Objective: To document levels of public support in Australia for smoking restrictions in licensed premises, including trends over time, and to examine the potential effects of a ban on patronage.
Method: Systematic review of published and unpublished studies of community and staff attitudes towards smoking in bars, gaming areas and related venues were identified using Medline, Current Contents, PsycINFO and AUSTHealth prior to September 2002. State and Territory health departments, cancer organisations and branches of the National Heart Foundation were approached. Cross-sectional surveys reporting data on attitudes towards smoking restrictions and/or perceptions of effects on patronage were sought. Two reviewers assessed studies for inclusion. One extracted data using pre-coded categories with checking by the second.
Results: Thirty-four community and seven staff surveys were synthesised qualitatively, with greater emphasis given to surveys using random selection. All surveys conducted since 1993, which included the separate smoking area response option, have demonstrated majority support for some form of smoking restriction on licensed premises. From 2000, surveys with the ban option alone report majority support for prohibiting smoking completely in bars (52-68%) and gaming areas (64-76%). Support increased significantly after the Sharp damages award. Customer preference data indicate banning smoking is most likely to have a neutral or positive effect on patronage.
Conclusions and implications: Support for a ban on smoking in licensed premises has increased by almost 20% in the past decade. State and Territory governments should introduce legislation banning smoking in all indoor drinking and gaming areas immediately.