The effects of the smoking ban

Federal researchers are studying the economic impact of North Carolina's nearly 2-year-old ban on smoking in restaurants and bars.

What they are likely to learn, according to local restaurant and bar operators and patrons, is that the law has been positive overall, but with some interesting side effects.

For example, since the no-smoking law went into effect, Brian and Kim Hall of King — both smokers — have ordered more takeout meals from restaurants than they used to. The Halls estimated they chose a smoking restaurant 90 percent of the time when they had the option.

"Being in smoke at a restaurant didn't bother us considering most places were well ventilated," Kim Hall said during lunchtime recently at Omega House on Peters Creek Parkway in Winston-Salem — a restaurant once known for its embrace of smokers.

"Now, we do the takeout most times for the convenience of being able to have a smoke after we're done eating. It may not make for as enjoyable an evening, but it's our new reality."

The smoking law played a role in the owners of Christopher's 1776, a downtown Winston-Salem restaurant, choosing to close as of today. The restaurant, which opened in 2005, is at 712 Brookstown Ave.

Christopher Fulk, a co-owner, said the restaurant had struggled because fewer people were eating out because of the recession.

"Christopher's always has been nonsmoking, and being that way represented good business for us at that time," Fulk said. "When the ban went into effect, and every restaurant went nonsmoking, it didn't represent a dramatic factor, but it didn't help us."

About 24,000 establishments are covered by the N.C. law, which went into effect Jan. 2, 2010. Smoking is allowed in outdoor areas of bars and restaurants. Cigar bars, country clubs and fraternal organizations are exempt.

The Centers for Disease Control and Prevention, through researchers at the Research Triangle Institute Foundation, is studying nine states' smoking ban policies. Previous CDC studies on the health side of the smoking bans cite a benefit by reducing nonsmokers' exposure to secondhand smoke and helping employees who smoke to quit.

"While the health benefits of smoke-free policies are clear, the perception that they might negatively affect restaurant and bar business can pose a barrier to the broader introduction and acceptance of these policies," the CDC said.

The institute said it will use non-disclosed "objective economic indicators" to project the impact of statewide smoking bans on restaurants and bars. Pharmaceutical giant Pfizer is providing a grant to the initiative.

However, some tobacco advocates are concerned that the CDC study will only reveal preconceived expectations, particularly since CDC Director Dr. Thomas Frieden said in the agency's statement that "making work sites, restaurants and bars smoke-free saves lives, increases productivity, reduces health-care costs and doesn't hurt business."

Other states involved in the initiative are Alabama, Indiana, Kentucky, Mississippi, Missouri, South Carolina, Texas and West Virginia. The economic analyses and related educational materials are scheduled to be finished in the second half of 2012.

One area where the smoke already may have cleared on economic benefits and costs may be in infrastructure expenses.

Some restaurants and bars reported having lower maintenance costs, while others are getting less benefit from five- and six-figure investments in high-level air-filtration systems.

Lea Thullberry, general manager of Finnigan's Wake on Trade Street in downtown Winston-Salem, said the restaurant — known for its smoking clientele before the ban — spent "thousands of dollars" on renovations. It already was planning to expand its dining space when the ban went into effect.

"We thoroughly cleaned the pub, swapped out the menus and mats, added an outdoor dining area that's not heated," Thullberry said. "We did a lot of research and figured we might see up to a 30 percent decline in customers in the first three months. Fortunately, we saw none of that.

"It's been more about people who had dined with us before the ban sticking with us — including making sure they still would be comfortable here — than a surge in new business because of the ban.

"We're doing our best to accommodate smokers and nonsmokers."

The smoking ban has produced more positives than negatives for New Town Bistro off Jonestown Road, according to its operator Kyle Agha. Officials spent more than $20,000 on patio furniture and heaters. There are plans to enclose the patio when funding permits, Agha said.

"There may be at times a decline in the number of people at the bar because they can't smoke," Agha said. "I know some people are choosing to buy their alcohol and take it home with them so they can smoke and drink in their comfort.

"At the same time, we're serving more meals in the bar area because more people feel comfortable sitting there because they're not dealing with smoke anymore."

Still, Agha said, he still can't determine how much the restaurant's sales have been affected by the smoking ban considering the overall sour economy.

"Some customers just aren't dining out as much, and they aren't as likely to linger," Agha said.

John Ioannou, co-owner of the Omega House restaurant, said the smoking ban has played out like he thought it would."

"Many smokers still come in here because they know they have an outlet for smoking in front of the restaurant," Ioannou said.

"But more people are leaving now soon after finishing their meal rather than lingering over a smoke and spending more time with family and friends."

Jim Martin, with the state's Tobacco Prevention and Control Branch, said he is eager to see the results of the CDC study.

His agency also is reviewing the economic performance of restaurants and bars in the 10 years before the ban went into effect. It also serves as the monitoring group for inspections and any bars and restaurants that are fined for violating the ban.

Businesses violating the ban receive a written warning for the first two violations and are fined $200 for subsequent violations. Customers who refuse to comply with requests to stop smoking can be fined up to $50.

"The system has worked well overall," Martin said. "We thought we would have a lot of complaints and violations in the first few months as some businesses and bars weighed whether to absorb the fines as a cost of doing business.

"There were 530 complaints in the first three months, but they've leveled off to about 20 a month during 2011."

Paul Shore, president and chief executive of the N.C. Restaurant and Lodging Association, said most restaurants have reported sales being flat or up overall since the ban went into effect. The association supported the ban once it became "comprehensive enough to create a level playing field," he said.

Shore said the ban's affect wasn't as intrusive with restaurants as bars because about half of restaurants already were smoke free in North Carolina.

Michael Walden, an economics professor at N.C. State, said the CDC study could help settle the debate over how smoking restrictions should be handled.

"Should private firms address them — as many have — either through bans or seating restrictions?" Walden said. "In this case, the individual firms will take into account the impacts on profitability.

"Or, should the public sector issue broad restrictions, which — some say — may not completely account for impacts on profitability. If this study can develop some definitive findings on these issues, then they will be helpful in the on-going discussion."

Another economic side of the smoking ban is on health care.

State health officials recently cited the ban in the decline of emergency-room visits for heart-attack symptoms. Those visits for North Carolinians have diminished 21 percent since 2009. However, an official with the American Council on Science and Health, a national group that analyzes and questions scientific studies, said she is skeptical of a correlation between the smoking ban and fewer heart attacks.

"It's an outrageous claim and unscientific," said Dr. Elizabeth Whelan of the ACSH. "There is no evidence that exposure to secondhand smoke involves heart attacks or cardiac arrest. The reduction is more likely the result of smokers giving up smoking than reduced exposure to secondhand smoke."

Researchers from the N.C. Division of Public Health and the UNC Department of Emergency Medicine conducted their study as a follow-up on national and international reports that found a cause-and-effect of smoke-free laws with reduced heart-attack rates.

Dr. Jeffrey Engel, the state's health director, said the decline in heart attacks in North Carolina during 2010 represents an estimated $3.3 million to $4.8 million in health-care cost savings.