Journal Article•
Indoor air quality in hospitality venues before and after implementation of a clean indoor air law - Western New York, 2003.
01 Jan 2004-Morbidity and Mortality Weekly Report (Epidemiology Program Office, Centers for Disease Control and Prevention (CDC))-Vol. 53, Iss: 44, pp 1038-1041
TL;DR: Assessment of changes in indoor air quality that occurred in 20 hospitality venues in western New York where smoking or indirect SHS exposure from an adjoining room was observed at baseline indicate that, on average, levels of respirable suspended particles, an accepted marker for SHS levels, decreased 84% in these venues after the law took effect.
Abstract: Secondhand smoke (SHS) contains more than 50 carcinogens. SHS exposure is responsible for an estimated 3,000 lung cancer deaths and more than 35,000 coronary heart disease deaths among never smokers in the United States each year, and for lower respiratory infections, asthma, sudden infant death syndrome, and chronic ear infections among children. Even short-term exposures to SHS, such as those that might be experienced by a patron in a restaurant or bar that allows smoking, can increase the risk of experiencing an acute cardiovascular event. Although population-based data indicate declining SHS exposure in the United States over time, SHS exposure remains a common but preventable public health hazard. Policies requiring smoke-free environments are the most effective method of reducing SHS exposure. Effective July 24, 2003, New York implemented a comprehensive state law requiring almost all indoor workplaces and public places (e.g., restaurants, bars, and other hospitality venues) to be smoke-free. This report describes an assessment of changes in indoor air quality that occurred in 20 hospitality venues in western New York where smoking or indirect SHS exposure from an adjoining room was observed at baseline. The findings indicate that, on average, levels of respirable suspended particles (RSPs), an accepted marker for SHS levels, decreased 84% in these venues after the law took effect. Comprehensive clean indoor air policies can rapidly and effectively reduce SHS exposure in hospitality venues.
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TL;DR: The Ireland smoke-free law stands as a positive example of how a population-level policy intervention can achieve its public health goals while achieving a high level of acceptance among smokers.
Abstract: Objective: To evaluate the psychosocial and behavioural impact of the first ever national level comprehensive workplace smoke-free law, implemented in Ireland in March 2004. Design: Quasi-experimental prospective cohort survey: parallel cohort telephone surveys of national representative samples of adult smokers in Ireland (n = 769) and the UK (n = 416), surveyed before the law (December 2003 to January 2004) and 8–9 months after the law (December 2004 to January 2005). Main outcome measures: Respondents’ reports of smoking in key public venues, support for total bans in those key venues, and behavioural changes due to the law. Results: The Irish law led to dramatic declines in reported smoking in all venues, including workplaces (62% to 14%), restaurants (85% to 3%), and bars/pubs (98% to 5%). Support for total bans among Irish smokers increased in all venues, including workplaces (43% to 67%), restaurants (45% to 77%), and bars/pubs (13% to 46%). Overall, 83% of Irish smokers reported that the smoke-free law was a “good” or “very good” thing. The proportion of Irish homes with smoking bans also increased. Approximately 46% of Irish smokers reported that the law had made them more likely to quit. Among Irish smokers who had quit at post-legislation, 80% reported that the law had helped them quit and 88% reported that the law helped them stay quit. Conclusion: The Ireland smoke-free law stands as a positive example of how a population-level policy intervention can achieve its public health goals while achieving a high level of acceptance among smokers. These findings support initiatives in many countries toward implementing smoke-free legislation, particularly those who have ratified the Framework Convention on Tobacco Control, which calls for legislation to reduce tobacco smoke pollution.
438 citations
TL;DR: A systematic review and a meta-analysis were performed to determine the association between public smoking bans and risk for hospital admission for acute myocardial infarction (AMI) as mentioned in this paper.
318 citations
Journal Article•
TL;DR: Smoking bans in public places and workplaces are significantly associated with a reduction in AMI incidence, particularly if enforced over several years.
227 citations
TL;DR: New York’s smoke-free law had its intended effect of protecting hospitality workers from exposure to secondhand smoke within three months of implementation and one year after implementation, the results suggest continued compliance with the law.
Abstract: Objective: To assess the impact on hospitality workers’ exposure to secondhand smoke of New York’s smoke-free law that prohibits smoking in all places of employment, including restaurants, bars, and bowling facilities Design: Pre-post longitudinal follow up design Settings: Restaurants, bars, and bowling facilities in New York State Subjects: At baseline, 104 non-smoking workers in restaurants, bars, and bowling facilities were recruited with newspaper ads, flyers, and radio announcements Of these, 68 completed a telephone survey and provided at least one saliva cotinine specimen at baseline At three, six, and 12 month follow up studies, 47, 38, and 32 workers from the baseline sample of 68 completed a telephone survey and provided at least one saliva cotinine specimen Intervention: The smoke-free law went into effect 24 July 2003 Main outcome measures: Self reported sensory and respiratory symptoms and exposure to secondhand smoke; self administered saliva cotinine specimens Analyses were limited to subjects in all four study periods who completed a telephone survey and provided at least one saliva cotinine specimen Results: All analyses were limited to participants who completed both an interview and a saliva specimen for all waves of data collection (n = 30) and who had cotinine concentrations ⩽ 15 ng/ml (n = 24) Hours of exposure to secondhand smoke in hospitality jobs decreased from 121 hours (95% confidence interval (CI) 80 to 163 hours) to 02 hours (95% CI −01 to 05 hours) (p Conclusion: New York’s smoke-free law had its intended effect of protecting hospitality workers from exposure to secondhand smoke within three months of implementation One year after implementation, the results suggest continued compliance with the law
218 citations
TL;DR: The results show that compliance with the Smoking, Health and Social Care (Scotland) Act 2005 has been high and this has led to a marked reduction in SHS concentrations in Scottish pubs, thereby reducing both the occupational exposure of workers in the hospitality sector and that of non-smoking patrons.
Abstract: Objective: To compare levels of particulate matter, as a marker of secondhand smoke (SHS) levels, in pubs before and 2 months after the implementation of Scottish legislation to prohibit smoking in substantially enclosed public places. Design: Comparison of SHS levels before and after the legislation in a random selection of 41 pubs in 2 Scottish cities. Methods: Fine particulate matter 2.5 ) was measured discreetly for 30 min in each bar on 1 or 2 visits in the 8 weeks preceding the starting date of the Smoking, Health and Social Care (Scotland) Act 2005 and then again 2 months after the ban. Repeat visits were undertaken on the same day of the week and at approximately the same time of the day. Results: PM 2.5 levels before the introduction of the legislation averaged 246 μg/m 3 (range 8–902 μg/m 3 ). The average level reduced to 20 μg/m 3 (range 6–104 μg/m 3 ) in the period after the ban. Levels of SHS were reduced in all 53 post-ban visits, with the average reduction being 86% (range 12–99%). PM 2.5 concentrations in most pubs post-ban were comparable to the outside ambient air PM 2.5 level. Conclusions: This study has produced the largest dataset of pre- and post-ban SHS levels in pubs of all worldwide smoke-free legislations introduced to date. Our results show that compliance with the Smoking, Health and Social Care (Scotland) Act 2005 has been high and this has led to a marked reduction in SHS concentrations in Scottish pubs, thereby reducing both the occupational exposure of workers in the hospitality sector and that of non-smoking patrons.
169 citations
References
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1,392 citations
TL;DR: In this article, the authors investigated whether there was a change in hospital admissions for acute myocardial infarction while a local law banning smoking in public and in workplaces was in effect and found that during the six months the law was enforced the number of admissions fell significantly (− 16 admissions, 95% confidence interval - 31.7 to - 0.3).
Abstract: Objective To determine whether there was a change in hospital admissions for acute myocardial infarction while a local law banning smoking in public and in workplaces was in effect. Design Analysis of admissions from December 1997 through November 2003 using Poisson analysis. Setting Helena, Montana, a geographically isolated community with one hospital serving a population of 68 140. Participants All patients admitted for acute myocardial infarction. Main outcome measures Number of monthly admissions for acute myocardial infarction for people living in and outside Helena. Results During the six months the law was enforced the number of admissions fell significantly (− 16 admissions, 95% confidence interval - 31.7 to - 0.3), from an average of 40 admissions during the same months in the years before and after the law to a total of 24 admissions during the six months the law was effect. There was a non-significant increase of 5.6 (− 5.2 to 16.4) in the number of admissions from outside Helena during the same period, from 12.4 in the years before and after the law to 18 while the law was in effect. Conclusions Laws to enforce smoke-free workplaces and public places may be associated with an effect on morbidity from heart disease.
565 citations
TL;DR: Establishment of smoke-free bars and taverns was associated with a rapid improvement of respiratory health and complete cessation of workplace ETS exposure (compared with continued exposure) wasassociated with improved mean FVC.
Abstract: Context.—The association between environmental tobacco
smoke (ETS) exposure and respiratory symptoms has not been well
established in adults.Objective.—To study the respiratory health of bartenders
before and after legislative prohibition of smoking in all bars and
taverns by the state of California.Design.—Cohort of bartenders interviewed before and
after smoking prohibition.Setting and Participants.—Bartenders at a random sample of
bars and taverns in San Francisco.Main Outcome Measures.—Interviews assessed respiratory
symptoms, sensory irritation symptoms, ETS exposure, personal smoking,
and recent upper respiratory tract infections. Spirometric assessment
included forced expiratory volume in 1 second (FEV1) and
forced vital capacity (FVC) measurements.Results.—Fifty-three of 67 eligible bartenders were
interviewed. At baseline, all 53 bartenders reported workplace ETS
exposure. After the smoking ban, self-reported ETS exposure at work
declined from a median of 28 to 2 hours per week (P<.001).
Thirty-nine bartenders (74%) initially reported respiratory symptoms.
Of those symptomatic at baseline, 23 (59%) no longer had symptoms at
follow-up (P<.001). Forty-one bartenders (77%) initially
reported sensory irritation symptoms. At follow-up, 32 (78%) of these
subjects had resolution of symptoms (P<.001). After
prohibition of workplace smoking, we observed improvement in mean FVC
(0.189 L; 95% confidence interval [CI], 0.082-0.296 L; 4.2% change)
and, to a lesser extent, mean FEV1 (0.039 L; 95% CI,
−0.030 to 0.107 L; 1.2% change). Complete cessation of workplace ETS
exposure (compared with continued exposure) was associated with
improved mean FVC (0.287 L; 95% CI, 0.088-0.486; 6.8% change) and
mean FEV1 (0.142 L; 95% CI, 0.020-0.264 L; 4.5% change),
after controlling for personal smoking and recent upper respiratory
tract infections.Conclusion.—Establishment of smoke-free bars and taverns
was associated with a rapid improvement of respiratory
health.
388 citations
TL;DR: This air-quality survey demonstrates conclusively that the health of hospitality workers and patrons is endangered by tobacco smoke pollution, and Smoke-free workplace laws eliminate that hazard and provide health protection impossible to achieve through ventilation or air cleaning.
Abstract: How do the concentrations of indoor air pollutants known to increase risk of respiratory disease, cancer, heart disease, and stroke change after a smoke-free workplace law? Real-time measurements were made of respirable particle (RSP) air pollution and particulate polycyclic aromatic hydrocarbons (PPAH), in a casino, six bars, and a pool hall before and after a smoking ban. Secondhand smoke contributed 90% to 95% of the RSP air pollution during smoking, and 85% to 95% of the carcinogenic PPAH, greatly exceeding levels of these contaminants encountered on major truck highways and polluted city streets. This air-quality survey demonstrates conclusively that the health of hospitality workers and patrons is endangered by tobacco smoke pollution. Smoke-free workplace laws eliminate that hazard and provide health protection impossible to achieve through ventilation or air cleaning. (J Occup Environ Med. 2004;46:887–905)
226 citations