Impact of a smoking ban in hospitality venues on second hand smoke exposure: a comparison of exposure assessment methods

BMC Public Health

Martin Röösli²  Susanne Hoffmann¹  Georg F Bauer¹  Cong Khanh Huynh³  Sarah Rajkumar² 

[1] Institute of Social and Preventive Medicine, University of Zürich and Center for Organizational and Occupational Sciences, ETH Zurich, Switzerland;University of Basel, Basel, Switzerland;Institute for Work and Health, Lausanne, Switzerland

关键词: Prospective study;    Passive sampler;    Second hand smoke;    Hospitality workers;    Smoking ban;   

Others  :  1162145
DOI  :  10.1186/1471-2458-13-536

 received in 2012-09-26, accepted in 2013-05-29,  发布年份 2013

【 摘 要 】

Background

In May 2010, Switzerland introduced a heterogeneous smoking ban in the hospitality sector. While the law leaves room for exceptions in some cantons, it is comprehensive in others. This longitudinal study uses different measurement methods to examine airborne nicotine levels in hospitality venues and the level of personal exposure of non-smoking hospitality workers before and after implementation of the law.

Methods

Personal exposure to second hand smoke (SHS) was measured by three different methods. We compared a passive sampler called MoNIC (Monitor of NICotine) badge, to salivary cotinine and nicotine concentration as well as questionnaire data. Badges allowed the number of passively smoked cigarettes to be estimated. They were placed at the venues as well as distributed to the participants for personal measurements. To assess personal exposure at work, a time-weighted average of the workplace badge measurements was calculated.

Results

Prior to the ban, smoke-exposed hospitality venues yielded a mean badge value of 4.48 (95%-CI: 3.7 to 5.25; n = 214) cigarette equivalents/day. At follow-up, measurements in venues that had implemented a smoking ban significantly declined to an average of 0.31 (0.17 to 0.45; n = 37) (p = 0.001). Personal badge measurements also significantly decreased from an average of 2.18 (1.31-3.05 n = 53) to 0.25 (0.13-0.36; n = 41) (p = 0.001). Spearman rank correlations between badge exposure measures and salivary measures were small to moderate (0.3 at maximum).

Conclusions

Nicotine levels significantly decreased in all types of hospitality venues after implementation of the smoking ban. In-depth analyses demonstrated that a time-weighted average of the workplace badge measurements represented typical personal SHS exposure at work more reliably than personal exposure measures such as salivary cotinine and nicotine.

【 授权许可】

   
2013 Rajkumar et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Keller R, Prinz-Kaltenborn R, Krebs H, Hornung R: Exposure to and annoyance with second-hand smoke in Switzerland: results of the Tobacco Monitoring survey. Soz Praventivmed 2005, 50(6):370-377.
• [2]Semple S, Maccalman L, Naji AA, Dempsey S, Hilton S, Miller BG, Ayres JG: Bar workers’ exposure to second-hand smoke: the effect of Scottish smoke-free legislation on occupational exposure. Ann Occup Hyg 2007, 51(7):571-580.
• [3]Jamrozik K: Estimate of deaths attributable to passive smoking among UK adults: database analysis. BMJ 2005, 330(7495):812.
• [4]Hyland A, Barnoya J, Corral JE: Smoke-free air policies: past, present and future. Tob Control 2012, 21(2):154-161.
• [5]WHO Framework Convention on Tobacco Control (FCTC). Geneva: World Health Organisation; 2003.
• [6]Verordnung zum Schutz vor Passivrauchen (Stand am 1. Mai 2010) (Legal ordinance on protection from passive smoking (status on 1st May, 2010)). Bern: Federal Office of Public Health; 2009.
• [7]Lopez MJ, Nebot M, Schiaffino A, Perez-Rios M, Fu M, Ariza C, Munoz G, Fernandez E: Two-year impact of the Spanish smoking law on exposure to secondhand smoke: evidence of the failure of the ‘Spanish model’. Tob Control 2011, 21(4):407-411.
• [8]Connolly GN, Carpenter CM, Travers MJ, Cummings KM, Hyland A, Mulcahy M, Clancy L: How smoke-free laws improve air quality: a global study of Irish pubs. Nicotine Tob Res 2009, 11(6):600-605.
• [9]Villarroel N, Lopez MJ, Sanchez-Martinez F, Fernandez E: Nebot M: [Second-hand smoke exposure in hospitality venues in Barcelona: measurement of respirable particles]. Gac Sanit 2011, 25(3):220-223.
• [10]Cains T, Cannata S, Poulos R, Ferson MJ, Stewart BW: Designated “no smoking” areas provide from partial to no protection from environmental tobacco smoke. Tob Control 2004, 13(1):17-22.
• [11]Huss A, Kooijman C, Breuer M, Bohler P, Zund T, Wenk S, Roosli M: Fine particulate matter measurements in Swiss restaurants, cafes and bars: what is the effect of spatial separation between smoking and non-smoking areas? Indoor Air 2010, 20(1):52-60.
• [12]Lee K, Hahn EJ, Robertson HE, Lee S, Vogel SL, Travers MJ: Strength of smoke-free air laws and indoor air quality. Nicotine Tob Res 2009, 11(4):381-386.
• [13]Semple S, Creely KS, Naji A, Miller BG, Ayres JG: Secondhand smoke levels in Scottish pubs: the effect of smoke-free legislation. Tob Control 2007, 16(2):127-132.
• [14]Barnoya J, Arvizu M, Jones MR, Hernandez JC, Breysse PN, Navas-Acien A: Secondhand smoke exposure in bars and restaurants in Guatemala City: before and after smoking ban evaluation. Cancer Causes Control 2011, 22(1):151-156.
• [15]Bohac DL, Hewett MJ, Kapphahn KI, Grimsrud DT, Apte MG, Gundel LA: Change in indoor particle levels after a smoking ban in Minnesota bars and restaurants. Am J Prev Med 2010, 39(6 Suppl 1):S3-9.
• [16]Reijula JP, Johnsson TS, Kaleva PS, Reijula KE: Exposure to tobacco smoke and prevalence of symptoms decreased among Finnish restaurant workers after the smoke-free law. Am J Ind Med 2012, 55(1):37-43.
• [17]Benowitz NL: Biomarkers of environmental tobacco smoke exposure. Environ Health Perspect 1999, 107(Suppl 2):349-355.
• [18]Al-Delaimy WK: Hair as a biomarker for exposure to tobacco smoke. Tob Control 2002, 11(3):176-182.
• [19]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; 2006.
• [20]Huynh CK, Moix J, Dubuis A: [Development and application of the passive smoking monitor MoNIC]. Rev Med Suisse 2008, 4(144):430-433.
• [21]Hammond SK, Leaderer BP: A diffusion monitor to measure exposure to passive smoking. Environ Sci Tech 1987, 21(5):494-497.
• [22]Ogden M, Maiolo K: Comparative Evaluation of Diffusive and Active Sampling Systems for Determining Airborne Nicotine and 3-Ethenylpyridine. Environ Sci Tech 1992, 26(6):1226-1234.
• [23]Durham AD, Bergier S, Morisod X, Locatelli I, Zellweger JP, Huynh CK, Cornuz J: Improved health of hospitality workers after a Swiss cantonal smoking ban. Swiss Med Wkly 2011, 141:w13317.
• [24]Huynh CK, Moix J-B, Dubuis A, Varonier HS, Stauffer Babel R, Celio M, Merz A-C, Cornuz J: Second Hand Tobacco Smoke exposure in Switzerland. Lausanne: vol. Environnement Humain EHU-4; 2009:26. [CHUV Research Day]
• [25]Erazo M, Iglesias V, Droppelmann A, Acuna M, Peruga A, Breysse PN, Navas-Acien A: Secondhand tobacco smoke in bars and restaurants in Santiago, Chile: evaluation of partial smoking ban legislation in public places. Tob Control 2010, 19(6):469-474.
• [26]Apsley A, Semple S: Secondhand smoke levels in Scottish bars 5 years on from the introduction of smoke-free legislation. Tob Control 2012, 21(5):511-513.
• [27]Cooper J, Borland R, Yong HH, Hyland A: Compliance and support for bans on smoking in licensed venues in Australia: findings from the International Tobacco Control Four-Country Survey. Aust N Z J Public Health 2010, 34(4):379-385.
• [28]Benowitz NL: Cotinine as a biomarker of environmental tobacco smoke exposure. Epidemiol Rev 1996, 18(2):188-204.
• [29]Benowitz NL, Hukkanen J, Jacob P 3rd: Nicotine chemistry, metabolism, kinetics and biomarkers. Handb Exp Pharmacol 2009, 192:29-60.
• [30]SRNT Subcommittee on Biochemical Validation: Biochemical verification of tobacco use and cessation. Nicotine Tob Res 2002, 4(2):149-159.
• [31]Agbenyikey W, Wellington E, Gyapong J, Travers MJ, Breysse PN, McCarty KM, Navas-Acien A: Secondhand tobacco smoke exposure in selected public places (PM2.5 and air nicotine) and non-smoking employees (hair nicotine) in Ghana. Tob Control 2011, 20(2):107-111.
• [32]Daly BJ, Schmid K, Riediker M: Contribution of fine particulate matter sources to indoor exposure in bars, restaurants, and cafes. Indoor Air 2010, 20(3):204-212.