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Global Momentum for Smoke-Free Indoor Environments at Tipping Point

Researchers from the Harvard School of Public Health (HSPH) and the Association of European Cancer Leagues describe the growing momentum for //indoor smoking bans in countries across the globe. They identify Ireland’s pioneering 2004 comprehensive indoor smoking ban as a likely tipping point for fundamental change in social norms and public health worldwide.

Since 2004, in only a few years, more than a dozen other countries have also adopted national indoor smoke-free policies that are being implemented or will be implemented in the near future.

Lead author Dr. Howard Koh, Professor and Associate Dean of Public Health Practice at HSPH said: “The 21st century is witnessing a paradigm shift, once considered impossible, whereby entire countries are declaring themselves smoke-free in indoor public places. Such mounting progress across the globe is making smoking history worldwide.”

Co-authors are Gregory Connolly, Professor of the Practice of Public Health at HSPH, and Luk Joossens of the Association of European Cancer Leagues.

The Perspective is accompanied by a world map showing countries, states and provinces that have passed smoke-free policies applying broadly to indoor workplaces and other indoor public places. Among the countries are Ireland, New Zealand, Bermuda (territory), Scotland, England and the United Kingdom, Lithuania, Uruguay, Iran, the British Virgin Islands (territory), Bhutan, Norway, Italy, Malta, Sweden, Iceland, Uganda, South Africa, France, Hong Kong (region), and Finland. While the United States lacks a federal policy, 17 states are currently recognized as smoke-free, with the number increasing steadily. California enacted the first state ban on smoking in bars and restaurants in 1998. In addition, most of Australia and Canada is currently covered by smoke-free laws in indoor public places.

While a number of these new policies currently allow exceptions, such as the possibility of design
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