Position Statement: Smokefree outdoor dining and drinking and other public outdoor areas in Victoria

Despite progress made in reducing smoking rates in Victoria, tobacco remains the leading avoidable cause of cancer and a leading cause of cardiovascular disease, killing 4,000 Victorians each year.

In 2006, the Victorian Government introduced smoking bans in enclosed workplaces under the Tobacco Act 1987 (Vic) with some exemptions, which included liquor-licensed premises. In 2007, the exemption for liquor-licensed premises was removed. The implementation of these bans was supported by substantial evidence attributing risk for serious health effects from secondhand smoke exposure in enclosed areas.

Since this time, all Australian states and territories, with the exception of Victoria, have either adopted smoking bans in outdoor dining areas (including liquor-licensed premises) or announced intentions to ban smoking in outdoor dining areas. Each jurisdiction with bans affecting liquor-licensed premises has allowed an exemption for the owner/operator to designate a smoking area/s in the outdoor area of the liquor-licensed premises (subject to certain conditions).

 

There are opportunities for the Victorian Government to further protect the public from the harmful effects of secondhand smoke and to reduce young people’s exposure to role modelling of smoking behaviour through the extension of smokefree legislation to outdoor dining and drinking areas, as well as in other public places.

This position statement provides key points of evidence on the health effects of secondhand smoke exposure (sec. 3.1) and the role of smokefree areas in de-normalising smoking (sec. 3.2). It summarises the importance of statewide legislation to ensure consistency in smokefree public places (sec. 3.3); the adoption of smokefree outdoor areas in other Australian jurisdictions (sec. 3.4); enforcement of smokefree policy (3.5) and outlines Victorian support for smokefree outdoor areas (sec. 3.6).

 

Quit Victoria, the Cancer Council Victoria, the Heart Foundation (Victoria) and AMA Victoria recommend amendments to the Tobacco Act 1987 (Vic) to prohibit smoking in outdoor dining and drinking areas and other public outdoor areas (sec. 2).

The recommendations in this position statement have been developed with a focus on affording protection to children from exposure to secondhand smoke and role-modelling of smoking behaviour in particular outdoor settings.

 

For this reason, the majority of the recommendations are focused on applying comprehensive smokefree policy in outdoor settings where children are likely to be present. However our approach has been developed to recognise the importance of providing smokefree environments for children and adults alike. We do not believe that application or enforcement of the policy be contingent on children being present or only at times children’s activities are taking place (e.g. at a facility where children’s sporting games are taking place, or between hours in a setting when children are likely to be present). Comprehensive smokefree policies also ensure ease of implementation and consistency in enforcement.

 

Quit Victoria, Cancer Council Victoria, Heart Foundation (Victoria) and AMA Victoria recommend as a priority a statewide ban on smoking in:

• Outdoor dining and drinking areas*

 

In addition, the group recommends statewide smoking bans in other outdoor areas, including:

• Within 10 metres of children’s playground equipment

• Within 4 metres of entrances to public buildings

• Within 4 metres of public transport stops

• Sporting grounds and facilities

• Patrolled beaches, in the area that falls between the lifesavers’ flags

• Pedestrian malls (e.g. Bourke Street Mall)

• Public events (e.g. cultural or music festivals)

 

* Appendix A provides background information specific to smokefree outdoor dining and drinking. It addresses secondhand smoke exposure in outdoor dining and drinking areas, the economic impacts of smokefree policy and makes recommendations on the definition of smokefree outdoor dining and drinking. It also outlines requirements for holders of certain categories of liquor licence in relation to smokefree outdoor dining or drinking.

 

Laws banning smoking in workplaces and other public places serve two primary purposes. First, they help to protect the population against the ill health effects of secondhand smoke.(1) Secondly, they help to de-normalise smoking in a variety of contexts, such as in social situations.(1-4) Smokefree policies are also likely to decrease smoking cues for quitters and former smokers (5, 6) as well as decrease consumption among current smokers.(7-9)

 

A summary of research is provided below:

 

• Secondhand smoke may bring on acute health events like asthma, wheezing, nasal, throat and sinus irritation.(10) Approximately two million Australians suffer from asthma. Asthma was the underlying cause in 411 deaths in Australia in 2009.(11)

• Exposure to secondhand smoke increases the risk for chronic, and even fatal, health conditions that include cardiovascular disease, heart disease, and lung cancer.(12)

• The 2010 report of the US Surgeon General advised exposure to secondhand smoke for as little as 30 minutes abruptly reduces coronary blood flow velocity in non-smokers. Brief exposure to secondhand smoke is also associated with an increased risk of acute cardiac events. (12)

• Children are particularly vulnerable to secondhand smoke due to their higher breathing rates per body weight, greater lung surface relative to adults (13) and under some circumstances, an inability to remove themselves from a smoky environment.

• The health effects in children from secondhand smoke exposure can include wheezing, lower respiratory tract infections, asthma, decreased lung function, middle ear disease and increased risk of sudden infant death syndrome.(13, 14)

• Recent studies in outdoor dining and drinking areas indicate that secondhand smoke levels can exceed prescribed air quality standards.(15-19)

 

• Young people’s exposure to other smokers can lead to a perception that tobacco use is socially acceptable and that a high proportion of people smoke, and is associated with increased adolescent smoking. [17]

• Children and young people underestimate the addictive nature of tobacco and are at risk of becoming addicted before being old enough to be fully informed about its harmful effects.(20)

• Most people who smoke, start smoking before the age of 18. Young people who smoke are likely to continue to do so for up to 25 years.(21)

• Limiting tobacco use in public, reducing areas for opportunities to smoke and reshaping public opinion on smoking can all help to prevent smoking experimentation and smoking uptake among youth.(2-4, 22)

• In its systematic review of all the scientific evidence concerning the effectiveness of smokefree policies, the World Health Organisation International Agency for Research on Cancer reported there was ‘strong’ evidence that such policies reduce tobacco use among youth.(1)

• A 2010 survey of Victorian adults (n=4500) found that 52% of smokers reported not smoking at all around children and a further 34% reported smoking less than normal when around children. The most common reasons for not smoking or smoking less around children, were to protect children from secondhand smoke exposure (81%) and to set a good example (48%).(23)

 

A recent survey by the Heart Foundation (Victoria) and Quit Victoria found 41% of Victorian councils have some form of outdoor smokefree policy.(24) While the number of Victorian councils adopting smokefree policies in outdoor areas has increased over the past twelve months, the approach has been inconsistent across the state and thereby fails to offer comprehensive protection to all members of the public in areas where secondhand smoke concentrations are high, (15) or a comprehensive reduction in modelling behaviour.

Differences between local council areas in close proximity as well as difficulties in coverage of some areas not under local government control is resulting in anomalies and unintended difficulties for individual businesses. Statewide legislation is needed to provide a consistent approach across Victoria and to help reduce the public’s exposure to secondhand smoke and modelling of smoking behaviour. (1-4)

 

Smokefree outdoor areas legislation is common in other Australian jurisdictions. Comprehensive statewide smoking bans have been successfully implemented in the Australian Capital Territory, Northern Territory, Queensland and Western Australia. In Queensland, smoking is banned within 10 metres of children’s playground equipment, within four metres of entrances to non-residential buildings, at sports stadia managed by the Major Sports Facilities Authority, between the flags at patrolled beaches, and in all outdoor eating or drinking areas (other than designated outdoor smoking areas of licensed premises). (25)

The Public Health Amendment Bill 2011 successfully passed through Tasmanian Parliament on 10 November 2011. Among a number of reforms, the legislation sets out smoking restrictions in outdoor dining areas and within 3 metres of outdoor dining areas that are not surrounded by a screen at least 2.1 metres high and impervious to smoke. It also prohibits smoking at public swimming pools, between the flags at beaches, in pedestrian and bus malls, in and within 3 metres of bus shelters and in and within 10 metres of children’s playgrounds. The new laws will take effect from March 2012.

The South Australian Government’s Tobacco Control Strategy 2011-2016 details plans to phase in smokefree outdoor dining by 2016.(27) Similarly, the NSW Government has set out its goal to implement smokefree outdoor dining as well as smokefree playgrounds, public sports grounds, swimming pools, public transport stops and entrances to public buildings under the NSW Tobacco Strategy 2012-2017.(28)

 

Much of the literature reports that smokefree policies are largely ‘self-enforcing’, which suggests there is little need to call on substantial additional resources for implementation and enforcement of smokefree policy.

Strong community backing, signage, a communication strategy that explains expectations in relation to business and public behaviour and allowing adequate lead-in time for establishment of the law, are reported to be key to effectively introducing a new smokefree law. These elements help to establish a strong footing for the law to be mostly ‘self-enforcing’. However, proactive enforcement by Government / city officials (e.g. premise inspections and penalties for infringements), particularly early in the implementation period, provides important backing to ensure these laws have their intended effect.

In a 2007 review of Queensland smokefree laws, a 98% compliance rate was reported from over 1,000 inspections of Queensland smokefree outdoor dining and drinking areas (29). In a population survey conducted as part of this review (n=500), eighty five per cent of respondents reported they had stopped smoking in all areas where it is illegal to smoke at all times.(30)

A 2010 survey of NSW café and owners/operators (n=450) reported that of the 143 operators that run a smokefree establishment, 85% require patrons to smoke off the premises and 91% of these establishments reported it was “easy” or “very easy” to enforce this rule. (31)

 

Smokefree outdoor areas are strongly supported by the community. A 2010 Cancer Council Victoria survey found 70% of Victorian adults disapprove of smoking in outdoor dining areas. The survey also reported that 78% of Victorian adults thought smoking should be allowed within a designated outdoor area of licensed bars, pubs and clubs, which is at least two metres away, or separated from other patrons. (32)

The survey also showed Victorian adult’s disapproval of smoking in other outdoor areas:

• At outdoor areas where children are present (parks and playgrounds) - 77%

• Between the flags at beaches – 74%

• Near building entrances – 74%

• Uncovered areas of bus stops, tram stops and train stations – 61% (33)

Smokefree areas are also supported by a majority of smokers. Sixty two per cent disapprove of smoking at outdoor areas where children are present and 58% disapprove of smoking between the flags at beaches. (33)

A 2010 survey of 1,264 people by the City of Monash found strong support for outdoor smokefree policies:

• 75% supported a smoking ban in outdoor dining areas

• 76% supported a smoking ban in sport and recreation areas

• 72% supported a smoking ban for council run or sponsored events(34)

 

Suggested definition – smokefree outdoor dining and drinking

 

Prohibit smoking in:

In any outdoor dining or drinking area/s where food or beverages are served and/or consumed as part of a business

 

An exemption for a Designated Outdoor Smoking Area (DOSA) could be granted only under the following circumstances to holders of one of the following categories of liquor licence:

1) Club licence

2) General licence

3) On premises licence

The following would be recommended as mandatory in the establishment of a DOSA:

(i) No children permitted in the designated outdoor smoking area;

(ii) No service or consumption of food (including pre-packaged snack foods) and no bar service at any time in the designated outdoor smoking area;

(iii) No entertainment (e.g. live music, gaming machines, television screens) in the designated outdoor smoking area;

(iv) The designated outdoor smoking area should not exceed 50% of the entire outdoor area and consideration should be given to phasing out designated outdoor smoking areas (i.e. eventually 100% smokefree outdoor area) to minimise exposure to secondhand smoke and ensure as much protection as possible for hospitality staff and patrons.

(v) The smokefree outdoor area should be separated from the designated outdoor smoking area by a smoke impervious wall.

Note: Most Australian states and territories have provided the option of 2-metre wide “buffer zones” which separate designated smoking areas from no-smoking areas. However a smoke-impervious wall is likely to offer more substantial protection to staff and patrons by impeding airflow or smoke-drift into no-smoking areas. An impervious wall also more clearly delineates the smoking and no-smoking areas.

(vi) Specifications should be made in terms of the composition of the smoke impervious wall e.g. the wall must be impervious to smoke (no lattice or shrubbery). The height at least 2.1 metres high (based on average adult breathing height of generally 1.5 metres) and calculated from the highest point of the floor/ground. A single entry/exit point to the DOSA should also be specified, with the entry/exit point being no wider than 1 metre.

(vii) The designated smoking area should not be adjacent to an entry/exit to the enclosed area of the premises.

Note: Consideration should also be given to requiring these premises to maintain a Smoking Management Plan for the purpose of supporting compliance and enforcement.

 

The Plan would detail the specifications of the designated outdoor smoking (e.g. size, location), specifications of smoke impervious walls/ barriers between smoking and non-smoking areas, and outline the approach the premises has taken to ensure secondhand smoke exposure to staff and patrons is minimised (e.g. through staff education on what is permitted/not permitted in designated smoking area and strategies to respond to non-compliance).

 

Interpretation of the Tobacco Act 1987 (Vic)

In the Tobacco Act 1987 (Vic) (“the Act”), smoking is prohibited in enclosed licensed premises (enclosed is defined as "an area, room or premises that is or are substantially enclosed by a roof and walls, regardless of whether the roof or walls or any part of them are: permanent or temporary; open or closed"). Smoking is additionally prohibited in an outdoor dining or drinking area if there is a "roof and walls in place" and "the total actual area of the wall surfaces exceeds 75% of the total notional wall area".

 

The Act defines an outdoor dining or drinking area (under section 3) as "any of the following outdoor areas that is predominantly used for the consumption of food or drinks or both - (a) a balcony or verandah; (b) a courtyard; (c) a rooftop; (d) a marquee; (e) a street or footpath; (f) any similar outdoor area".(35)

Interpretation of these definitions in the Act can lead to 'quasi' outdoor areas that are substantially enclosed by walls and overhead cover.

 

Research findings indicate that secondhand smoke levels can exceed prescribed air quality standards in outdoor dining and drinking areas particularly when enclosure increases (i.e. roofs and walls), when the number of ignited cigarettes increases, when the measurement is taken nearby a smoker / smoking area, and when there is little wind movement.(15-19)

 

Klepeis, Ott and Switzer (2007), also reported that outdoor smoke particles near active sources (ignited cigarettes) can, under certain conditions, reflect that of smoke particles in enclosed areas.(15)

In a review of literature addressing environmental tobacco smoke in outdoor areas, the authors set out to gauge secondhand smoke exposure levels among hospitality staff in outdoor dining areas, given that hospitality staff’s work prescribes they spend extended periods in these settings. Using findings from observational studies (which recorded secondhand smoke particulate levels in outdoor dining areas), the authors projected possible secondhand exposure levels in staff working a typical eight-hour shift. Their modelling suggested that hospitality staff in outdoor dining settings could plausibly be exposed to secondhand smoke levels that exceed the annual average benchmark of the Australian National Environmental Protection Measures for Ambient Air Quality. (36)

 

Downturns in hospitality trade may be cited in opposition to the implementation of smokefree policy, yet there is substantial evidence to show that loss of revenue (if any) is short-lived or never actually realised when a smokefree policy is introduced. A 2003 review of 100 economic studies assessing the impact of indoor smokefree law on trade found there was no impact, or no lasting negative impact on trade as a result of the bans. (37) In a systematic review of all the scientific evidence concerning the effectiveness of smokefree policies, the World Health Organization International Agency for Research on Cancer found that there was “sufficient” evidence (the highest category of scientific certainty) that such policies do not cause a decline in business. (1)

 

1. IARC Working Group on the Evaluation of the Effectiveness of Smoke-free Policies. Evaluating the effectiveness of smoke-free policies. Lyon, France: International Agency for Research on Cancer, 2009 May 30, 2011. Report No.: Contract No.: May 30. Available from: http://www.iarc.fr/en/publications/pdfs-online/prev/handbook13/index.php.

2. Smart RG, Stoduto G. Interventions by students in friends' alcohol, tobacco, and drug use. J Drug Educ. 1997;27(3):213-22. Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9366127.

3. Wakefield MA, Chaloupka FJ, Kaufman NJ, Orleans CT, Barker DC, Ruel EE. Effect of restrictions on smoking at home, at school, and in public places on teenage smoking: cross sectional study. BMJ. 2000;321(7257):333-7. Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10926588.

4. Winstanley M, Wood L. Chapter 5. Factors influencing the uptake and prevention of smoking. Melbourne: Cancer Council Victoria; 2008. Available from: http://www.tobaccoinaustralia.org.au/chapter-5-uptake.

5. Baker J. What helped recent quitters in Victoria to quit: findings from the 2009 population survey. Topline research report. Centre for Behavioural Research in Cancer, Cancer Council Victoria, 2009.

6. McCarthy M, Abbott J. What helped recent quitters in Victoria to quit: findings from the 2008 population survey. Melbourne, Australia: Centre for Behavioural Research in Cancer, Cancer Council Victoria, 2009.

7. Chapman S, Borland R, Scollo M, Brownson RC, Dominello A, Woodward S. The impact of smoke-free workplaces on declining cigarette consumption in Australia and the United States. Am J Public Health. 1999;89(7):1018-23. Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10394309.

8. Pierce JP, Leon M. Effectiveness of smoke-free policies. Lancet Oncol. 2008;9(7):614-5. Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19274803.

9. Owen N, Borland R. Delayed compensatory cigarette consumption after a workplace smoking ban. Tob Control. 1997;6(2):131-5. Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9291223.

10. United States. Surgeon-General's Office. United States. Office on Smoking and Health. The health consequences of involuntary smoking : a report of the Surgeon General. Rockville, Md.: United States. Public Health Service. Office on Smoking and Health; 1986. Available from: http://sgreports.nlm.nih.gov/NN/B/C/P/M/

11. Australian Centre for Asthma Monitoring 2011. Asthma in Australia 2011: with a focus chapter on chronic obstructive pulmonary disease. Asthma series no. 4. Cat. no. ACM 22. Canberra: AIHW, 2011. Available from: http://www.aihw.gov.au/publication-detail/?id=10737420159.

12. United States Public Health Service. Office of the Surgeon General. How tobacco smoke causes disease: the biology and behavioral basis for smoking-attributable disease : a report of the Surgeon General. Rockville, MD: Dept. of Health and Human Services, Public Health Service, Office of Surgeon General; 2010. Available from: http://www.surgeongeneral.gov/library/tobaccosmoke/report/index.html.

13. Office of Environmental Health Hazard Assessment OEHHA. California Air Resources Board ARB. California Environmental Protection Agency Cal/EPA. Health effects of exposure to

Position statement – Smokefree outdoor dining & drinking and other public outdoor areas in Victoria

Quit Victoria, Cancer Council Victoria, Heart Foundation (Victoria) and AMA Victoria

11

environmental tobacco smoke: Final Report, approved at the Panel's June 24, 2005 meeting. Sacramento: Office of Environmental Health Hazard Assessment; 2005 [updated September 01, 2005; cited 2011 May 30]; Available from:

http://oehha.ca.gov/air/environmental_tobacco/2005etsfinal.html.

14. U.S. Department of Health and Human Services. The health consequences of involuntary exposure to tobacco smoke: a report of the Surgeon General. [Atlanta, Ga.]: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2006. Available from: http://www.surgeongeneral.gov/library/secondhandsmoke/report/.

15. Klepeis N, Ott W, Switzer P. Real-time measurement of outdoor tobacco smoke particles. J Air Waste Manag Assoc. 2007;57(5):522–34. Available from: http://www.ashaust.org.au/pdfs/OutdoorSHS0705.pdf.

16. Cameron M, Brennan E, Durkin S, Borland R, Travers MJ, Hyland A, et al. Secondhand smoke exposure (PM2.5) in outdoor dining areas and its correlates. Tob Control. 2010;19(1):19-23. Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19850553.

17. Stafford J, Daube M, Franklin P. Second hand smoke in alfresco areas. Health Promot J Austr. 2010;21(2):99-105. Available from: http://healthsciences.curtin.edu.au/watdsp/local/docs/second_hand_smoke_in_alfresco_areas.pdf.

18. Travers M, Higbee C, Hyland A. Vancouver Island Outdoor Smoking Area Air Monitoring Study 2007. Buffalo NY: Roswell Park Cancer Institute; 2007 [updated 13 April, 2007; cited 2011 May 30]; 1-20]. Available from: http://www.itcconference.com/ITCWorkshopResources/SFA_Resources/TSI_Sidepak_Particle_Monitoring_Refs/VancouverIslandOSAReport4-10-07.pdf.

19. Wilson N, Edwards R, Parry R. A persisting secondhand smoke hazard in urban public places: results from fine particulate (PM2.5) air sampling. The New Zealand Medical Journal. 2011;124(1330):34-46. Available from: http://www.nzma.org.nz/journal/124-1330/4564/.

20. DiFranza JR, Savageau JA, Fletcher K, O'Loughlin J, Pbert L, Ockene JK, et al. Symptoms of tobacco dependence after brief intermittent use: the Development and Assessment of Nicotine Dependence in Youth-2 study. Arch Pediatr Adolesc Med. 2007;161(7):704-10. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17606835.

21. Pierce JP, Gilpin E. How long will today's new adolescent smoker be addicted to cigarettes? Am J Public Health. 1996;86(2):253-6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8633747.

22. Alesci NL, Forster JL, Blaine T. Smoking visibility, perceived acceptability, and frequency in various locations among youth and adults. Prev Med. 2003;36(3):272-81. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12634018.

23. Hayes L, Baker J. Smoking behaviour in homes, cars and around children in Victoria, 1998−2010. Topline Research Report. Melbourne, Victoria: Centre for Behavioural Research in Cancer. Cancer Council Victoria, 2011.

24. Heart Foundation (Victoria) and Quit Victoria. Smoke-free policies in outdoor areas - A 2011 Victorian council survey report. Melbourne: 2011.

25. Tobacco and Other Smoking Products Act 1998 (s2c). Sect. 2c (2010).

26. Public Health Amendment Bill 2011. no. 56.

27. Government of South Australia. South Australian Tobacco Control Strategy 2011-2016. Drug and Alcohol Services South Australia, 2011. Available from: http://www.dassa.sa.gov.au/site/page.cfm?u=117.

28. NSW Government. NSW Tobacco Strategy 2012-2017. NSW Ministry of Health, 2012. Available from: http://www.health.nsw.gov.au/pubs/2012/pdf/nsw_tobacco_strategy_2012.pdf.

29. Queensland Health. 2007 Review of Smoke-free Laws - Discussion Paper. Queensland Government; 2007 [cited 2011 May 31]; 1-26]. Available from: http://www.health.qld.gov.au/tobaccolaws/documents/33161.pdf.

Position statement – Smokefree outdoor dining & drinking and other public outdoor areas in Victoria

Quit Victoria, Cancer Council Victoria, Heart Foundation (Victoria) and AMA Victoria

12

30. Market Communications Research. Tobacco Laws Campaign Evaluation - A quantitative research report. Queensland: MCR for Queensland Health; 2006 [updated September 2006; cited 2011 June 2]; Available from: http://www.ashaust.org.au/SF'03/files/QldReport0609.pdf.

31. Ipsos-Eureka Social Research Institute. Smoking bans in alfresco dining areas - Attitudes of cafe and restaurant owners / managers. North Sydney, NSW: National Heart Foundation and the Cancer Council NSW, 2010.

32. Baker J, Hayes L. Attitudes towards smoking in outdoor areas of restaurants, and licensed bars, pubs and clubs: findings from the 2010 population survey (Topline research report). Melbourne, Australia: Centre for Behavioural Research in Cancer, Cancer Council Victoria, 2011.

33. Baker J. Attitudes towards smoking at outdoor areas: Findings from the Victorian Smoking and Health Surveys (Topline research report). Melbourne, Australia: Centre for Behavioural Research in Cancer, Cancer Council Victoria, 2011.

34. Monash City Council. Report to Council. Section 8.3, Smoke Free Environments. 22 February 2011. Available from: http://monash.vic.gov.au/reports/pdftext/cp22feb11/8.3.pdf.

35. Tobacco Act 1987 (Vic).

36. Chapman S, Hyland A. Environmental tobacco smoke in outdoor areas: a rapid review of the research literature. New South Wales: NSW Health, 2010. Available from: http://ses.library.usyd.edu.au/handle/2123/7914.

37. Scollo M, Lal A, Hyland A, Glantz S. Review of the quality of studies on the economic effects of smoke-free policies on the hospitality industry. Tob Control. 2003;12(1):13-20. Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12612356