Since some countries banned smoking in public places in 2004, there has been a reduction in secondhand smoke exposure (being affected by smoke from other people's cigarettes), and health has improved for smokers and nonsmokers. Being exposed to secondhand smoke can increase the chances of illness and death, and so a number of international health organisations support the introduction of methods to reduce exposure to tobacco and secondhand smoke, including smoking bans. Studies have shown that workplaces providing services to help smokers to stop smoking have been effective. Services can include providing nicotine replacement therapy (NRT) and counselling support to help smokers quit. However, it is not known if policies that stop people smoking in institutions are effective. Whilst smoking is banned in many public places, it is not banned in all of them. Smoking is allowed in some healthcare organisations, universities and prisons.

Study characteristics

We searched for studies that measured whether introducing a smoking policy or ban, in hospitals, universities or prisons, reduced secondhand smoke exposure and helped people to quit smoking. The study could be in any language. It had to report information on health and smoking before the policy or ban started and for at least six months afterwards. We have included 17 studies in this review. Twelve studies provide evidence from hospitals, three from prisons and two from universities. The evidence is up-to-date to June 2015.

Key results

We grouped together 11 of the included studies, involving 12,485 people, and found that banning smoking in hospitals and universities increased the number of smoking quit attempts and reduced the number of people smoking. In prisons, there was a reduction in the number of people who died from diseases related to smoking and a reduction in exposure to secondhand smoke after policies and bans were introduced, but there was no evidence of reduced smoking rates.

Quality of the evidence

We found no relevant high-quality studies to include in our review. Future high-quality research may lead to a change in these conclusions and it is not possible to draw firm conclusions from the current evidence. We need more research from larger studies to investigate smoking bans and policies in these important settings.