Health and mortality outcomes
Study	Country	Setting	National Ban and Settings ban	Participants	Results
Binswanger 2014	USA	Prisons	National: Enactment varied by state ordinance. Since 1993 US Supreme Court ruling that suggested exposure of prisoners to environmental tobacco smoke considered "cruel and unusual punishment" in violation of 8th Amendment. Settings: Either smoke‐free (indoor ban), comprehensive (indoor and outdoor) or tobacco‐free policy.	Prisoners n = 287 prisons n = 14,499 prisoners	Smoking bans in place for 9 or more years were associated with reductions in smoking‐related mortality: RR 0.89, 95% CI 0.85 to 0.94. Cancer deaths: RR 81, 95% CI 0.74 to 0.90. Pulmonary deaths RR 0.66, 95% CI 0.54 to 0.80 compared to states with no bans. After adjusting for deaths from smoking‐related causes in the population, little change in point estimates, 95% CI were marginally wider. No significant results when analysed deaths from other causes 2001 to 2011, RR 1.05, 95% CI 1.00 to 1.09. 2004, 75.8% had ever smoked. Current male smokers aged 35 ‐ 64 years = 38.5%, and 17.7% for 65 years and older. Current female smokers: 46.7% (35 ‐ 64 years) and 5.9% (65 years and older). In 2001 25 states had a smoking ban. By 2011 48 states had a smoking ban. 44 banned smoking indoors and 39 banned smoking or tobacco outdoors.
Dickert 2015	USA, New Jersey	Prisons	National ban: New Jersey’s Smoke‐Free Air Act prohibits smoking in enclosed indoor spaces (2006). March 2010, an amendment banned the use of electronic smoking devices in indoor public places and workplaces and the sale to people 19 years and younger. Settings: NJDOC policy decision for tobacco‐free prisons, including grounds 2012. 13th Feb 2013 policy enacted to ban sales and use of all tobacco products for employees, visitors and prisoners.	Prisoners n = 13 prisons Census prisoners Jan ‐ June 2005 n = 26,239, prisoners special needs n = 3533 Census Jan ‐ June 2011, n = 22,318, prisoners special needs n = 3020	Total mortality was 3 times higher for persons with special health needs compared to all prisoners. Annual mortality rate decreased 13% from 232 to 203/100,000 population between 2005 and 2013 after smoking ban introduced. The mortality rate for persons with special mental health needs decreased 48% from average of 676/100,000 to 353/100,000 in 18 months after ban introduced.
Harris 2007	Canada, Ontario	Hospital	National: Ontario's Tobacco Control Act in 1994 banned smoking in all government buildings. Large psychiatric facilities, including MHCP, sought and received special dispensation to allow patients and some staff to smoke in specially ventilated rooms. "Smoking rooms" were already in existence on most wards and some common patient areas at MHCP. The hospital constructed smoking gazebos outside various buildings for patients and staff to use. Ontario's national smoke‐free legislation adopted in 2006. Settings: Comprehensive tobacco ban. Tobacco products no longer allowed anywhere on 225‐acre grounds after May 6, 2003.	Patients n = 119 n = 83 maximum security division n = 32 open wards	89% male, mean age 46.8 years (SD 11.1 yrs). Among 23 smokers rated as having signs of compromised cardiopulmonary health at their annual medical check‐ups in the year before the tobacco ban, 17 received a clear/healthy assessment at their annual physical examinations in the year after (P < 0.05, Fisher's exact test). For the majority of patients who were in the maximum security forensic division, the tobacco ban was associated with almost no detectable ill effects with some clear benefits. The ban was associated with an increase in physical aggression towards staff members in open wards only F (1,106) = 4.33, P < 0.05. Clozapine prescribing increased in smokers and weight increased in max security patients.
Morito 2015	Japan, Fukuoka	Hospital	No national ban. Settings: 1981 ‐ 2002 hospital provided separate facilities for smokers and nonsmokers. 2003 to 2006 introduced smoke‐free zones in hospital. Smoking areas and smoking tables subsequently removed. Hospital became smoke‐free (indoors) in 2007.	Patients Pre‐ changes 2002: n = 4 Stage 1 2003 ‐ 2006: n = 14 Stage 2 2007 ‐ 2010: n = 4 Stage 3 2011 ‐ 2014: n = 3	AMI data from January 2002 ‐ June 2014. Patients with an in‐hospital onset of AMI were defined as those who had AMI but were not under the care of Departments of Cardiology or Emergency. N = 25 patients identified in total Pre changes 2002: n = 4 Stage 1 2003 ‐ 2006: n = 14 Stage 2 2007 ‐ 2010: n = 4 Stage 3 2011 ‐ 2014: n = 3 P for trend = 0.010. n = 6 died ( Age 76 (SD 7)) ( 3 were smokers) n = 19 survived (Age 68 (SD 9)) (12/19 smokers) 10/ 25 AMI after surgical operation. 16 men and 9 women. No statistically significant difference in patient characteristics between operation and non‐operation groups except for DL (lipid‐lowering therapy). No differences between smoking and nonsmoking groups except for DL. Increasing nonsmoking policy decreased in hospital onset of AMI.