Views About Secondhand Smoke and Smoke-Free Policies Among North Carolina Restaurant Owners Before Passage of a Law to Prohibit Smoking

Abstract

Background: This study examined the knowledge, attitudes, and beliefs about secondhand smoke and smoke-free policies among North Carolina restaurant owners and managers before passage of House Bill 2, which prohibited smoking in most restaurants and bars.

Methods: A random sample of North Carolina restaurants was selected to participate. A 15-minute telephone survey was completed by 523 restaurant owners and managers (one per participating restaurant) who spoke English and operated a restaurant that had seating for guests and was not a corporate headquarters for a restaurant chain (response rate, 36.7%). Bivariable analyses using χ² tests of association were conducted. Multivariable modeling with logistic regression was used to examine relationships among several predictor variables and current smoking policies at participating restaurants, support among owners and managers for a statewide ban on smoking in restaurants, and beliefs among owners and managers about the economic impact of smoke-free policies.

Results: Restaurant owners and managers were aware that secondhand smoke causes cancer and asthma (79% and 73% or respondents, respectively) but were less aware that it causes heart attacks (56%). Sixty-six percent of restaurants did not permit any smoking indoors. Sixty percent of owners and managers supported a statewide smoke-free law. Owners and managers who were current smokers, those who worked at a restaurant with an employee smoking prevalence of more than 25%, and those who worked in a restaurant without a 100% smoke-free policy were significantly less likely to support a statewide law requiring smoke-free public places. Only owner and manager smoking status and no current smoke-free indoor policy were significant independent predictors of the belief that instituting a smoke-free policy would have negative economic consequences for the restaurant.

Limitations: Although participating establishments were a representative sample of North Carolina restaurants, an overall survey response rate of 36.7% limits the generalizability of these findings.

Conclusions: Most North Carolina restaurant owners and managers in our sample had a smoke-free indoor policy and supported a law to make public places smoke-free. Results were used to strengthen interventions that create a safe and healthy environment for restaurant employees and customers, in anticipation of passage of House Bill 2.