As evidence of the negative effects of environmental tobacco smoke (ETS) has mounted, an increasingly popular public policy response has been to impose restrictions on smoking through 100 percent smoke-free bans (comprehensive smoking bans). Yet sparse information exists regarding the impact these smoking bans at the state and local levels have on the health of children and infants. A rationale for expansion of smoke-free laws implicitly presumes that potential public health gains from reducing adult cigarette consumption and declines in adult ETS exposure extend to children. However, if smokers compensate by shifting their consumption of cigarettes from public venues that impose a comprehensive smoking ban to smoking at home, then these policies may have a harmful effect on children and infants. This study provides estimates of how comprehensive smoking bans impact the venue of smoking, and the health of children and infants. Using models that exploit state- and county-level changes to smoking ban legislation over time, estimates suggest that smoking bans have improved the health of both infants and children, mainly through implementation of more comprehensive bans. Further, we find no evidence of displacement among smokers (both smokers with and without children in the household), and actually find that the bans had a positive spillover effect in terms of reducing smoking inside the home—an effect that may further explain the improvement in infants’ and children’s health. Our effect magnitudes imply that expanding comprehensive coverage from 60 percent (current level) to 100 percent of the population can prevent between approximately 1,110 and 1,750 low birth weight births among low-educated mothers, resulting in economic cost savings of about $71–111 million annually. Health improvements among older children add to these economic benefits.

中文翻译：

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全面禁烟对婴幼儿健康的影响

随着越来越多的证据表明环境烟草烟雾（ETS）产生了负面影响，越来越流行的公共政策对策是通过100％无烟禁令（全面禁烟）对吸烟进行限制。然而，关于这些州和地方禁烟令对儿童和婴儿健康的影响的信息稀少。扩大无烟法律的理由隐含地假设，减少成人吸烟量和减少成人ETS暴露可能带来的公共健康收益将扩大到儿童身上。但是，如果吸烟者通过将禁止公共场所吸烟的公共场所的香烟消费转移到在家吸烟来进行补偿，那么这些政策可能会对儿童和婴儿产生有害影响。这项研究提供了关于全面禁止吸烟如何影响吸烟场所以及儿童和婴儿健康的估计。估计使用的模型利用州和县对吸烟禁令随时间的变化，主要是通过实施更全面的禁令，吸烟禁令改善了婴儿和儿童的健康。此外，我们没有发现吸烟者（家庭中有小孩和无小孩的吸烟者）之间有流离失所的迹象，并且实际上发现该禁令在减少家庭内部吸烟方面具有积极的溢出效应，这一效应可能进一步解释了这种改善在婴儿和儿童的健康方面。我们的影响程度表明，将全面覆盖率从60％（当前水平）扩大到100％的人口可以预防大约1 低学历的母亲中有110例和1,750例低体重儿出生，每年节省的经济成本约为71-1.11亿美元。年长儿童的健康改善增加了这些经济利益。