Context: On July 1, 2005, the city of Appleton became the 3rd Wisconsin community to implement an ordinance banning smoking in all public places, including bars and restaurants. Two referenda to appeal the restrictions were subsequently defeated in April and November, 2006.

Problem/Objective: 1) To examine changes in public preferences, acceptance, and bar patronage behaviors related to the smoke-free ordinance over a 20-month period; 2) To analyze the relationship between smoking status, socioeconomic background and changes in attitudes and behaviors.

Methods: Multivariate analysis of cross-sectional data. Study subjects were 1,200 Appleton residents age 18 and older, who were randomly selected and interviewed either in June 2005, February 2006, or February 2007.

Results: The level of support and acceptance stalled after the first 7 months. While the preference toward smoke-free bars or taverns increased slowly, the bar-goers did not frequent bars as often as they used to and tended to patronize establishments outside of city limits. Most negative outcomes were determined by smoking status. However, 20 months after the implementation, preferences for smoke-free establishments continued to increase and support and acceptance increased. Age, socioeconomic status, smoking status, drinking behavior, smoking restrictions in the home and living with smokers were associated with those behaviors and attitudes.

Conclusions: Public preference and support for smoke-free bars and taverns takes time. This change in attitudes is more apparent approximately one year post-implementation. Smoke-free indoor air campaign workers should continue to focus efforts on educating smokers and their families about the harms associated with ETS.