1. AVOIDANCE OF SMOKY ESTABLISHMENTS, ERIE/NIAGARA COUNTIES, NEW YORK, 2002/03. Cheryl Higbee Joseph Bauer, PhD K. Michael Cummings, PhD, MPH William Wieczorek, PhD Terry Alford Andrew Hyland, PhD Presented at 2003 National Conference on Tobacco or Health Boston, Massachusetts December 10, 2003

2. Acknowledgement This project was supported by grants through the New York State Department of Health, the Erie-Niagara Tobacco Free Coalition and the National Cancer Institute Cancer Center Support Grant (CA16056).

4. Background People are bothered by secondhand smoke. Workers in bars and restaurants where smoking is allowed report irritation to their throat and lungs due to secondhand smoke. The discomfort associated with secondhand smoke leads many people to avoid smoky places, particularly restaurants and bars.

5. Background Hundreds of municipalities in the United States have regulations that restrict smoking in restaurants and bars. Now 5 states serving 21% of the nation’s population have smoke-free bars.

6. * Includes ordinances effective for any part of the year ** Year to Date Source: American Nonsmokers’ Rights Foundation. (www.no-smoke.org/ordgraph)

7. ? Do people avoid going to smoky places?

8. Objective To estimate the extent to which consumers report an aversion to secondhand smoke. To examine the level of avoidance of smoky places. To examine the characteristics of those who avoid smoky establishments.

9. Methods Data regarding tobacco purchase patterns was obtained through a random digit dialed telephone tobacco use survey in Erie and Niagara County, NY, between October 2002 and May 2003. The survey was administered to 1,548 adults including 922 current smokers. The response rate for the survey was 60%.

10. Erie-Niagara Tobacco Use Survey http://www.stopthebutts.com/

11.  Are you bothered by secondhand smoke?  How does secondhand smoke bother you? Watery eyes?…the smell?…allergies? …asthma?…itching?…stuffy nose? … coughing?…in some other way? (Yes/No) Survey Measures

12.  In the past 12 months, did the presence of secondhand cigarette smoke keep you from going to a restaurant, bar or tavern, bowling alley, casino or bingo hall? Survey Measures

13.  Which locations did it keep you from going to? Was it…. Restaurants? Bars or taverns? Bowling alleys? Casinos? Bingo halls?

14. Results: Attitudes about secondhand smoke 71% of non-smokers reported that they are bothered by secondhand smoke. The most frequent complaints include: –Bad smell (90%) –Coughing (60%) –Watery eyes (57%)

15. Results: Avoidance of smoky establishments 29% of all respondents reported having avoided patronizing a smoky establishment in the past 12 months. –34% of non-smokers avoided a smoky establishment –10% of current smokers avoided a smoky establishment

16. *Assuming these smokers buy 50% of the cigarettes that they smoke from Indian Reservations and that they smoke 16 cigarettes per day.

17. Number of Residents Who have Avoided Restaurants and Bars in the Past 12 Months Because of Secondhand Smoke

18. Who Avoids Smoky Places?

19. *Odds Ratio = 1.4, 95% CI = (1.1 – 1.8), from a logistic regression modeling the report of having avoided an establishment in the past 12 months while controlling for gender, race, age, educational status, income, tobacco-related illness, smoking status, and county of residence. Avoidance of Smoky Establishments: Who Avoids Them? *

20. *Odds Ratio = 0.4, 95% CI = (0.2 – 0.7), from a logistic regression modeling the report of having avoided an establishment in the past 12 months while controlling for gender, race, age, educational status, income, tobacco-related illness, smoking status, and county of residence. *

21. Avoidance of Smoky Establishments: Who Avoids Them? *Odds Ratio = 2.0, 95% CI = (1.1 – 3.8), from a logistic regression modeling the report of having avoided an establishment in the past 12 months while controlling for gender, race, age, educational status, income, tobacco-related illness, smoking status, and county of residence. *

22. Avoidance of Smoky Establishments: Who Avoids Them? *Odds Ratio = 1.8, 95% CI = (1.2 – 2.7), **Odds Ratio = 1.9, 95% CI = (1.2 – 3.2), from a logistic regression modeling the report of having avoided an establishment in the past 12 months while controlling for gender, race, age, educational status, income, tobacco-related illness, smoking status, and county of residence. ** *

23. Avoidance of Smoky Establishments: Who Avoids Them? *Odds Ratio = 2.1, 95% CI = (1.5 – 2.8), from a logistic regression modeling the report of having avoided an establishment in the past 12 months while controlling for gender, race, age, educational status, income, tobacco-related illness, smoking status, and county of residence. **Respondents were considered to have a tobacco related illness if they responded that they have been told by a doctor that they have had a heart attack, stroke, asthma, emphysema, chronic bronchitis, or cancer of the esophagus, larynx, throat, lung, oral cavity or mouth. *

24. Avoidance of Smoky Establishments: Who Avoids Them? *Odds Ratio = 3.7, 95% CI = (2.2 – 6.2), **Odds Ratio = 6.0, 95% CI = (3.8 – 9.6), from a logistic regression modeling the report of having avoided an establishment in the past 12 months while controlling for gender, race, age, educational status, income, tobacco-related illness, smoking status, and county of residence. ** *

25. Few smokers have left Erie County to dine in restaurant where smoking is allowed in the past 12 months. 5%

26. Some non-smokers are seeking out smoke-free restaurants. 10%

27. Conclusions A large majority of non-smokers are bothered by secondhand smoke. Consumers avoid patronizing smoky establishments in large numbers

28. Conclusions By reaching out to this population, patronage and sales could be boosted when smoke-free regulations are implemented. Some businesses by benefit from redeveloped business plans and alternative marketing strategies to be consistent with the consumer market.