Associations of Bar and Restaurant Smoking Bans with Smoking Behavior in the CARDIA Study: A 25-Year Study

Stephanie L. Mayne, Amy H. Auchincloss, Loni Philip Tabb, Mark Stehr, James M. Shikany, Pamela J. Schreiner, Rachel Widome, Penny Gordon-Larsen

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Indoor smoking bans have often been associated with reductions in smoking prevalence. However, few studies have evaluated their association with within-person changes in smoking behaviors. We linked longitudinal data from 5,105 adults aged 18-30 years at baseline from the Coronary Artery Risk Development in Young Adults (CARDIA) Study (1985-2011) to state, county, and local policies mandating 100% smoke-free bars and restaurants by census tract. We used fixed-effects models to examine the association of smoking bans with within-person change in current smoking risk, smoking intensity (smoking ≥10 cigarettes/day on average vs. <10 cigarettes/day), and quitting attempts, using both linear and nonlinear adjustment for secular trends. In models assuming a linear secular trend, smoking bans were associated with a decline in current smoking risk and smoking intensity and an increased likelihood of a quitting attempt. The association with current smoking was greatest among participants with a bachelor's degree or higher. In models with a nonlinear secular trend, pooled results were attenuated (confidence intervals included the null), but effect modification results were largely unchanged. Findings suggest that smoking ban associations may be difficult to disentangle from other tobacco control interventions and emphasize the importance of evaluating equity throughout policy implementation.

Original languageEnglish (US)
Pages (from-to)1250-1258
Number of pages9
JournalAmerican journal of epidemiology
Issue number6
StatePublished - Jun 1 2018

Bibliographical note

Publisher Copyright:
© The Author(s) 2018. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved.


  • fixed-effects models
  • smoke-free policies
  • smoking
  • smoking bans
  • tobacco use


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