Longitudinal evaluation of smoke-free Scotland on pub and home drinking behaviour: Findings from the International Tobacco Control Policy Evaluation Project

Abstract

On March 26, 2006 Scotland implemented a smoke-free policy prohibiting smoking in indoor public venues, including bars and pubs. Drinking and smoking are highly associated behaviors, so we evaluated whether the regulations would decrease drinking behavior in public venues among smokers. We further assessed whether this effect would be more pronounced in heavier drinkers, and whether decreases in drinking behavior in pubs would be offset by increased drinking in the home. Participants (n=1,059) were adult smokers and non-smokers from Scotland and from the rest of the United Kingdom, which did not have comprehensive smoke-free policies during the study period. Data was collected using a random digit-dialed telephone survey from February to March 2006, just prior to the policy implementation in Scotland. Follow-up surveys were conducted in March 2007. Using baseline data, participants were categorized into abstainers, moderate drinkers, and heavy drinkers. Overall, results demonstrated that drinking behavior did not change significantly in Scotland compared to the rest of the UK following the implementation of the smoke-free policy in Scotland. However, planned comparisons examining mean changes in drinks consumed in pubs or bars following the legislation demonstrated that the smoke-free legislation was associated with reduced drinking behavior in pubs and bars among moderate and heavy drinking smokers in Scotland. These moderate and heavy drinking Scottish smokers also reduced their pub attendance following policy implementation. The smoke-free Scottish law did not increase drinking in the home. These findings suggest that there may be additional alcohol-related public health benefits to smoke-free policies in those at greater risk for alcohol-related health problems.