Bartenders' respiratory health after establishment of smoke-free bars and taverns

JAMA. 1998 Dec 9;280(22):1909-14. doi: 10.1001/jama.280.22.1909.


Context: The association between environmental tobacco smoke (ETS) exposure and respiratory symptoms has not been well established in adults.

Objective: To study the respiratory health of bartenders before and after legislative prohibition of smoking in all bars and taverns by the state of California.

Design: Cohort of bartenders interviewed before and after smoking prohibition.

Setting and participants: Bartenders at a random sample of bars and taverns in San Francisco.

Main outcome measures: Interviews assessed respiratory symptoms, sensory irritation symptoms, ETS exposure, personal smoking, and recent upper respiratory tract infections. Spirometric assessment included forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) measurements.

Results: Fifty-three of 67 eligible bartenders were interviewed. At baseline, all 53 bartenders reported workplace ETS exposure. After the smoking ban, self-reported ETS exposure at work declined from a median of 28 to 2 hours per week (P<.001). Thirty-nine bartenders (74%) initially reported respiratory symptoms. Of those symptomatic at baseline, 23 (59%) no longer had symptoms at follow-up (P<.001). Forty-one bartenders (77%) initially reported sensory irritation symptoms. At follow-up, 32 (78%) of these subjects had resolution of symptoms (P<.001). After prohibition of workplace smoking, we observed improvement in mean FVC (0.189 L; 95% confidence interval [CI], 0.082-0.296 L; 4.2% change) and, to a lesser extent, mean FEV1 (0.039 L; 95% CI, -0.030 to 0.107 L; 1.2% change). Complete cessation of workplace ETS exposure (compared with continued exposure) was associated with improved mean FVC (0.287 L; 95% CI, 0.088-0.486; 6.8% change) and mean FEV1 (0.142 L; 95% CI, 0.020-0.264 L; 4.5% change), after controlling for personal smoking and recent upper respiratory tract infections.

Conclusion: Establishment of smoke-free bars and taverns was associated with a rapid improvement of respiratory health.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Attitude
  • California
  • Data Collection
  • Female
  • Humans
  • Male
  • Middle Aged
  • Occupational Health*
  • Respiratory Function Tests
  • Respiratory Tract Diseases / epidemiology
  • Restaurants* / legislation & jurisprudence
  • Smoking / legislation & jurisprudence*
  • Statistics, Nonparametric
  • Tobacco Smoke Pollution*


  • Tobacco Smoke Pollution