Comprehensive Smoking Bans: A Win for Public Health, Workers, and Hospitality Revenues

The updated WHO Tobacco Control Playbook highlights that comprehensive smoke-free environments protect public health, boost hospitality revenues, and counter industry misinformation. It urges decisive action to enforce complete bans, including for new nicotine products, to create healthier, smoke-free societies.

The tobacco epidemic remains one of the most persistent public health threats globally, demanding urgent and comprehensive action. Over the past few decades, remarkable progress has been achieved in the WHO European Region, largely due to the adoption of the WHO Framework Convention on Tobacco Control (WHO FCTC). Key institutions such as the WHO Regional Office for Europe, the Global Center for Good Governance in Tobacco Control, the Campaign for Tobacco-Free Kids, and the International Agency for Research on Cancer have played instrumental roles by supplying critical evidence and supporting policymakers. Yet despite these efforts, tobacco use continues to cause widespread devastation, further complicated by the increasingly aggressive tactics of the tobacco industry. In response, WHO launched the Tobacco Control Playbook to dismantle myths promoted by the tobacco lobby. Now, as new challenges emerge, particularly the marketing of novel nicotine products to youth, WHO has updated the Playbook, beginning with a bold reaffirmation of the need for smoke-free environments.

Smoke-Free Spaces: Healthier People, Thriving Businesses

Smoke-free environments are not merely a health imperative; they present clear economic advantages as well. Contrary to the persistent claims pushed by the tobacco industry, comprehensive smoking bans often lead to increases in customer patronage and revenue in hospitality venues. The majority of people in society are non-smokers, and providing safe, clean environments attracts wider audiences. Workers in these venues benefit enormously too, as their exposure to deadly second-hand smoke (SHS) decreases, leading to improved respiratory health and fewer sick days. Beyond health and financial gains, smoke-free environments help shift social norms. Reducing the visibility of smoking in public venues plays a crucial role in denormalizing tobacco use, especially among impressionable youth, ultimately supporting long-term public health objectives.

Industry Myths and the Evidence That Disproves Them

Despite the growing body of evidence in favor of comprehensive smoking bans, the tobacco industry, often in partnership with sectors of the hospitality industry, continues to resist. Industry arguments typically claim that total smoking bans would devastate business revenues and alienate smoking customers. They promote ineffective alternatives like partial bans or costly ventilation systems, measures that have consistently been shown to offer inadequate protection from SHS. Research conducted by leading public health institutions across Europe reveals that hospitality groups opposing smoking bans are often financially influenced by tobacco companies, operating through so-called “grassroots” organizations that conceal their true affiliations. Studies across multiple European countries have shown that where full smoking bans are implemented, SHS exposure is significantly reduced, in contrast to countries where only partial bans exist.

As of 2022, less than half of the WHO European Region's 53 Member States had achieved comprehensive smoking bans covering restaurants, pubs, and hotels. Even where indoor bans exist, outdoor exposure remains a significant concern. Field studies across 11 European countries found nicotine contamination on 94% of hospitality terraces. Meanwhile, the rise of waterpipes, which are mistakenly perceived as safer, and the booming popularity of electronic nicotine-delivery systems and heated tobacco products, have introduced new threats to public health. These devices pollute indoor air with fine particles and toxic chemicals, adding to the health burden in ways the original smoke-free regulations did not fully anticipate.

Second-Hand Smoke: The Invisible Killer

The human cost of SHS exposure is staggering. According to the Global Burden of Disease Study, second-hand smoke causes approximately 1.3 million non-smoker deaths annually, including nearly 39,000 children under the age of five. SHS exposure is strongly linked to heart disease, strokes, cancers, chronic respiratory diseases in adults, and asthma, ear infections, and sudden infant death syndrome in children. Comprehensive smoke-free laws dramatically reduce these risks. Partial bans, or reliance on ventilation systems, have been repeatedly proven ineffective in safeguarding public health. WHO FCTC guidelines unequivocally state that only complete indoor smoking bans can achieve the required level of protection.

Air-quality assessments conducted in various countries, including Italy, Portugal, and Scotland, before and after implementing smoking bans showed drastic improvements, with significant reductions in airborne nicotine and fine particles. Workers' health also improved rapidly, with studies in Scotland showing reduced respiratory symptoms among hospitality employees just four months after a smoking ban took effect. Meanwhile, economic fears have proven unfounded. Comprehensive reviews show that smoking bans either have a neutral or positive effect on revenue and employment across hospitality industries. Countries like Belgium, Cyprus, Czechia, Italy, Norway, and Spain have demonstrated that smoke-free policies can coexist with thriving hospitality businesses.

Success Stories: Hungary and Spain Show the Way

Hungary offers one of the most striking examples of how determined public health action can overcome industry pressure. Despite intense lobbying from the tobacco and hospitality sectors, Hungary enacted a complete smoking ban in hospitality venues in 2012. The benefits were swift and dramatic: better public health outcomes, growing revenues in hospitality, and more vibrant tourism. Air quality improved significantly, and observed smoking rates in public venues dropped to some of the lowest levels in Europe.

Spain’s journey was somewhat more gradual. After partial bans failed to protect most workers and customers, the country toughened its laws in 2011, prohibiting smoking in all hospitality venues. Despite intense industry opposition and fears of economic collapse, the legislation’s impact was overwhelmingly positive. Exposure to second-hand smoke in public venues plummeted, and there was no significant negative impact on hospitality business activity. More recently, Spain has taken further steps to address SHS exposure in outdoor areas, culminating in the approval of the National Tobacco Control Plan 2024–2027, which includes a ban on smoking in outdoor hospitality terraces.

The updated Tobacco Control Playbook makes a compelling case: comprehensive smoke-free environments are essential for protecting health, sustaining businesses, and building a future where tobacco no longer holds sway over public life. The evidence is overwhelming, the benefits undeniable, and the time for decisive action is now.