Secondhand Smoke Exposure in the Nonsmoking Section: How Much Protection?

Center for Energy and Environment, Minneapolis, MN 55401.
Nicotine & Tobacco Research (Impact Factor: 3.3). 12/2012; 15(7). DOI: 10.1093/ntr/nts263
Source: PubMed


Secondhand smoke (SHS) exposure continues to be a problem in bars and restaurants where smoking is permitted. This study measures the relative SHS exposure reduction in nonsmoking sections of establishments that allow some smoking.

Measurements were conducted simultaneously in the smoking and nonsmoking sections of 14 Minnesota hospitality venues. All of the 16 two-hr visits included photometer measurements of fine particles (PM2.5) and 12 of the visits also included measurements of 4 gas-phase tracers of SHS.

The median ratio of nonsmoking/smoking section PM2.5 concentrations was 0.65 with an interquartile range (IQR) of 0.49-0.72. Measurements conducted after implementation of a smoking ban at 13 of the venues resulted in a smoking section PM2.5 post-ban/pre-ban ratio of 0.06 (IQR = 0.02-0.16). The median nonsmoking/smoking section ratios for gas-phase compound were 0.67 (IQR = 0.35-0.78) for pyridine, 0.52 (IQR = 0.30-0.70) for pyrrole, 0.43 (IQR = 0.35-0.84) for 3-EP, and 0.27 (IQR = 0.16-0.47) for nicotine. These results are consistent with the expectations of differential removal: the lowest ratios are for the least volatile, most strongly sorbing gases and the highest ratios for less sorbing gases and PM2.5.

Designated nonsmoking sections in establishments that allow some smoking resulted in a median PM2.5 reduction of 35% compared with a 94% reduction after a smoking ban. The only adequate protection from cigarette smoke exposure is to eliminate smoking in indoor spaces.

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    ABSTRACT: Background Despite efforts to reduce exposure to secondhand smoke (SHS), only 5% of the world's population enjoy smoke-free restaurants and bars. Methods Lifetime excess risk (LER) of cancer death, ischaemic heart disease (IHD) death and asthma initiation among non-smoking restaurant and bar servers and patrons in Minnesota and the US were estimated using weighted field measurements of SHS constituents in Minnesota, existing data on tobacco use and multiple dose-response models. Results A continuous approach estimated a LER of lung cancer death (LCD) of 18×10−6(95% CI 13 to 23×10−6) for patrons visiting only designated non-smoking sections, 80×10−6(95% CI 66 to 95×10−6) for patrons visiting only smoking venues/sections and 802×10−6(95% CI 658 to 936×10−6) for servers in smoking-permitted venues. An attributable-risk (exposed/non-exposed) approach estimated a similar LER of LCD, a LER of IHD death about 10−2 for non-smokers with average SHS exposure from all sources and a LER of asthma initiation about 5% for servers with SHS exposure at work only. These risks correspond to 214 LCDs and 3001 IHD deaths among the general non-smoking population and 1420 new asthma cases among non-smoking servers in the US each year due to SHS exposure in restaurants and bars alone. Conclusions Health risks for patrons and servers from SHS exposure in restaurants and bars alone are well above the acceptable level. Restaurants and bars should be a priority for governments’ effort to create smoke-free environments and should not be exempt from smoking bans.
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