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Original Contribution |

Tourism and Hotel Revenues Before and After Passage of Smoke-Free Restaurant Ordinances FREE

Stanton A. Glantz, PhD; Annemarie Charlesworth, MA
[+] Author Affiliations

Author Affiliations: Institute for Health Policy Studies, Department of Medicine, University of California, San Francisco.


JAMA. 1999;281(20):1911-1918. doi:10.1001/jama.281.20.1911.
Text Size: A A A
Published online

Context Claims that ordinances requiring smoke-free restaurants will adversely affect tourism have been used to argue against passing such ordinances. Data exist regarding the validity of these claims.

Objective To determine the changes in hotel revenues and international tourism after passage of smoke-free restaurant ordinances in locales where the effect has been debated.

Design Comparison of hotel revenues and tourism rates before and after passage of 100% smoke-free restaurant ordinances and comparison with US hotel revenue overall.

Setting Three states (California, Utah, and Vermont) and 6 cities (Boulder, Colo; Flagstaff, Ariz; Los Angeles, Calif; Mesa, Ariz; New York, NY; and San Francisco, Calif) in which the effect on tourism of smoke-free restaurant ordinances had been debated.

Main Outcome Measures Hotel room revenues and hotel revenues as a fraction of total retail sales compared with preordinance revenues and overall US revenues.

Results In constant 1997 dollars, passage of the smoke-free restaurant ordinance was associated with a statistically significant increase in the rate of change of hotel revenues in 4 localities, no significant change in 4 localities, and a significant slowing in the rate of increase (but not a decrease) in 1 locality. There was no significant change in the rate of change of hotel revenues as a fraction of total retail sales (P=.16) or total US hotel revenues associated with the ordinances when pooled across all localities (P=.93). International tourism was either unaffected or increased following implementation of the smoke-free ordinances.

Conclusion Smoke-free ordinances do not appear to adversely affect, and may increase, tourist business.

Figures in this Article

As the evidence that secondhand tobacco smoke endangers nonsmokers has accumulated,1,2 more and more communities have eliminated smoking in public places and workplaces. As of September 1998, 212 communities and 3 states had enacted laws mandating smoke-free restaurants3 and 1 state (California4) and 31 communities3 had enacted local ordinances requiring smoke-free bars. These ordinances not only protect nonsmokers from the toxins in secondhand smoke, they also create an environment that encourages smokers to quit.5

The tobacco industry vigorously opposes these public health measures to protect its sales. During the debates over these laws, it is common for the tobacco industry (acting directly or through front groups68) to claim that these ordinances create severe economic problems for the restaurants and bars. After Glantz and Smith9,10 published their study demonstrating that smoke-free restaurant ordinances have had no effect on restaurant revenues in the first 15 cities to pass such ordinances, the tobacco industry's claims of economic chaos lost credibility, particularly in California and Colorado, where the cities were located. Glantz and Smith11,12 later updated this study and extended it to include smoke-free bars. Subsequent work by other researchers yielded similar findings for smoke-free restaurant ordinances in 89 cities in 6 states.1319 Despite tobacco industry protestations to the contrary, all the empirical evidence supports the proposition that smoke-free restaurant ordinances do not hurt the restaurant business.20

As the tobacco industry's claims of adverse effects on the restaurant and bar business have lost credibility, it has advanced a new economic argument against passing smoke-free restaurant ordinances: these ordinances will adversely affect tourism. In some places, the industry has claimed that tourism from countries such as Japan and Germany will be particularly affected. There is only 1 study of 1 city on the effects of a smoke-free ordinance on tourism.18 We identified 3 states and 6 cities in which opponents of clean indoor air ordinances specifically advanced claims that the ordinance would adversely affect tourism (Table 12135) and obtained data on tourism from the local authorities. Contrary to industry claims, these ordinances were not associated with significant drops in tourism. Quite the contrary, in several locales the ordinances were associated with significant increases in tourism.

Table Graphic Jump LocationTable 1. Predicted Effects of Smoke-Free Restaurant Ordinance on Tourism Made by the Tobacco Industry and Related Groups*

We searched newspaper databases and publications by tobacco industry groups (such as the National Smokers' Alliance that was created for Philip Morris Incorporated36) and contacted tobacco control advocates in voluntary health agencies, nonsmokers' rights groups, and health departments to identify localities in which the issue of effect on tourism was raised in the debate over clean indoor air ordinances.

We then identified those local ordinances and state laws that required 100% smoke-free restaurants. (An exemption for the bar area of a restaurant did not disqualify a smoke-free restaurant ordinance from our study, so long as the eating areas were smoke-free.) Smoke-free restaurant ordinances and their effective dates were confirmed with local health department officials. This process yielded the 3 states and 6 cities that met the criteria for inclusion in the study outlined earlier. Because hotel revenue data for Aspen, Colo, were not available predating passage of its ordinance in 1985, we could not include it, leaving 6 cities for analysis (Table 1).

We used revenues from hotel rooms as our measure of tourism. Data on hotel revenues were obtained from the appropriate authorities (Table 23746). We analyzed the hotel revenues directly and in constant 1997 dollars using the appropriate seasonally unadjusted all-items consumer price index.

We also analyzed hotel revenues as a fraction of total retail sales, similar to the analysis we did in our studies of restaurant revenues.912 Analyzing hotel revenues as a fraction of total retail sales accounts for underlying economic conditions and inflation.

In our earlier studies,912 we compared restaurant revenues in similar control cities that did not have 100% smoke-free restaurant ordinances. Rather than doing a locality-by-locality matching, in this study our comparisons against control are done by comparing hotel revenues in the study localities with hotel revenues for the entire United States. We followed this approach because, unlike our earlier study, there was often not a natural match to the study cities and states or, when there may have been a logical match, the "control" locality did not have available data or had a smoking-restriction ordinance in place that prevented it from qualifying as a control locality. Comparing revenues in the study localities with the United States as a whole controlled for the overall health of the tourist industry.

The issue of impact of smoke-free ordinances on international tourism was raised in California, Utah, and New York City (Table 1). We obtained data on the numbers of international tourists for California, Utah, and New York City (Table 2) and analyzed the effects of the ordinance on the number of tourists over time. The dependent variable was the hotel revenues in the study locality divided by total US hotel revenues for the same year. To facilitate comparisons between localities, this ratio was normalized by 1989 population for each locality (Table 1) divided by the US population (248,709,873) from the 1990 census.21 Data were analyzed with linear regression: y=b0+btt+bL(ttlaw)LbiSi where y indicates the dependent variables in Table 3 and Table 4; t, time to represent the underlying secular trend; L, a dummy variable that indicates whether a smoke-free restaurant law is in force; and tlaw, the time the law went into force. The dummy variable L quantifies the presence of a smoke-free restaurant ordinance according to L=0 if no ordinance and L=1 if an ordinance is in effect. For the period in which the ordinance goes into effect, L is set to a value between 0 and 1 that corresponds to the fraction of the period that the ordinance was in force. The term bL (ttlaw)L models the effect of the smoke-free law as a change in the slope of tourism revenues or volume over time. This approach differs from our earlier work, which modeled the effect of the ordinance as a simple intercept change. We found that modeling it as a slope change consistently gave better fits to the data than an intercept change model; the results obtained with an intercept change model were qualitatively similar to those presented in this article using the model above. For locations where data were available more frequently than annually (ie, quarterly or monthly), we also included a dummy variable, Si, to allow for seasonal variability. The estimate of the coefficient bt quantifies the annual rate of increase (or decrease) in the dependent variable y each year. The coefficient bL quantifies the magnitude of the effect of the ordinance on the rate of change over time of the dependent variable.

Table Graphic Jump LocationTable 3. Change in Hotel Revenues After Passage of Smoke-Free Restaurant Ordinances*
Table Graphic Jump LocationTable 4. Number of International Tourists in Thousands*

For hotel revenues as a fraction of retail sales and normalized locality hotel revenues divided by total US revenues, we also conducted a pooled analysis with the equation above by adding effects-coded dummy variables to code for between-locality effects. The pooled analysis was done using annual data for all localities. A change is considered statistically significant when P<.05.

Table 3 and Figure 1 present the results for total hotel revenues over time before and after implementation of the law. In terms of constant 1997 dollars, the smoke-free law was associated with a significant increase in the rate of growth of hotel revenues in 4 localities, no significant change in 4 localities, and a significant slowing in the rate of increase of hotel revenues in 1 city (Flagstaff) where revenues tended to flatten out. Analysis of hotel revenues in current dollars or as a fraction of total retail sales (Table 3) yielded similar results. Pooled across all localities, there was no significant change in the fraction of hotel revenues as total retail sales (P=.16).

Figure 1. Hotel Revenues Before and After Implementation of the Ordinance
Graphic Jump Location
Hotel revenues in constant 1997 dollars for the 3 states and 6 cities with smoke-free restaurants included in this study. Significant changes in slope (P<.05) occurred for Utah, Los Angeles, Mesa, New York City, and Flagstaff.

The smoke-free law was associated with no significant change in the rate of growth of hotel revenues compared with the United States as a whole in 5 localities, a significant speeding in 2, and a significant slowing in 2 localities (Table 3). Pooled across all localities, there was no significant change in the rate of change of hotel revenues compared with the United States as a whole (P=.93).

Figure 2 and Table 4 show the changes in the number of tourists from Japan (or Asia) and Germany (or Europe) associated with implementation of the California, Utah, and New York City smoke-free restaurant ordinances. The implementation of the ordinances was associated with a significant increase in the rate of change of tourists from Japan to California and from Europe to New York City. The other trends were not significantly affected by the ordinances.

Figure 2. Annual International Tourists and Effect of Smoke-Free Ordinances
Graphic Jump Location
Annual visitors from Japan (or Asia) and Germany (or Europe) to 3 locales where the effects of smoke-free restaurant ordinances on international tourism were an issue. The years in which 100% smoke-free bar ordinances were in effect are shown as solid points. Asterisks indicate significant changes in slope.

The regressions for Flagstaff and Mesa, Ariz, exhibited significant Durbin-Watson statistics, indicating the presence of serial correlations in the residuals. We attempted a variety of alternate models using functions of time, changes in the intercept term associated with the ordinance, or interactions between the seasonal variables and the presence of the ordinance. None of these approaches substantially changed the value of the Durbin-Watson statistics. Figure 1 suggests that the significant Durbin-Watson statistic for Flagstaff is due to a period of rapid hotel building between 1989 and 1993; the rate of change in hotel revenues before and after this period (which includes the time covered by the smoke-free ordinance) were similar. For Mesa, the significant Durbin-Watson statistic is due to the disproportionate seasonal increase in business following implementation of the smoke-free ordinance.

This study debunks the tobacco industry allegation that smoke-free restaurant laws adversely affect tourism, including international tourism. Quite the contrary, implementation of these laws is often associated with an increase in the rate of growth of tourism revenues. In the pooled analysis, the ordinances had no significant effect, one way or the other, on tourist revenues as a fraction of total retail sales or compared with the rate of change in the United States as a whole. The cities and states included in this study represent a wide range of geographic locations and types of tourist destinations, a fact that increases the confidence one can have in the generality of the results.

The result that smoke-free restaurant ordinances did not hurt, and may have helped, international tourism was surprising because of the commonly held belief that Europeans are more willing to tolerate secondhand smoke and less supportive of clean indoor air regulations than are Americans. Secret research conducted for Philip Morris Incorporated in 1989, however, shows that this belief is incorrect.46 Philip Morris polled 1000 people in each of 10 European countries and found that smokers were more accepting of smoke-free restaurant ordinances than were Americans (Figure 3).

Figure 3. Reactions of European and American Smokers to Smoke-Free Ordinances in Restaurants
Graphic Jump Location
A survey done by Philip Morris Incorporated in 1989 demonstrated that European smokers were more accepting of smoke-free regulations than were Americans. Source of the data was the Minnesota Tobacco Litigation Depository (Bates No. 2500147496).46

In our analysis of smoke-free restaurant ordinances, we include Boulder, Colo, which permits the construction of a separately ventilated smoking room. While the Boulder Environmental Enforcement Office has not done a formal survey, they reported that "actual use" of such separate smoking rooms is rare. We also included Flagstaff and Mesa, cities that allowed for the application of hardship exemptions or exceptions. The Flagstaff County Health Department reported that no such hardship exemptions have been granted. As of August 1998, the City of Mesa Code Compliance Office cited 73 (3.5%) of 2080 businesses (including smoke shops) that were granted such exceptions. Our results are based on aggregate data, not results from individual businesses. As a result, we cannot exclude the possibility that some establishments experienced gains in business that exactly offset losses in other businesses. At the same time, no data have ever been published to support this possibility. In any event, it is the aggregate data that are necessary to test the tobacco industry's hypothesis that business is severely depressed by these laws.

Food-service workers enjoy the least protection from secondhand tobacco smoke of any employee group.47 Legislators and government officials can enact such health and safety requirements to protect patrons and employees48 in restaurants from the toxins in secondhand tobacco smoke without the fear of adverse effects on tourism. Indeed, these ordinances may even be beneficial for business.

US Environmental Protection Agency.  Respiratory Health Effects of Passive Smoking: Lung Cancer and Other DisordersWashington, DC: US Environmental Protection Agency; 1992. Document EPA/600/6-90/006F.
Office of Environmental Health Hazard Assessment.  Health Effects of Exposure to Environmental Tobacco SmokeBerkeley: California Environmental Protection Agency; 1997. Available at: http://www.oehha.org/scientific/ets/finalets.htm. Accessed April 15, 1999.
Americans for Nonsmokers' Rights.  100% Smokefree OrdinancesBerkeley, Calif: Americans for Nonsmokers' Rights; September 1998.
Macdonald H, Glantz S. The political realities of statewide smoking legislation: the passage of California's Assembly Bill 13.  Tob Control.1997;6:41-54.
Woodruff T, Rosebrook B, Pierce J, Glantz S. Lower levels of cigarette consumption found in smoke-free workplaces in California.  Arch Intern Med.1993;153:1485-1493.
Samuels B, Glantz S. The politics of local tobacco control.  JAMA.1991;266:2110-2117.
Samuels B, Begay M, Hazan A, Glantz S. Philip Morris' failed experiment in Pittsburgh.  J Health Polit Policy Law.1992;17:329-351.
Traynor M, Begay ME, Glantz SA. New tobacco industry strategy to prevent local tobacco control.  JAMA.1993;270:479-486.
Glantz S, Smith LRA. The effect of ordinances requiring smoke-free restaurants on restaurant sales.  Am J Public Health.1994;84:1081-1085.
Glantz S, Smith L. Erratum for "The Effect of Ordinances Requiring Smoke-Free Restaurants on Restaurant Sales."  Am J Public Health.1997;88:1122.
Glantz S, Smith L. The effect of ordinances requiring smoke-free restaurants and bars on revenues: a follow-up.  Am J Public Health.1997;87:1687-1693.
Glantz S, Smith L. Erratum for "The Effect of Ordinances Requiring Smoke-Free Restaurants and Bars on Revenues: A Follow-up."  Am J Public Health.1998;88:1122.
Maroney N, Sherwood D, Stubblebin W. The Impact of Tobacco Control Ordinances on Restaurant Revenues in CaliforniaClaremont, Calif: Claremont Institute for Economic Policy Studies, Claremont Graduate School; January 1994.
Bartosch W, Pope G. The Economic Impact of Brookline's Restaurant Smoking BanWaltham, Mass: Health Economics Research Inc; November 1995.
Sciacca J, Ratliff M. Prohibiting smoking in restaurants: effects on restaurant sales.  Am J Health Promotion.1998;12:176-184.
Hwang P, Toblas S, Kohout S.  et al.  Assessment of the impact of a 100% smoke-free ordinance on restaurant sales, West Lake Hill, Texas, 1992-1994.  MMWR Morb Mortal Wkly Rep.1995;44:370-372.
Bialous SA, Glantz S. Tobacco control in Arizona, 1973-1997. San Francisco: University of California, San Francisco Institute for Health Policy Studies. Available at: http://www.library.ucsf.edu/tobacco/az/. Accessed April 15, 1999.
Hyland A, Cummings K, Nauenberg E. Analysis of taxable sales receipts: was New York City's smoke-free air bad for restaurant business?  J Public Health Manage Pract.1999;5:14-21.
Bartosch W, Pope G. The economic effect of smoke-free restaurant policies on restaurant business in Massachusetts.  J Public Health Manage Pract.1999;5:53-62.
Glantz S. Smokefree restaurant ordinances don't affect restaurant business.  J Public Health Manage Pract.1999;5:vi-ix.
US Census Bureau.  1990 Census Data Lookup Tools [database online]. C90STF3C1, Summary Level, Nation. Available at: http://venus.census.gov/cdrom/lookup/921606559. Accessed February 4, 1999.
Price Waterhouse.  Potential Economic Effects of a Smoking Ban in the State of California: Prepared for Southern California Business Association, Los Angeles County Hotel Motel Group, San Diego Tavern & Restaurant AssociationPrice Waterhouse, May 1993.
Harrie D, Crosby C. Senate rejects ban.  Salt Lake Tribune.February 20, 1992:B1.
Semerad T. Anti-smoking bill clears another hurdle: Senate passes measure, returns it to House for fine-tuning.  Salt Lake Tribune.March 1, 1994:A1.
Houskeeper E. Despite smoking ban, meals receipts grow: criticism of law continues to rage.  Sunday Rutland Herald & Sunday Times Argus.April 14, 1996:3.
Evans C. Smoking ban didn't burn bars, eateries.  Daily Camera.December 28, 1996:1A, 8A.
Restauranteurs for Responsible Choice.  Table Tent Advertisement Opposing Flagstaff Proposition 310Flagstaff, Ariz: Restauranteurs for Responsible Choice; 1992.
Innes C. Smoking ban revisited.  Arizona Daily Sun.July 18, 1993:1, 4.
Wagner G. Smoking ban threatens LA.  Lodging Hospitality.1993:48.
Los Angeles County Hotel and Motel Group.  California smoking law causing revenue loss in restaurant and hospitality industry: a recent study shows next year's smoking ban for bar areas expected to get worse [press release]. Los Angeles, Calif: KPMG Peat Marwick LLP; 1996.
Nowicki D. Anti-tobacco measure on ballot: would ban smoking in all "public places."  Mesa, Arizona Tribune.August 12, 1995:B1, B4.
National Smoker's Alliance.  The mess in Mesa.  NSA Voice.November/December 1996;4:4.
United Restaurant Hotel Tavern Association.  The City Council has it backwards.  New York Times.September 23, 1994.
Tobacco Institute and United Restaurant Hotel Tavern Association of New York State.  This Is a Restaurant Bill New York City Can't Afford to PayWashington, DC: Tobacco Institute; Albany: United Restaurant Hotel Tavern Association of New York State; 1994.
Stauber J, Rampton S. Toxic Sludge Is Good for YouMonroe, Me: Common Courage Press; 1995.
Dean Runyan Associates; for California Trade and Commerce Agency, Division of Tourism.  California Travel Impacts by CountyPortland, Ore: Dean Runyan Associates; 1998.
CIC Research I.  A Market Profile of Overseas Visitors to California.  San Diego, Calif: CIC Research I; 1998:xxi, xxiii.
State Board of Equalization.  Taxable Sales in California, Sales and Use Tax, 1986-1997Sacramento, Calif: State Board of Equalization; 1986-1997.
Utah Division of Travel Development.  International visitation to Utah, 1990-1997. Available at: http://www.dced.state.ut.us/travel/ResearchPlanning/utahdata97.pdf. Accessed April 15, 1999.
City of Boulder.  Sales and Use Tax Revenue Report, 1998Boulder, Colo: City of Boulder; May 1998.
Lines LM. Summary of total transient occupancy tax revenue, Mesa, Ariz, 1992-1998 [memo to C.K. Luster]. Mesa, Ariz: Office of Tax and Licensing Administrator, City of Mesa Tax and Licensing; 1992, 1994, 1996, 1998.
PKF Consulting.  New York City visitor statistics. In: New York City, NY: New York Convention & Visitor's Bureau; New York, NY: PKF Consulting; 1998.
San Francisco Treasurer/Tax Collector.  Annual Report, FY 96-97San Francisco, Calif: San Francisco Treasurer/Tax Collector; 1997.
San Francisco Treasurer/Tax Collector.  Annual Report, FY 92-93San Francisco, Calif: San Francisco Treasurer/Tax Collector; 1993.
US Department of Commerce Bureau of Economic Analysis.  National accounts data, gross domestic product by industry in current dollars, 1987-91 and 1992-97, line 62: hotels and other lodging places. [US Dept of Commerce Web site]. Available at: http://www.bea.doc.gov/bea/dn2/gpoc/htm. Accessed November 12, 1998.
Philip Morris Incorporated Web site.  Tobacco issues 1989: how today's smokers and non-smokers in Europe feel about smoking issues. Available at: http://www.pmdocs.com. Accessed April 15, 1999.
Siegel M. Involuntary smoking in the restaurant workplace: a review of employee exposure and health effects.  JAMA.1993;270:490-493.
Gerlach K, Shopland D, Hartman A, Gibson J, Pechacek T. Workplace smoking policies in the United States: results from a national survey of over 100,000 workers.  Tob Control.1997;6:199-206.

Figures

Figure 1. Hotel Revenues Before and After Implementation of the Ordinance
Graphic Jump Location
Hotel revenues in constant 1997 dollars for the 3 states and 6 cities with smoke-free restaurants included in this study. Significant changes in slope (P<.05) occurred for Utah, Los Angeles, Mesa, New York City, and Flagstaff.
Figure 2. Annual International Tourists and Effect of Smoke-Free Ordinances
Graphic Jump Location
Annual visitors from Japan (or Asia) and Germany (or Europe) to 3 locales where the effects of smoke-free restaurant ordinances on international tourism were an issue. The years in which 100% smoke-free bar ordinances were in effect are shown as solid points. Asterisks indicate significant changes in slope.
Figure 3. Reactions of European and American Smokers to Smoke-Free Ordinances in Restaurants
Graphic Jump Location
A survey done by Philip Morris Incorporated in 1989 demonstrated that European smokers were more accepting of smoke-free regulations than were Americans. Source of the data was the Minnesota Tobacco Litigation Depository (Bates No. 2500147496).46

Tables

Table Graphic Jump LocationTable 1. Predicted Effects of Smoke-Free Restaurant Ordinance on Tourism Made by the Tobacco Industry and Related Groups*
Table Graphic Jump LocationTable 3. Change in Hotel Revenues After Passage of Smoke-Free Restaurant Ordinances*
Table Graphic Jump LocationTable 4. Number of International Tourists in Thousands*

References

US Environmental Protection Agency.  Respiratory Health Effects of Passive Smoking: Lung Cancer and Other DisordersWashington, DC: US Environmental Protection Agency; 1992. Document EPA/600/6-90/006F.
Office of Environmental Health Hazard Assessment.  Health Effects of Exposure to Environmental Tobacco SmokeBerkeley: California Environmental Protection Agency; 1997. Available at: http://www.oehha.org/scientific/ets/finalets.htm. Accessed April 15, 1999.
Americans for Nonsmokers' Rights.  100% Smokefree OrdinancesBerkeley, Calif: Americans for Nonsmokers' Rights; September 1998.
Macdonald H, Glantz S. The political realities of statewide smoking legislation: the passage of California's Assembly Bill 13.  Tob Control.1997;6:41-54.
Woodruff T, Rosebrook B, Pierce J, Glantz S. Lower levels of cigarette consumption found in smoke-free workplaces in California.  Arch Intern Med.1993;153:1485-1493.
Samuels B, Glantz S. The politics of local tobacco control.  JAMA.1991;266:2110-2117.
Samuels B, Begay M, Hazan A, Glantz S. Philip Morris' failed experiment in Pittsburgh.  J Health Polit Policy Law.1992;17:329-351.
Traynor M, Begay ME, Glantz SA. New tobacco industry strategy to prevent local tobacco control.  JAMA.1993;270:479-486.
Glantz S, Smith LRA. The effect of ordinances requiring smoke-free restaurants on restaurant sales.  Am J Public Health.1994;84:1081-1085.
Glantz S, Smith L. Erratum for "The Effect of Ordinances Requiring Smoke-Free Restaurants on Restaurant Sales."  Am J Public Health.1997;88:1122.
Glantz S, Smith L. The effect of ordinances requiring smoke-free restaurants and bars on revenues: a follow-up.  Am J Public Health.1997;87:1687-1693.
Glantz S, Smith L. Erratum for "The Effect of Ordinances Requiring Smoke-Free Restaurants and Bars on Revenues: A Follow-up."  Am J Public Health.1998;88:1122.
Maroney N, Sherwood D, Stubblebin W. The Impact of Tobacco Control Ordinances on Restaurant Revenues in CaliforniaClaremont, Calif: Claremont Institute for Economic Policy Studies, Claremont Graduate School; January 1994.
Bartosch W, Pope G. The Economic Impact of Brookline's Restaurant Smoking BanWaltham, Mass: Health Economics Research Inc; November 1995.
Sciacca J, Ratliff M. Prohibiting smoking in restaurants: effects on restaurant sales.  Am J Health Promotion.1998;12:176-184.
Hwang P, Toblas S, Kohout S.  et al.  Assessment of the impact of a 100% smoke-free ordinance on restaurant sales, West Lake Hill, Texas, 1992-1994.  MMWR Morb Mortal Wkly Rep.1995;44:370-372.
Bialous SA, Glantz S. Tobacco control in Arizona, 1973-1997. San Francisco: University of California, San Francisco Institute for Health Policy Studies. Available at: http://www.library.ucsf.edu/tobacco/az/. Accessed April 15, 1999.
Hyland A, Cummings K, Nauenberg E. Analysis of taxable sales receipts: was New York City's smoke-free air bad for restaurant business?  J Public Health Manage Pract.1999;5:14-21.
Bartosch W, Pope G. The economic effect of smoke-free restaurant policies on restaurant business in Massachusetts.  J Public Health Manage Pract.1999;5:53-62.
Glantz S. Smokefree restaurant ordinances don't affect restaurant business.  J Public Health Manage Pract.1999;5:vi-ix.
US Census Bureau.  1990 Census Data Lookup Tools [database online]. C90STF3C1, Summary Level, Nation. Available at: http://venus.census.gov/cdrom/lookup/921606559. Accessed February 4, 1999.
Price Waterhouse.  Potential Economic Effects of a Smoking Ban in the State of California: Prepared for Southern California Business Association, Los Angeles County Hotel Motel Group, San Diego Tavern & Restaurant AssociationPrice Waterhouse, May 1993.
Harrie D, Crosby C. Senate rejects ban.  Salt Lake Tribune.February 20, 1992:B1.
Semerad T. Anti-smoking bill clears another hurdle: Senate passes measure, returns it to House for fine-tuning.  Salt Lake Tribune.March 1, 1994:A1.
Houskeeper E. Despite smoking ban, meals receipts grow: criticism of law continues to rage.  Sunday Rutland Herald & Sunday Times Argus.April 14, 1996:3.
Evans C. Smoking ban didn't burn bars, eateries.  Daily Camera.December 28, 1996:1A, 8A.
Restauranteurs for Responsible Choice.  Table Tent Advertisement Opposing Flagstaff Proposition 310Flagstaff, Ariz: Restauranteurs for Responsible Choice; 1992.
Innes C. Smoking ban revisited.  Arizona Daily Sun.July 18, 1993:1, 4.
Wagner G. Smoking ban threatens LA.  Lodging Hospitality.1993:48.
Los Angeles County Hotel and Motel Group.  California smoking law causing revenue loss in restaurant and hospitality industry: a recent study shows next year's smoking ban for bar areas expected to get worse [press release]. Los Angeles, Calif: KPMG Peat Marwick LLP; 1996.
Nowicki D. Anti-tobacco measure on ballot: would ban smoking in all "public places."  Mesa, Arizona Tribune.August 12, 1995:B1, B4.
National Smoker's Alliance.  The mess in Mesa.  NSA Voice.November/December 1996;4:4.
United Restaurant Hotel Tavern Association.  The City Council has it backwards.  New York Times.September 23, 1994.
Tobacco Institute and United Restaurant Hotel Tavern Association of New York State.  This Is a Restaurant Bill New York City Can't Afford to PayWashington, DC: Tobacco Institute; Albany: United Restaurant Hotel Tavern Association of New York State; 1994.
Stauber J, Rampton S. Toxic Sludge Is Good for YouMonroe, Me: Common Courage Press; 1995.
Dean Runyan Associates; for California Trade and Commerce Agency, Division of Tourism.  California Travel Impacts by CountyPortland, Ore: Dean Runyan Associates; 1998.
CIC Research I.  A Market Profile of Overseas Visitors to California.  San Diego, Calif: CIC Research I; 1998:xxi, xxiii.
State Board of Equalization.  Taxable Sales in California, Sales and Use Tax, 1986-1997Sacramento, Calif: State Board of Equalization; 1986-1997.
Utah Division of Travel Development.  International visitation to Utah, 1990-1997. Available at: http://www.dced.state.ut.us/travel/ResearchPlanning/utahdata97.pdf. Accessed April 15, 1999.
City of Boulder.  Sales and Use Tax Revenue Report, 1998Boulder, Colo: City of Boulder; May 1998.
Lines LM. Summary of total transient occupancy tax revenue, Mesa, Ariz, 1992-1998 [memo to C.K. Luster]. Mesa, Ariz: Office of Tax and Licensing Administrator, City of Mesa Tax and Licensing; 1992, 1994, 1996, 1998.
PKF Consulting.  New York City visitor statistics. In: New York City, NY: New York Convention & Visitor's Bureau; New York, NY: PKF Consulting; 1998.
San Francisco Treasurer/Tax Collector.  Annual Report, FY 96-97San Francisco, Calif: San Francisco Treasurer/Tax Collector; 1997.
San Francisco Treasurer/Tax Collector.  Annual Report, FY 92-93San Francisco, Calif: San Francisco Treasurer/Tax Collector; 1993.
US Department of Commerce Bureau of Economic Analysis.  National accounts data, gross domestic product by industry in current dollars, 1987-91 and 1992-97, line 62: hotels and other lodging places. [US Dept of Commerce Web site]. Available at: http://www.bea.doc.gov/bea/dn2/gpoc/htm. Accessed November 12, 1998.
Philip Morris Incorporated Web site.  Tobacco issues 1989: how today's smokers and non-smokers in Europe feel about smoking issues. Available at: http://www.pmdocs.com. Accessed April 15, 1999.
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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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