The impact of the Cyprus comprehensive smoking ban on air quality and economic business of hospitality venues

BMC Public Health

Gregory N Connolly²  Constantine Vardavas²  Martha Kehagias¹  Despina Pampaka¹  Martha Paisi¹  Costas A Christophi³ 

[1] Cyprus International Institute for Environmental and Public Health in association with Harvard School of Public Health, Cyprus University of Technology, 95 Eirinis Street, Rm 201, 3041, Limassol, CYPRUS;Center for Global Tobacco Control, Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA, USA;Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA

关键词: Economic viability;    Smoking ban;    Secondhand smoking;    Tobacco smoke;    Environmental pollution;   

Others  :  1162603
DOI  :  10.1186/1471-2458-13-76

 received in 2012-07-30, accepted in 2013-01-16,  发布年份 2013

【 摘 要 】

Background

Several countries, including Cyprus, have passed smoke-free legislations in recent years. The goal of this study was to assess the indoor levels of particulate matter in hospitality venues in Cyprus before and after the implementation of the law on 1/1/2010, evaluate the role of enforcement, and examine the legislation’s effect on revenue and employment.

Methods

Several hospitality venues (n = 35) were sampled between April 2007 and January 2008, and 21 of those were re-sampled after the introduction of the smoking ban, between March and May 2010. Data on enforcement was provided by the Cyprus Police whereas data on revenue and employment within the hospitality industry of Cyprus were obtained from the Cyprus Statistical Service; comparisons were made between the corresponding figures before and after the implementation of the law.

Results

The median level of PM_2.5 associated with secondhand smoking was 161 μg/m³ pre-ban and dropped to 3 μg/m³ post-ban (98% decrease, p < 0.0001). Furthermore, in the year following the ban, the hotel turnover rate increased by 4.1% and the restaurant revenue by 6.4%; employment increased that same year by 7.2% and 1.0%, respectively.

Conclusion

Smoke free legislations, when enforced, are highly effective in improving the air quality and reducing the levels of indoor PM_2.5. Strict enforcement plays a key role in the successful implementation of smoking bans. Even in nations with high smoking prevalence comprehensive smoking laws can be effectively implemented and have no negative effect on accommodation, food, and beverage services.

【 授权许可】

   
2013 Christophi et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Koh HK, Joossens MA, Connolly G: Making smoking history worldwide. N Engl J Med 2007, 356:1496-1498.
• [2]World Health Organization: WHO Report on the Global Tobacco Eepidemic, 2009: Implementing Smoke-Free Environments. Geneva (Switzerland): The Organization; 2008. [(accessed 2009 Jan. 29)]. Available: http://www.who.int/tobacco/mpower/en/index.html webcite
• [3]U.S. Department of Health and Human Services: Chidren and Secondhand Smoke Exposure. Excerpts from The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Atlanta, GA: U.S: Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2007. http://www.surgeongeneral.gov/library/reports/smokeexposure/fullreport.pdf webcite
• [4]US Department of Health and Human Services: The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Atlanta, G.A: US Department of Health and Human Services, Center for Disease Control and Prevention, Coordinating Center of Health Promotion, National Center for Chronic Disease Prevention and Health Promotion. Office on Smoking and Health; 2006. http://www.surgeongeneral.gov/library/reports/secondhandsmoke/index.html webcite
• [5]Repace JL: Respirable particles and carcinogens in the air of Delaware hospitality venues before and after a smoking ban. JOEM 2004, 46:887-905.
• [6]Liu R, Yang Y, Travers MJ, Fong GT, O’Connor RJ, Hyland A, Li L, Nan Y, Feng GZ, Li Q, Jiang Y: A cross-sectional study on levels of second-hand smoke in restaurants and bars in five cities in China. Tob Control 2010, 19(2):i24-i29.
• [7]Travers MJ, Cummings KM, Hyland A, Repace J, Babb S, Caraballo R: Indoor air quality in hospitality venues before and after the implementation of a clean indoor air law – Western New York. MMWR 2003, 53(44):1038-1041.
• [8]Ellingsen DG, Fladseth G, Daae HL, Gjølstad M, Kjaerheim K, Skogstad M, Olsen R, Thorud S, Molander P: Airborne exposure and biological monitoring of bar and restaurant workers before and after the introduction of a smoking ban. J Environ Monit 2006, 8(3):362-8.
• [9]Valente P, Forastiere F, Bacosi A, Cattani G, Di Carlo S, Ferri M, Figΰ-Talamanca I, Marconi A, Paoletti L, Perucci C, Zuccaro P: Exposure to fine and ultrafine particles from secondhand smoke in public places before and after the smoking ban, Italy 2005. Tob Control 2007, 16(5):312-317.
• [10]Meyers DG, Neuberger JS, He J: Cardiovascular effect of bans on smoking in public places: a systematic review and meta-analysis. J Am Coll Cardiology 2009, 54(14):1249-1255.
• [11]Sargent RP, Shepard RM, Glantz S: Reduced incidence of admissions for myocardial infarction associated with public smoking ban: before and after study. BMJ 2004, 328:977-983.
• [12]Bartecchi C, Alsever RN, Nevin-Woods C, Thomas WM, Estacio RO, Bartelson BB, Krantz MJ: Reduction in the incidence of acute myocardial infarction associated with a citywide smoking ordinance. Circulation 2006, 114:1490-1496.
• [13]Barone-Adesi F, Vizzini L, Merletti F, Richiardi L: Short-term effects of Italian smoking regulation on rates of hospital admission for acute myocardial infarction. Eur Heart J 2006, 27:2468-2472.
• [14]Khuder SA, Milz S, Jordan T, Price J, Silvestri K, Butler P: The impact of a smoking ban on hospital admissions for coronary heart disease. Prev Med 2007, 45:3-8.
• [15]Juster HR, Loomis MS, Hinman TM, Farrelly MC, Hyland A, Bauer UE, Birkhead GS: Declines in hospital admissions for acute myocardial Infarction in New York state after implementation of a comprehensive smoking ban. Am J Public Health 2007, 97:2035-2039.
• [16]Cesaroni G, Forastiere F, Agabiti N, Valente P, Zuccaro P, Perucci C: Effect of the Italian smoking ban on population rates of acute coronary events. Circulation 2008, 117:1183-1188.
• [17]Pell JP, Haw S, Cobbs S, Newby DE, Pell ACH, Fischbacher C, McConnachie A, Pringle S, Murdoch D, Dunn F, Oldroyd K, MacIntyre P, O'Rourke B, Borland W: Smoke-free legislation and hospitalizations for acute coronary syndrome. N Engl J Med 2008, 359:482-491.
• [18]Naiman A, Glazier RH, Moineddin R: Association of anti-smoking legislation with rates of hospital admission for cardiovascular and respiratory conditions. CMAJ 2012, 182(8):761-767.
• [19]Semple S, Creely KS, Naji A, Miller BG, Ayres JG: Second-hand smoke levels in Scottish pubs: the effect of smoke-free legislation. Tob Control 2007, 16:127-132.
• [20]Rosen LJ, Zucker DM, Rosen BJ, Connolly GN: Second-hand smoke levels in Israeli bars, pubs and cafes before and after implementation of smoke-free legislation. Eur J Public Health 2011, 21(1):15-20.
• [21]Goodin M, McAllister I: Evaluating compliance with Australia's first smoke-free public places legislation. Tob Control 1997, 6(4):326-31.
• [22]Villalbí JR, Cusí M, Madrueño V, Durán J, Balfagon P, Portaña S, Salamero M, Guix J: Espacios sin humo: persuasión y obligación. [Smoke-free areas: persuasion and enforcement]. Gac Sanit 2008, 22(6):614-7. Spanish
• [23]Heim D, Ross A, Eadie D, MacAskill S, Davies JB, Hastings G, Haw S: Public health or social impacts? A qualitative analysis of attitudes toward the smoke-free legislation in Scotland. Nicotine Tob Res 2009, 11(12):1424-30.
• [24]Griffith G, Cardone A, Jo C, Valdemoro A, Sebrié E: Implementation of smoke free workplaces: challenges in Latin America. Salud Publica Mex 2010, 52(Suppl 2):S347-54.
• [25]Vardavas CI, Dimitrakaki C, Schoretsaniti S, Patelarou E, Filippidis FT, Connolly GN, Tountas Y: The role of the non-smoker in enforcing smoke-free laws. J Public Health Policy 2011, 32(1):46-59.
• [26]Scollo M, Lal A, Hyland A, Glantz S: Review of the quality of studies on the economic effects of smoke-free policies on the hospitality industry. Tob Control 2003, 12:13-20.
• [27]Glantz SA: Commentary: Assessing the effects of the Scottish Smokefree Law- the placebo effect and the importance of obtaining unbiased data*. Int J Epidemiol 2007, 36:155-256.
• [28]Cyprus International Institute for the Environment and Public Health: Tobacco Research Program. Cyprus: A Strategic Plan for Tobacco Control in Cyprus; 2007.
• [29]Christophi CA, Kolokotroni O, Alpert HR, Warren CW, Jones NR, Demokritou P, Connolly GN: Prevalence and social environment of cigarette smoking in Cyprus youth. BMC Publ Health 2008, 8:190. BioMed Central Full Text
• [30]Cyprus Statistical Service, Cyprus: Health Survey 2003. Nicosia, Cyprus: Republic of Cyprus; 2005.
• [31]Christophi CA, Savvides ECG, Warren CW, Demokritou P, Connolly GN: Main determinants of cigarette smoking in youth based on the 2006 Cyprus GYTS. Prev Med 2009, 48:232-236.
• [32]World Health Organizationhttp://www.who.int/fctc/protocol/guidelines/adopted/article_8/en/index.html webcite
• [33]Statistical Service, Cyprus[http://www.mof.gov.cy/mof/cystat/statistics.nsf/services_74main_keyfarchive_en/services_74main_keyfarchive_en?OpenForm&yr=2009D87D0C1BDA9ECC543A993A11B7C1FF8D&n=2009 webcite]
• [34]Cyprus Statistical Service, Cyprus: Hotels and Restaurants Statistics 2010. Nicosia, Cyprus: Republic of Cyprus; 2012.
• [35]Siegel M: Smoking and Restaurants: A guide for policy makers. Oakland, USA: American Heart Association, Alameda County Division; 1992.
• [36]Alpert HR, Carpenter CM, Travers MJ, Connolly GN: Environmental and economic evaluation of the Massachusetts smoke-free workplace law. J Community Health 2007, 32(4):269-281.
• [37]Eriksen M, Chaloupka F: The economic impact of Clean Indoor Air Laws. CA Cancer J Clin 2007, 57(6):367-378.
• [38]Engelen M, Farrelly M: The Health and Economic Impact of New York’s Clean Indoor Air Act. New York: New York State Department of Health Report; 2006.
• [39]Luk R, Ferrence R, Gmel G: The economic impact of a smoke-free bylaw on restaurant and bar sales in Ottawa, Canada. Addiction 2006, 101(5):738-745.
• [40]Melberg HO, Lund KE: Do smoke free laws affect revenues in pubs and restaurants? Eur J Health Econ 2012, 13(1):93-99.
• [41]Abascal W, Esteves E, Goja B, Mora FG, Lorenzo A, Sica A, Triunfo P, Harris JE: Tobacco control campaign in Uruguay: a population-based trend analysis. Lancet 2012, 380(9853):1575-1582.