Moving toward people's needs for smoke-free restaurants: Before and after a National Promotion Program in Taiwan, 2003-2005

Introduction: In Taiwan, the Smoke-Free Restaurant Program (SFRP) was implemented from 2003 to 2005 as an initial phase before the introduction of restrictive legislation promoting smoke-free restaurants (SFRs). No studies have evaluated trends in public opinion before and after a national health promotion campaign for the introduction of SFRs on a voluntary basis. The present study investigated whether public opinion with respect to eliminating environmental tobacco smoke (ETS) in restaurants changed after implementation of the SFRP. Methods: Data were obtained from four large-scale, nationally representative surveys conducted in 2003-2005 before and after implementation of the SFRP. Weighted analyses were performed to obtain nationally representative results. Results: After a series of SFRP campaigns, reported exposure to ETS in restaurants by survey participants decreased by approximately 14%. Approximately 20% more people had heard of SFRs, and approximately 25% more had chosen to dine in a smoke-free restaurant. We found consistently high community support for SFRs (ca. 95%), and approximately 80% supported smoke-free restaurant legislation, although both rates dropped slightly in 2005. People aged 60 years or more, nonsmokers, and those who had greater knowledge of ETS hazards were more likely to support smoke-free restaurant legislation. Discussion: The SFRP was effective at promoting SFRs on a voluntary basis. Strong community endorsement has major implications for legislators who are considering the nature and extent of further smoke-free restaurant legislation in Taiwan and other countries.