Exposure to workplace smoking bans and continuity of daily smoking patterns on workdays and weekends

INTRODUCTION: Individuals may compensate for workplace smoking bans by smoking more before or after work, or escaping bans to smoke, but no studies have conducted a detailed, quantitative analysis of such compensatory behaviors using real-time data. METHODS: 124 daily smokers documented smoking occasions over 3 weeks using ecological momentary assessment (EMA), and provided information on real-world exposure to smoking restrictions and type of workplace smoking policy (full, partial, or no bans). Mixed modeling and generalized estimating equations assessed effects of time of day, weekday (vs weekend), and workplace policy on mean cigarettes per hour (CPH) and reports of changing location to smoke. RESULTS: Individuals were most likely to change locations to smoke during business hours, regardless of work policy, and frequency of EMA reports of restrictions at work was associated with increased likelihood of changing locations to smoke (OR=1.11, 95% CI 1.05 – 1.16; p < .0001). Workplace smoking policy, time block, and weekday/weekend interacted to predict CPH (p < .01), such that individuals with partial work bans –but not those with full bans - smoked more at night (9pm – bed) on weekdays compared to weekends. CONCLUSIONS: There was little evidence that full bans interfered with subjects' smoking during business hours across weekdays and weekends. Smokers largely compensate for exposure to workplace smoking bans by escaping restrictions during business hours. Better understanding the effects of smoking bans on smoking behavior may help to improve their effectiveness and yield insights into determinants of smoking in more restrictive environments.