Developing survey measures to guide tobacco regulation in a large municipality

A survey of resident opinion regarding changes to the Fort Worth, Texas municipal smoking ordinance was requested by an ad hoc committee tasked with reviewing current regulations and making recommendations to elected officials regarding additional restrictions. Following a multi-disciplinary questionnaire design process, stakeholder approval for the instrument was secured prior to telephonic administration. The cross-sectional survey employed a random sample of telephone numbers with further randomization of household residents. Surveys were administered in English and Spanish by trained interviewers. A remarkably high response rate (61%) was attained, possibly indicating heightened interest in the issue. Over eighty percent of respondents consider exposure to second hand smoke a moderate to serious health hazard and the majority of respondents (56.8%) favored changing the current ordinance. Respondents were asked about additional restrictions at eight specific venue classifications, with almost all of those who favor changes to the ordinance stating a preference for smoke free restaurants and fewer than half favoring additional restrictions in sexually oriented businesses. Almost ninety percent of respondents reported increased or sustained patronization levels of bars and restaurants if a more restrictive smoking ordinance were enacted. However over ninety percent of smokers reported they would patronize bars and restaurants less frequently if more smoking restrictions were enacted. Many factors are important in the consideration of policy changes targeting public health improvements. Though often not primary among these factors, measures of public opinion and perception are essential to gauge the acceptability, feasibility, and ultimate success of any new law or regulation.