examined support for clean indoor air (CIA) laws among 2,044 young adults in Minnesota during 2006 and 2007. Two-thirds of young adult participants supported restaurant CIA laws and 40% supported bar/club CIA laws. A higher proportion of young adults living with CIA laws supported the laws, compared to young adults living without them. Nonsmokers, college students, those with nonsmoking friends, and those living with home smoking bans were consistently more supportive of both CIA laws.
Individuals exposed to secondhand smoke (SHS) are at risk for negative health outcomes (1–3). SHS causes nearly 50,000 deaths annually due to heart disease and lung cancer (3). Smoke-free environments are considered the most effective measure for reducing SHS exposure (4, 5).
This study assesses support for restaurant and bar clean indoor air (CIA) laws among young adults. Few studies have examined support among young adults, and most show lower support than adults (3). Coverage by CIA laws is less common in restaurants and bars than in other workplaces, increasing the likelihood of SHS exposure in these settings (4). Young adult support is critical because they are more likely to work in the hospitality industry (6), and thus, may be disproportionately exposed to SHS.
Data from a cohort originating from a stratified random sample of adolescents across Minnesota were analyzed (see www.epi.umn.edu/research/macc). Data were collected via telephone interviews between October 2006 and March 2007 (13th Round; 73% retention rate). Data were collected prior to Minnesota’s statewide CIA law (effective 10/1/07).
Given the focus on young adult support for CIA laws, participants over 18, not in high school, and Minnesota residents were included (n=2,044; aged 18–23). The sample is primarily white (89.6%) and consists of slightly more females (51.9%).
Young adults who endorsed, “Smoking should not be allowed at all in restaurants and bars/clubs” were considered supportive of CIA laws. Past-month cigarette use, past-month alcohol use, college attendance, parent(s) smoke, friend(s) smoke, and home smoking ban were all dichotomous variables with “1” indicating the described attribute. Workplace smoking ban is a 3-level variable, distinguishing young adults who did not work (“0”), worked where smoking was not allowed (“1”) and worked where smoking was allowed (“2”). Existing CIA laws were coded for each participant based on city of residence, however participants living in areas with large exceptions were excluded (n=78).
Support for restaurant and bar/club CIA laws was examined overall and by existing law. Chi-square and multivariate regression were used to assess differences in support by individual characteristics. Data were analyzed using SAS 9.1 (7).
Two-thirds (66%) of young adults supported restaurant CIA laws and 40% supported bar/club CIA laws. A larger proportion of participants living in communities with CIA laws supported these laws versus participants living without them (see Table 1). This pattern was observed for both laws.
Chi-square analyses showed that participants who were female, older, in college, did not smoke or drink in the past 30 days, had non-smoking friends, and live and work with a smoking ban were more supportive of both laws, regardless of the law in their community (see Table 1). Parental smoking was associated with support for CIA laws only among those who did not live with CIA laws. Participants with non-smoking parents expressed greater support for CIA laws than participants with a parent who smoked.
The multivariate models, adjusted for age and gender, revealed similar results to the chi-square analyses (see Table 2). Past-month alcohol use and parent smoking, however, were not related to support for CIA laws. Working with a smoking ban was associated with greater support for restaurant CIA laws only.
This study provides much needed information about support for CIA laws among young adults. Few studies have examined support among this age group, and most have been limited to college students (8, 9). Support among this population-based cohort in Minnesota was higher than reported in previous nationwide studies. We found 66% of young adults supported restaurant CIA laws, higher than the 51% reported from a 2002 nationwide sample of 18–24 year olds; support for bar/club CIA laws was also higher (40% vs. 25%)(3). Findings suggest that support for restaurant and bar/club CIA laws may be increasing among young adults.
Similar to previous studies (3), support was higher for restaurant CIA laws compared to bar/club laws. Support also varied by demographic and personal characteristics. Further, support (for both laws) was higher among young adults living with existing laws, compared to those living without such laws. Importantly, these findings reflect support prior to Minnesota’s statewide CIA ordinance; support has been shown to increase after enactment (10).
This study has several limitations. First, this sample may not be representative of the young adult population in Minnesota. However, a large and diverse sample of young adults was drawn from a population-based cohort that likely provides a more accurate assessment than would have been obtained from a convenience sample. This is a cross-sectional study, so change over time was not assessed. Although this sample matches Minnesota demographics, it may not generalize to other areas in the U.S. Finally, the outcome variables were assessed with single item measures, which may not fully reflect attitudes towards CIA laws.
CIA laws are key to tobacco prevention, and these data suggest that support for CIA laws may be increasing among young adults. Furthermore, a greater proportion of young adults living with CIA laws support those laws, suggesting that they are satisfied with the laws when they are enacted.
The project described was supported by award number R01-CA086191 (Jean Forster, Principal Investigator) from the National Cancer Institute and by award number RC-2007-0018 from ClearWay Minnesota (Debra Bernat, PI). The content is solely the responsibility of the authors and does not necessarily represent the official view of the National Cancer Institute or ClearWay Minnesota.
This research was funded by the National Cancer Institute (R01 CA86191-03) and ClearWay Minnesota (RC-2007-0018). The University Institutional Review Board approved this study and participants consented to participate.
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