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ATLANTA—Expanding smoke-free laws in bars or restaurants may be more impactful in preventing asthma-related hospitalizations than smoke-free laws in nonhospitality workplaces, according to a Georgia State University study published in the Canadian Respiratory Journal.
While the majority of nonhospitality workplaces (e.g., office buildings) are covered by either public or private smoking bans, only about half of the U.S. population lives in places where 100 percent smoke-free laws are in force in all workplaces, including bars and restaurants.
Previous research on the impact of smoke-free laws has focused on state laws. In the present study, the researchers examined multistate county-level data using Healthcare Cost and Utilization Project (HCUP) state inpatient data (2002 to 2009) in combination with the American Nonsmokers’ Rights Foundation’s smoke-free laws database of state and county laws.
In total, data from 17 states was included in the analysis: 12 with state smoke-free laws and five without state smoke-free laws. These 17 states represent 840 counties with approximately 103 million people, or 35 percent of the U.S. population. Twenty-nine counties included in the study passed a county-level clean indoor law during the study period, 16 counties already had a county-level nonhospitality workplace law in place, and 20 counties already had a county-level restaurant or bar law in place.
Overall, the researchers found that asthma-related hospital discharges were not reduced by enacting smoke-free workplace laws within county jurisdictions. However, enacting smoke-free restaurant and bar laws was tied to reductions in asthma discharges.
“Only 49 percent of the U.S. population lives in a location where smoke-free laws are in force in all bars, restaurants, and workplaces,” says lead author Glenn Landers, Sc.D., director of health systems at the Georgia Health Policy Center. “Clearly, there are still opportunities to reduce secondhand smoke exposure and health outcomes through changes in county smoking laws.”
Study coauthors include Pat Ketche from the J. Mack Robinson College of Business at Georgia State University, as well as Mark Diana and Claudia Campbell, both from Tulane University’s School of Public Health and Tropical Medicine.
Featured Researcher

Glenn Landers is an assistant research professor in the Andrew Young School of Policy Studies and the director of health system transformation at GHPC. In his current portfolio, Landers leads the community health system development and long-term services and supports teams. He also plays a lead role in the center’s approaches to evaluation, collective impact, and health system transformation.
He was recently a senior adviser with the U.S. Centers for Disease Control and Prevention, Office of the Associate Director for Policy, Office of Health System Collaboration.
His published research has appeared in the American Journal of Public Health, Medicare and Medicaid Research and Review, and the Journal of Health Care for the Poor and Underservedamong others.
