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Literature Review of Smoke-Free Policies

Rosaisela Pineda
University of Texas at El Paso


Smoking is considerate to be one of the top reasons that causes death. Smoking tobacco
has been a top marketing product for a long time now and has brought many discussions towards
smoking in public areas. Many places including schools, hospitals, and parks have implemented
the smoke-free policy. This literature review will discuss the pros and cons of having a smokefree policy in the hope that one day smokers and non-smokers can one day live together.


Introduction: Literature Review of Smoke-Free Policies

According to the American Lung Association the tobacco industry is one of the largest
marketing products in the United States. A tobacco company can spend up to $12.49 billion in
advertisements. These advertisements are aimed to attract young teenagers so that by the age of
19 they have become fully addicted to smoking. (Reynolds, 1995). Smoking tobacco can lead to
having lung cancer or heart diseases. Now many states have implemented smoke-free policies in
public areas due to secondhand smoke exposure. According to the Center of Disease Control 443
thousands of people have died from secondhand smoke exposure.
Smoking in public areas has become a topic of argument towards the community. Some
citizens feel that smoking anywhere is part of their individual rights while others feel that
smoking is only harming the people around them and the environment. Most people argue that
implementing the policy would be the right thing to do, but has this policy gone too far?
The following literature review will review peoples opinion toward the policy and
enhance the knowledge of secondhand smoke exposure. With the following questions this
literature review will answer common questions based on the smoke-free policy:
1). Should smoking cessations continue?
2). Does having a smoke free policy on campus affect the students academic
3). Whom does smoke-free policy affect?
Smoking tobacco is an industry that is and will continue to grow throughout the years but
not only will it raise in marketing but also in the death rates. Since it would be quite difficult to


stop people from smoking we can reach a goal were non-smokers dont have to get affected by
the smokers around them.

Should smoking cessations continue?

Smoking cessations have gone to the point where not only are campuses becoming part of
the smoke-free policy but also businesses such as hospitals. Some hospitals are even considering
not hiring smokers because they feel that if they implement the policy they will lower the
employee health cost, workers will become more productive, and they will help promote healthy
life styles. (Sulzberger, 2011). This smoking cessation will cause many their jobs because in
order to ensure that they are smoke-free they must pass a nicotine urine test and if they dont
pass it will eliminate their chances of having a job in there institute. They have even gone as far
as firing a worker who left during his lunch break and came back smelling like cigarettes and had
later confessed to have smoked on his way back to the hospital. (Sulzberger, 2011). This policy
in businesses may result in many people losing their jobs or their chances on obtaining one. By
putting this policy in businesses they hope to get many people to consider quitting due to not
being able to acquire a job.
A survey was conducted in a university in Saudi Arabia showing that most of the
smokers on campus were between the age group of 25-34 and them being staff members. The
survey also showed that the second age group that smoked the most were students between ages
18-24. (Journal of Community Health, 2014). They all showed to be in agreement with the policy
but were not sure if they agreed to being fined if the policy was broken. By doing the survey
they were able to get people around smokers and smokers to say their opinions and even though


they all agreed the policy makers feel that if no punishment is enforced there is no point into
having the policy in the first place. Some people feel that the smoke-free policies should be
treated like any other policy and if broken there should be a fine. (Journal of Community Health,
2014). Whether there should be a fine or not is still a topic of debate.

Does having a smoke-free policy on campus affect the students academic score?

Since the vast majority of the smokers around campus are staff members and students
smoking on campus is very common. Research showed that students who smoked had a lower
grade point average than those who didn't smoke. It also showed that 1,310 college students are
smokers and 1,500 are high school graduates that smoke. Also research shows that 28% of
smokers have not continued their education. (National Institute on Drug Abuse, 1989).
According to the WHO many students get addicted to smoking due to stress and to wanting to
fit in with society by smoking. It is common the students smoke due to stress and getting
attracted to smoking at such an early age. Whether it affects the students performance is still a
question that needs further research.
A survey was conducted to show how many young adults smoked and the results showed
that from all the dropouts 92% were non-smokers. After two years 9.5% of them became
smokers due to having a drop in their grades and changed from living with both parents to just
one. (Child: Care, Health & Development, 2013).
Students choose to start smoking for various reasons but more research has to be conduct
ed in order to see how smoking effects their academic scores due to other factors such as family
problems or simply not being understood.


Whom does the smoke-free policy affect?

The smoke-free policy affects both the smoker and the ones around the smokers. Studies
shows that many children have been exposed to secondhand smoke. These children are most
likely to have a low socio-economic status and come from low income families. (Journal of
Community Health, 2014). These children are more likely to acquire a lung diseases because they
have lack knowledge on how being around smokers can affect their health. By implementing
the smoke-free policies in public places they feel that children will have less exposure to
secondhand smoke. Some people feel that even if the some-free policy is enforced, we cannot
fully put a stop to children being exposed to secondhand smoke. (Journal of Community Health,
Although it is unclear how much cigarette smoke one has to be exposed to in order to
remain healthy, many resources have been made to determine the levels of exposure. Flagship
University conducted an experiment were they measured the PM levels around the campus to
determine the amount of exposure to cigarette smoke. The results showed that the levels were
really high in areas that people stopped to socialize around smokers. (Journal of the Air & Waste
Management Association (Taylor & Francis Ltd), 2014). There is still much argument in how
one can measure the amount of smoke from tobacco usage is in the air and how much does it
take for it to be considered hazardous to peoples health.
Many states have tried to reach out to smokers in many ways. They have even have put
smoking cessation resources to the cost of Medicaid. This change has impacted many low
income smokers due to them being able to seek the help they need without any or little cost to


them. (The New York Times, 2009). Even though this approached showed results in the decrease
of emergency visits to the hospital due to smoking issues, a lot of states cannot offer smoking
cessations to the Medicaid patients. (The New York Times, 2009).
Smoking in public areas is slowly becoming a thing of the past, although it is still a
discussion of what places should become part of the policy, there is a huge difference in health
care records. Even though some places have taken it to the point of not getting hired people
people should always look for ways to remain healthy without compromising the rights of others.
With the right knowledge and research we can one day implement the smoke-free policy in an
efficient manner where non-smokers and smokers can remain happy.


Reference page

Almutairi, K. M. (2014). Attitudes of students and employees towards the

implementation of a totally smoke free university campus policy at King Saud University
in Saudi Arabia: A cross sectional baseline study on smoking behavior following the
implementation of policy. Journal of Community Health, 39(5), 894-900.

Bachman, J., Johnston, L., & OMalley, P. (1989). Prevalence of drug abuse among
college students. Drug use, drinking, and smoking: National survey results from
high school, college, and young adults population (pp.263-273). Rockville, MD:
National Institute on Drug Abuse.

Bratset, H., Cho, H., Hahn, E.J., Hwang, Y., Lee, K., Record, R., Richardson, P., Ricker,
C., & Teeters, E. (2014). Outdoor tobacco smoke exposure at the perimeter of a
tobacco- free university. Journal of the Air & Waste Management Association
(Taylor & Francis Ltd), 64(8), 863-866.

Bullock, A., Hamasaka, L., Moody-Thomas, S., Ross-Viles, S., & Sparks, M. (2014).
The head start tobacco cessation initiative: Using systems change to support staff
identification and intervention for tobacco use in low- income families. Journal of
Community Health, 30(4), 646-652.

Egan, S. (2013, June 25). Why Smoking Rates Are at New Lows. The New York Times.
Retrieved from



Fennell, R. (2012). Should college campuses become tobacco free

without an enforcement plan? Journal of American College Health, 60(7), 491-494.

Goodnough, A. (2009, December 19). Massachusetts Antismoking Plan Gets Attention.

The New York Times.
Retrieved from
Lotrean, L.M., Mesters, I., Vries, H. ( 2013, November). Why do Romanian junior high school
students start to smoke? Child: Care, Health & Development, 39 (6), 851-855.

Reynolds, P. (1995, May 31). Vancouver, Canada

Retrieved from

Sulzberger, A.G. (2011, February 10). Hospitals Shift Smoking Bans to Smoker Ban.
The New York Times.
Retrieved from