To the Editor: The introduction of indoor smoking restrictions in Western Australian pubs, clubs and nightclubs1 has been championed as a public health success and an advance in tobacco control. But how well is it being observed, and is the current legislation adequate?

Although smoking in Australia is declining, a report showed that one in seven 16–17-year-olds had smoked cigarettes in the previous month.2 Peer pressure has an important influence on smoking uptake,3 and alfresco hospitality settings, being exempt from the smoke-free restrictions, constitute important risk environments for young people. Moreover, 85% of adults in WA do not smoke, but continue to be affected by second-hand smoke drifting from alfresco balconies, beer gardens and street cafes. Indeed, the legislation risks turning these popular and highly visible entertainment areas into nicotine classrooms4 for the young, and “no-go” zones for health-conscious non-smokers.

We set out to evaluate compliance with the smoke-free legislation, and its impact on smoking in licensed premises. Twenty medical students were recruited to monitor smoking in 93 Perth hotels and nightclubs on two Friday evenings during November 2006. Entertainment areas were classified as indoor (smoke-free), semi-outdoor (smoke-free, failing to meet exemption criteria) and alfresco (smoking allowed), in accordance with the new legislation. Average observation times were 20 minutes, 17 minutes and 15 minutes respectively.

Indoor compliance with the legislation was high, with smoking noted in only five (5%) of the 93 premises. Whether by default or design, 58 premises (62%) had alfresco areas and there was smoking activity in those areas in 56 (97%) of these premises. Forty premises (43%) also had semi-outdoor areas where, contrary to the legislation, smoking remained prevalent (23 premises; 57.5%). Overall, smoking was observed in 69 of the 93 premises (74%). In 35 of these premises (51%), smoking was visible to the passing public.

These results demonstrate the inadequacy of the new smoke-free legislation in restricting smoking, protecting the health of non-smokers and strengthening tobacco control. The legislation has been well accepted, but smoking (legal and illegal) remains prevalent in licensed premises. This presents a serious challenge to tobacco control and efforts to reduce smoking by young people. A key lesson from the history of tobacco control is that partial bans achieve partial results.5 A complete ban on smoking, both inside and outside licensed premises and restaurants, is urgently required.