Smoke-Free Laws and Direct Democracy Initiatives on Smoking Bans in Germany: A Systematic Review and Quantitative Assessment

Abstract

Background: Germany’s 16 states regulate smoking differently within health protection principles laid down in the federal law. All state smoke-free laws in Germany have undergone at least one change since taking effect. Methods: We systematically review federal and state laws regulating smoking, as well as petitions, popular initiatives and referenda that aimed at changing statutory smoking bans. Data generated through the systematic review were correlated with state smoking rates. Results: The protection from the dangers of secondhand smoke is the primary motive for smoking bans in Germany. The first smoke-free laws affecting smoking in pubs, restaurants and several other public places were introduced in 2007. In 2008, the Federal Constitutional Court of Germany ruled in a leading decision on the smoke-free laws of two states that some common smoking ban exemptions of the introduced smoke-free laws violate the basic right to freely exercise a profession and mandated revisions. All states but Bavaria and Saarland, whose smoking bans were more and less comprehensive than those judged by the constitutional court, respectively, needed to change the smoking ban exemptions to reconcile their smoke-free laws with the constitution. Direct democracy initiatives to change smoking bans were only successful in Bavaria in 2010, but a total of 15 initiatives by citizens’ or interest groups attempted to influence non-smokers protection legislation through direct democratic procedures. Early ratification of a smoking ban in a federal state correlates with a higher reduction in the smoking rate from 2005 to 2009 (Spearman’s ρ = 0.51, p = 0.04). Conclusions: The federal government structure and direct democratic participation in smoke-free legislation in Germany has produced a diversity of local smoking bans and exemptions.

Normative misperceptions of tobacco use among university students in seven European countries: Baseline findings of the ‘Social Norms Intervention for the prevention of Polydrug usE’ study

“…In contrast, in Germany, while federal smoke-free laws to ban smoking in public places were passed in 2007 (Federal non-smokers protection Act , 2007; Law to protect against the dangers of passive smoking, 2007), smoking ban exemptions of the introduced law were subsequently passed at the state level. As a consequence, reductions in smoking rates (from 2005-2009) were only noted in those states with an early ratification of the law (Kohler & Minkner, 2014). Initiatives to harmonize tobacco control efforts across Europe, for example MPOWER (World Health Organization, 2014) which was launched in 2013, may result in more consistent reductions in smoking rates and associated morbidity and mortality in the decades to come.…”

The Effects of Smoking Bans on Self‐Assessed Health: Evidence from Germany

“…This interpretation of compliance due to norm activation is corroborated by popular support in favour of stricter bans: despite some controversial discussions, a majority of the German population largely supported strict smoking bans. For instance, more than 60% of voters voted for an intensification of bans in a plebiscite in the state of Bavaria in 2010 (Kohler and Minkner, ).…”

“…The key identifying assumption for the DD approach is that the federal states did not simultaneously adopt other tobacco control policies or health reforms with the introduction of smoking bans. In an extensive review of the legal framework of smoking bans in Germany, Kohler and Minkner () were “not aware of other significant differences between states with regards to tobacco control activities apart from the state smoke‐free legislation” (p. 691). In particular, no tobacco prevention campaigns overlap with the introduction of bans.…”

Public responses to a comprehensive smoking ban

“…Exceptions of this kind are in effect in parts of Germany, which permit smoking in small alcohol-serving establishments subject to a number of additional restrictions (Kohler and Minkner, 2014). Elsewhere, availability of a limited number of licenses to permit smoking could accommodate the highest volume bar and club customers, individuals who smoke and are the most confirmed opponents of ETS laws.…”

“…In Australia, support for a ban in alcohol-serving establishments varied according to the individual's dependence on tobacco, 44.2 percent of the "highly dependent" supporting a ban compared with 59.2 percent of the less dependent (Cooper et al, 2010). Opposition to bans covering alcohol-serving establishments in Germany has taken the form of legal action, opponents raising constitutional issues and claiming discrimination against small businesses (Kohler and Minkner, 2014).…”