Policy Factsheet

Tobacco-Free Policies (Smoke-free workplaces, restaurants, and other public places)

Reasons for Policy

  • Secondhand smoke exposure is linked with cancer, heart disease, respiratory illness and is the leading source of indoor air pollution.1
  • In the United States, secondhand smoke exposure causes approximately 46,000 heart disease deaths among adult nonsmokers per year.2
  • In the U.S, secondhand smoke exposure causes 3,400 lung cancer deaths among adult nonsmokers per year.2

Community Groups

  • Businesses
  • Community Colleges
  • Government Agencies
  • Local Government
  • State Government
  • Universities

Policy Components

  • Totally smoke-free workplaces (private or corporate business workplace, government workplace)
  • Smoke-free public places (restaurants and bars)
  • Smoke-free campuses
  • Legislation restricting smoking in public and in workplaces

Desired Outcomes

  • Decreased prevalence of smoking
  • Decreased daily cigarette consumption
  • Decreased exposure to second-hand smoke

Level of Evidence Available to Evaluate Effectiveness of Policy

For all policies we describe on this website, we have applied the Standards of Evidence as defined by Flay et al. (2005) in the Standards of Evidence document published by Prevention Science.

The effectiveness level of this policy is 1: Evidence-Based Policies Meeting Criteria for Effectiveness.

The levels of effectiveness as noted are:

  1. meets criteria for policy effectiveness (consistent, positive outcomes from at least two high-quality experimental or quasi-experimental trials using a comparison group or interrupted time series design);
  2. consistent evidence available linking policy with positive outcomes from high-quality observational studies only;
  3. insufficient evidence available for policy or policy components.

Achievable Results

On average, smoke-free workplace policies can achieve:

  • 29% reduction in total cigarette consumption per employee (95% CI: 11%, 53%).1
  • 3.8% reduction in smoking prevalence (95% CI: 2.8%, 4.7%).1
  • Decrease in consumption of 3.1 cigarettes per day per smoker (95% CI: 2.4, 3.8).1
  • Teenagers who worked in totally smoke-free worksites were 32% less likely to ever smoke than those who worked in less restricted work sites.1

On average, local and state legislation restricting smoking in public and in workplaces can achieve:

  • Decreases in consumption of 0.16 -0.73 cigarettes per day per capita.1
  • 3.7% -4.5% reduction in smoking prevalence.1

Community Examples

University of Florida is a tobacco-free campus and prohibits tobacco use on all university-owned properties.

Triangle Area, North Carolina, Duke University Health System, UNC Health Care, and WakeMed Health & Hospitals are tobacco-free health systems.

Links to Policy Examples

Regulations of the University of Florida, UF-2.022; No Smoking and Tobacco Use.

University of North Carolina, UNC Health Safety Policy Manual, #52 Smoking Policy.

Duke University, Duke Human Resources, Workplace Health and Safety, 10.02 Smoking Policy


1 Fichtenberg, CM, Glantz, SA (2002) Effect of smoke-free workplaces on smoking behavior: systematic review. British Medical Journal, 325(7357), 188-195.

2 Centers for Disease Control and Prevention. Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses- United States, 2000-2004. Morbidity and Mortality Weekly Report,57(45), 1226–1228

3 Flay, BR, Biglan, A, Boruch, RF, Ganzalez Castro, F, Gottfredson, D, Kellam, S, Moscicki, EK, Schinke, S, Valentine, JC, & Ji, P (2005). Standards of evidence: Criteria for efficacy, effectiveness and dissemination. Prevention Science, 6(3), 151-175.