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Tynan MA, Cohen MA, Harris JR. What happens in Vegas, stays in your lungs: an assessment of fine particulate matter in casinos that prohibit and allow smoking in Las Vegas, Nevada, USA. Tob Control 2024; 33:545-548. [PMID: 36822833 PMCID: PMC10998699 DOI: 10.1136/tc-2022-057861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 02/03/2023] [Indexed: 02/25/2023]
Abstract
INTRODUCTION Despite progress in adoption of smoke-free policies, smoking in casinos is allowed in some US states, including Nevada. In 2020, for the first time, a resort-style casino in Las Vegas prohibited smoking voluntarily. This study is the first to assess air quality in this casino and compare results with similar casinos that allow smoking. METHODS A real-time personal aerosol monitor evaluated particulate matter with a diameter <2.5 µm (PM2.5), a surrogate for secondhand smoke (SHS). PM2.5 was measured at eight Las Vegas casinos, including the smoke-free casino. Each casino was visited twice, and PM2.5 was assessed in smoking-permitted gaming areas and areas where smoking is otherwise prohibited. RESULTS Average PM2.5 levels were significantly higher in casinos that allow smoking, for both casino gaming areas and areas where smoking is otherwise prohibited (p<0.05). Mean PM2.5 in gaming areas was 164.9 µg/m3 in casinos that allow smoking and 30.5 µg/m3 in the smoke-free casino. Mean PM2.5 in areas where smoking is otherwise prohibited was 83.2 µg/m3 in casinos which allowed smoking in gaming areas, and 48.1 µg/m3 in the smoke-free casino. CONCLUSION Despite robust evidence about the harms of SHS, tens of thousands of casino employees and tens of millions of tourists are exposed to high levels of SHS in Las Vegas casinos annually, with PM2.5 levels 5.4 times higher in gaming areas when compared with a smoke-free casino. The only way to protect people from SHS exposure is to prohibit smoking in all indoor areas.
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Affiliation(s)
- Michael A Tynan
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, Washington, USA
| | - Martin A Cohen
- Department of Environmental & Occupational Health Sciences, University of Washington School of Public Health, Seattle, Washington, USA
| | - Jeffrey R Harris
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, Washington, USA
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O'Leary BF, Hill AB, Akers KG, Esparra-Escalera HJ, Lucas A, Raoufi G, Huang Y, Mariscal N, Mohanty SK, Tummala CM, Dittrich TM. Air quality monitoring and measurement in an urban airshed: Contextualizing datasets from the Detroit Michigan area from 1952 to 2020. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 809:152120. [PMID: 34871691 DOI: 10.1016/j.scitotenv.2021.152120] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 11/24/2021] [Accepted: 11/28/2021] [Indexed: 06/13/2023]
Abstract
With urban air quality being a pressing public health concern, community members are becoming increasingly engaged in determining the links between air quality and human health. Although new measurement tools such as low-cost sensors make local data more accessible, a better understanding of gaps in regional datasets is needed to develop effective metropolitan-scale solutions. Using scoping review methodology, we compiled 214 published journal articles and grey literature reports of air quality data from the Detroit, Michigan area from 1952 through 2020. This critical scoping review focuses on air quality datasets, but related topics such as health studies and community-based participatory science studies were examined from the included articles. Most of these publications were peer-reviewed journal articles published after 2001. Particulate matter, nitrous oxides, and sulfur dioxide were the most commonly studied air pollutants, and asthma was the most frequently associated health outcome paired with air pollution datasets. Few publications reported methods for community-based participatory science. This critical scoping review establishes a foundation of historical air quality data for the Detroit metropolitan area and a set of evaluation criteria that can be replicated in other urban centers. This foundation enables future detailed analysis of air quality datasets and showcases strategies for implementing effective community science programs and monitoring efforts.
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Affiliation(s)
- Brendan F O'Leary
- Department of Civil and Environmental Engineering, Wayne State University, 5050 Anthony Wayne Drive, Detroit, MI 48202, USA
| | - Alex B Hill
- Center for Urban Studies, Wayne State University, Detroit, MI 48202, USA
| | - Katherine G Akers
- Shiffman Medical Library, Wayne State University, 320 E. Canfield St., Detroit, MI 48201, USA
| | | | - Allison Lucas
- Department of Communication, Wayne State University, 585 Manoogian Hall, Detroit, MI 48202, USA
| | - Gelareh Raoufi
- College of Education, Wayne State University, 441 Education Building, Detroit, MI 48202, USA
| | - Yaoxian Huang
- Department of Civil and Environmental Engineering, Wayne State University, 5050 Anthony Wayne Drive, Detroit, MI 48202, USA
| | - Noribeth Mariscal
- Department of Civil and Environmental Engineering, Wayne State University, 5050 Anthony Wayne Drive, Detroit, MI 48202, USA
| | - Sanjay K Mohanty
- Institute of the Environment and Sustainability, University of California Los Angeles, Los Angeles, CA 90024, USA
| | - Chandra M Tummala
- Department of Civil and Environmental Engineering, Wayne State University, 5050 Anthony Wayne Drive, Detroit, MI 48202, USA
| | - Timothy M Dittrich
- Department of Civil and Environmental Engineering, Wayne State University, 5050 Anthony Wayne Drive, Detroit, MI 48202, USA.
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Bakhturidze G, Peikrishvili N, Gvinianidze K. Impact of comprehensive smoke-free policy compliance on SHS exposure and health condition of the Georgian population. Tob Prev Cessat 2021; 7:70. [PMID: 34901565 PMCID: PMC8619785 DOI: 10.18332/tpc/143329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 10/25/2021] [Accepted: 10/27/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Georgia made steps forward in 2017 and adopted new amendments to its tobacco control legislation, which mostly correspond to the FCTC requirements. Among other changes in the regulations is a ban on smoking in public buildings and public transport, with a few exemptions (casinos, big slot clubs, performances in theatres, taxis). The regulation entered into force on 1 May 2018. METHODS The aim of the study is to assess the outcomes of the comprehensive smoke-free legislation in Georgia. We used a logical model for data collection and analysis. Our evaluation focuses on smoking prevalence related survey data, SHS exposure, monitoring results on compliance of new tobacco control regulations, Quitline data, and air quality measurement results. RESULTS The indoor air quality improved by 91% in the hospitality sector (from 1408 to 126 μg/m3 in 2018 and 117 μg/m3 in 2019), by 80% in public settings (from 531 to 112 μg/m3 in 2018 and 98 μg/m3 in 2019) and sufficiently in healthcare facilities (from 219 to 97-98 μg/m3 in 2018-2019). Demand for Quitline services increased by 30%. New cases of AMI declined by 32% during 2017-2019. CONCLUSIONS A comprehensive smoke-free policy with a high level of compliance (≥95%) had a positive impact on the decline of SHS exposure and tremendous improvement of indoor air quality in public places and promotes a decrease in illnesses related to the cardiovascular system in Georgia. Also, demand increased for smoking-cessation services.
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Affiliation(s)
- George Bakhturidze
- Framework Convention on Tobacco Control Implementation and Monitoring Center, Tbilisi, Georgia
| | - Nana Peikrishvili
- Framework Convention on Tobacco Control Implementation and Monitoring Center, Tbilisi, Georgia
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Singh A, Dobbie F, Kinnunen TI, Okello G, Semple S, Okyere PB, Logo DD, Lartey KF, McNeil A, Britton J, Bauld L, Owusu-Dabo E. Adherence to smoke-free policies in Ghana: Findings from a cross-sectional survey of hospitality venue owners and staff. Tob Prev Cessat 2021; 7:4. [PMID: 33474517 PMCID: PMC7811357 DOI: 10.18332/tpc/131058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/25/2020] [Accepted: 11/30/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Implementation of and compliance with smoke-free policies (SFPs) can be problematic in many low- and middle-income countries (LMICs) due to limited resources. This study evaluated knowledge, opinions and compliance related to Ghana’s SFPs among owners and staff of hospitality venues by city, staff designation, and venue type. METHODS A cross-sectional study design was used in venue types including hotels, bars, pubs and restaurants in the three cities of Kumasi, Accra, and Tamale, in Ghana. Data were collected between July and September 2019. Interviewer administered face-to-face surveys were conducted with owners and staff (n=142) recruited from randomly selected hospitality venues (n=154) in these three large cities of Ghana. The relationship between knowledge, opinions, and compliance items on SFPs, and city, venue type and staff designation was first studied using χ2 or a Fisher’s exact test, and then with univariate logistic regression model analysis. RESULTS Of the 142 respondents, some had heard of Ghana’s 2012 Tobacco Control Act (27.5%), smoking restriction in public places (29%), smoke-free places (22%), and display of ‘no smoking’ signage (6.3%). Knowledge levels were higher in Accra compared to Tamale (OR=3.08; 95% CI: 1.10–8.60). Staff designation and type of venue did not have any relationship with knowledge levels. Support for SFPs was over 80%, but opinions in support of SFPs were lower in Accra than Tamale (OR=0.25; 95% CI: 0.08–0.71). Compliance with SFPs was similar in the three cities. Hotels were three times more compliant compared to bars and pubs (OR=3.16; 95% CI: 1.48–6.71). CONCLUSIONS The study highlights the strong support for restriction of smoking in public places including hospitality venues despite poor knowledge and low compliance levels with the current SFPs. A review of the current SFP in Ghana together with education of hospitality staff on the benefits and requirements of SFPs is recommended.
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Affiliation(s)
- Arti Singh
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Fiona Dobbie
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Tarja I Kinnunen
- Faculty of Social Sciences (Health Sciences), Tampere University, Tampere, Finland
| | | | - Sean Semple
- Institute for Social Marketing and Health, University of Stirling, Stirling, United Kingdom
| | - Portia Boakye Okyere
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Kwabena Fosu Lartey
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Ann McNeil
- King's College London, London, United Kingdom
| | - John Britton
- University of Nottingham, Nottingham, United Kingdom
| | - Linda Bauld
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Ellis Owusu-Dabo
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Singh A, Okello G, Semple S, Dobbie F, Kinnunen TI, Lartey KF, Logo DD, Bauld L, Ankrah ST, McNeill A, Owusu-Dabo E. Exposure to secondhand smoke in hospitality settings in Ghana: Evidence of changes since implementation of smoke-free legislation. Tob Induc Dis 2020; 18:44. [PMID: 32477039 PMCID: PMC7252429 DOI: 10.18332/tid/120934] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 04/08/2020] [Accepted: 04/21/2020] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Ghana has a partial smoking ban with smoking allowed in designated smoking areas. Studies evaluating smoke-free laws are scarce in Sub-Saharan Africa. Evaluation of smoke-free laws is an effective means of measuring progress towards a smoke-free society. This study assessed the level of compliance to the provisions of the current smoke-free policy using air quality measurements for fine particulate matter (PM2.5) in hospitality venues in Ghana. METHODS This was a cross-sectional observational study conducted in 2019 using a structured observational checklist complemented with air quality measurements using Dylos monitors across 152 randomly selected hospitality venues in three large cities in Ghana. RESULTS Smoking was observed in a third of the venues visited. The median indoor PM2.5 concentration was 14.6 μg/m3 (range: 5.2-349). PM2.5 concentrations were higher in venues where smoking was observed (28.3 μg/m3) compared to venues where smoking was not observed (12.3 μg/m3) (p<0.001). Hospitality locations in Accra, Ghana's capital city, had the lowest compliance levels (59.5%) and poorer air quality compared to the cities of Kumasi and Tamale. CONCLUSIONS The study shows that while smoking and SHS exposure continues in a substantial number of hospitality venues, there is a marked improvement in PM2.5 concentrations compared to earlier studies in Ghana. There is still a considerable way to go to increase compliance with the law. Efforts are needed to develop an action plan to build upon recent progress in providing smoke-free public spaces in Ghana.
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Affiliation(s)
- Arti Singh
- School of Public Health, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Sean Semple
- University of Stirling, Stirling, United Kingdom
| | - Fiona Dobbie
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Tarja I Kinnunen
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Kwabena F Lartey
- School of Public Health, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Divine D Logo
- School of Public Health, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Linda Bauld
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Sampson T Ankrah
- Department of Mathematics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Ann McNeill
- King's College London, London, United Kingdom
| | - Ellis Owusu-Dabo
- School of Public Health, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Abstract
With the rapid increase in electronic cigarette (e-cig) users worldwide, secondhand exposure to e-cig aerosols has become a serious public health concern. We summarize the evidence on the effects of e-cigs on indoor air quality, chemical compositions of mainstream and secondhand e-cig aerosols, and associated respiratory and cardiovascular effects. The use of e-cigs in indoor environments leads to high levels of fine and ultrafine particles similar to tobacco cigarettes (t-cigs). Concentrations of chemical compounds in e-cig aerosols are generally lower than those in t-cig smoke, but a substantial amount of vaporized propylene glycol, vegetable glycerin, nicotine, and toxic substances, such as aldehydes and heavy metals, has been reported. Exposures to mainstream e-cig aerosols have biologic effects but only limited evidence shows adverse respiratory and cardiovascular effects in humans. Long-term studies are needed to better understand the dosimetry and health effects of exposures to secondhand e-cig aerosols.
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Affiliation(s)
- Liqiao Li
- Department of Environmental Health Sciences, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, California 90095-1772, USA;
| | - Yan Lin
- Department of Environmental Health Sciences, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, California 90095-1772, USA;
| | - Tian Xia
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California 90095-1772, USA
| | - Yifang Zhu
- Department of Environmental Health Sciences, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, California 90095-1772, USA;
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Abstract
With the rapid increase in electronic cigarette (e-cig) users worldwide, secondhand exposure to e-cig aerosols has become a serious public health concern. We summarize the evidence on the effects of e-cigs on indoor air quality, chemical compositions of mainstream and secondhand e-cig aerosols, and associated respiratory and cardiovascular effects. The use of e-cigs in indoor environments leads to high levels of fine and ultrafine particles similar to tobacco cigarettes (t-cigs). Concentrations of chemical compounds in e-cig aerosols are generally lower than those in t-cig smoke, but a substantial amount of vaporized propylene glycol, vegetable glycerin, nicotine, and toxic substances, such as aldehydes and heavy metals, has been reported. Exposures to mainstream e-cig aerosols have biologic effects but only limited evidence shows adverse respiratory and cardiovascular effects in humans. Long-term studies are needed to better understand the dosimetry and health effects of exposures to secondhand e-cig aerosols.
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Affiliation(s)
- Liqiao Li
- Department of Environmental Health Sciences, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, California 90095-1772, USA;
| | - Yan Lin
- Department of Environmental Health Sciences, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, California 90095-1772, USA;
| | - Tian Xia
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California 90095-1772, USA
| | - Yifang Zhu
- Department of Environmental Health Sciences, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, California 90095-1772, USA;
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Kim J, Lee K. Changes in urinary cotinine concentrations in non-smoking adults from the Korean National Environmental Health Survey (KoNEHS) II (2012-2014) after implementation of partial smoke-free regulations. Int J Hyg Environ Health 2019; 224:113419. [PMID: 31761730 DOI: 10.1016/j.ijheh.2019.113419] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 11/12/2019] [Accepted: 11/12/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND The Korean government implemented partial smoke-free regulations in hospitality venues ≥150 m2 in July 2013 and in venues ≥100 m2 in February 2014. This study examined changes in urinary cotinine concentrations in the Korean non-smoking adult population, and socio-demographic subgroups thereof, between 2012 and 2014, and the relationships between urinary cotinine concentrations and socio-demographic factors in 2014. METHODS Data from the Korean National Environmental Health Survey II (2012-2014), a nationally representative cross-sectional study, were used. In total, 4218 non-smoking adults (≥19 years) were selected based on questionnaires and urinary cotinine concentrations. Linear trend tests of urinary cotinine over time and socio-demographic factors associated with urinary cotinine in 2014 were examined based on weighted linear regression models. RESULTS Overall, the covariate-adjusted least-square geometric mean concentrations of urinary cotinine were 2.95 μg/g creatinine (Cr) (95% confidence interval, CI = 2.37-3.67) in 2012, 1.54 μg/g Cr (95% CI = 1.26-1.88) in 2013, and 1.47 μg/g Cr (95% CI = 1.23-1.76) in 2014, a significant decrease during 2012-2014. Urinary cotinine concentrations decreased significantly during 2012-2014 in most socio-demographic subgroups. However, concentrations in adults who worked in hospitality venues, including restaurants, bars, cafes, fast-food franchises, and bakeries, remained unchanged. Data from 2014, when smoke-free regulations were implemented in hospitality venues ≥100 m2, showed urinary cotinine concentrations were significantly higher in adults working in hospitality venues than in unemployed adults. CONCLUSIONS Overall, urinary cotinine concentrations of Korean non-smoking adults decreased during 2012-2014. However, implementation of partial smoke-free regulations in hospitality venues was not effective in reducing secondhand smoke exposure in workers at hospitality venues.
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Affiliation(s)
- Jeonghoon Kim
- Department of Environmental Health Research, Seoul Medical Center, 156 Sinnae-ro, Jungnang-gu, Seoul, 02053, Republic of Korea; Indoor Environment and Noise Research Division, Environmental Infrastructure Research Department, National Institute of Environmental Research, Seo-gu, Incheon, 22689, Republic of Korea.
| | - Kiyoung Lee
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Republic of Korea; Institute of Health and Environment, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Republic of Korea.
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Rivas I, Fussell JC, Kelly FJ, Querol X. Indoor Sources of Air Pollutants. INDOOR AIR POLLUTION 2019. [DOI: 10.1039/9781788016179-00001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
People spend an average of 90% of their time in indoor environments. There is a long list of indoor sources that can contribute to increased pollutant concentrations, some of them related to human activities (e.g. people's movement, cooking, cleaning, smoking), but also to surface chemistry reactions with human skin and building and furniture surfaces. The result of all these emissions is a heterogeneous cocktail of pollutants with varying degrees of toxicity, which makes indoor air quality a complex system. Good characterization of the sources that affect indoor air pollution levels is of major importance for quantifying (and reducing) the associated health risks. This chapter reviews some of the more significant indoor sources that can be found in the most common non-occupational indoor environments.
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Mayne SL, Widome R, Carroll AJ, Schreiner PJ, Gordon-Larsen P, Jacobs DR, Kershaw KN. Longitudinal Associations of Smoke-Free Policies and Incident Cardiovascular Disease: CARDIA Study. Circulation 2018; 138:557-566. [PMID: 29735485 PMCID: PMC6202173 DOI: 10.1161/circulationaha.117.032302] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 03/21/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Smoke-free legislation has been associated with lower rates of cardiovascular disease hospital admissions in ecological studies. However, prior studies lacked detailed information on individual-level factors (eg, sociodemographic and clinical characteristics) that could potentially confound associations. Our objective was to estimate associations of smoke-free policies with incident cardiovascular disease in a longitudinal cohort after controlling for sociodemographics, cardiovascular disease risk factors, and policy covariates. METHODS Longitudinal data from 3783 black and white adults in the CARDIA study (Coronary Artery Risk Development in Young Adults; 1995-2015) were linked to state, county, and local 100% smoke-free policies in bars, restaurants, and nonhospitality workplaces by Census tract. Extended Cox regression estimated hazard ratios (HRs) of incident cardiovascular disease associated with time-dependent smoke-free policy exposures. Models were adjusted for sociodemographic characteristics, cardiovascular disease risk factors, state cigarette tax, participant-reported presence of a smoking ban at their workplace, field center, and metropolitan statistical area poverty. RESULTS During a median follow-up of 20 years (68 332 total person-years), 172 participants had an incident cardiovascular disease event (2.5 per 1000 person-years). Over the follow-up period, 80% of participants lived in areas with smoke-free policies in restaurants, 67% in bars, and 65% in nonhospitality workplaces. In fully adjusted models, participants living in an area with a restaurant, bar, or workplace smoke-free policy had a lower risk of incident cardiovascular disease compared with those in areas without smoke-free policies (HR, 0.75, 95% confidence interval, 0.49-1.15; HR, 0.76, 95% confidence interval, 0.47-1.24; HR, 0.54, 95% confidence interval, 0.34-0.86, respectively; HR, 0.58, 95% confidence interval, 0.33-1.00 for living in an area with all 3 types of policies compared with none). The estimated preventive fraction was 25% for restaurant policies, 24% for bar policies, and 46% for workplace policies. CONCLUSIONS Consistent with prior ecological studies, these individual-based data add to the evidence that 100% smoke-free policies are associated with lower risk of cardiovascular disease among middle-aged adults.
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Affiliation(s)
- Stephanie L Mayne
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (S.L.M., A.J.C., K.N.K.)
| | - Rachel Widome
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneap-olis (R.W., P.J.S., D.R.J.)
| | - Allison J Carroll
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (S.L.M., A.J.C., K.N.K.)
| | - Pamela J Schreiner
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneap-olis (R.W., P.J.S., D.R.J.)
| | - Penny Gordon-Larsen
- Department of Nutrition, University of North Carolina Gillings School of Public Health, Chapel Hill (P.G.-L.)
| | - David R Jacobs
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneap-olis (R.W., P.J.S., D.R.J.)
| | - Kiarri N Kershaw
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (S.L.M., A.J.C., K.N.K.)
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Kim J, Ban H, Hwang Y, Ha K, Lee K. Impact of Partial and Comprehensive Smoke-Free Regulations on Indoor Air Quality in Bars. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13080754. [PMID: 27472349 PMCID: PMC4997440 DOI: 10.3390/ijerph13080754] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 07/16/2016] [Accepted: 07/19/2016] [Indexed: 11/16/2022]
Abstract
In Korea, smoke-free regulations have been gradually implemented in bars based on venue size. Smoking bans were implemented in 2013 for bars ≥150 m², in 2014 for bars ≥100 m², and in 2015 for bars of all sizes. The purpose of this study was to determine indoor fine particle (PM2.5) concentrations in bars before and after implementation of the smoke-free policies based on venue size. Indoor PM2.5 concentrations were measured with real-time aerosol monitors at four time points: (1) pre-regulation (n = 75); (2) after implementing the ban in bars ≥150 m² (n = 75); (3) after implementing the ban in bars ≥100 m² (n = 107); and (4) when all bars were smoke-free (n = 79). Our results showed that the geometric mean of the indoor PM2.5 concentrations of all bars decreased from 98.4 μg/m³ pre-regulation to 79.5, 42.9, and 26.6 μg/m³ after the ban on smoking in bars ≥150 m², ≥100 m², and all bars, respectively. Indoor PM2.5 concentrations in bars of each size decreased only after the corresponding regulations were implemented. Although smoking was not observed in Seoul bars after smoking was banned in all bars, smoking was observed in 4 of 21 bars in Changwon. Our study concludes that the greatest decrease in PM2.5 concentrations in bars was observed after the regulation covering all bars was implemented. However, despite the comprehensive ban, smoking was observed in bars in Changwon. Strict compliance with the regulations is needed to improve indoor air quality further.
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Affiliation(s)
- Jeonghoon Kim
- Department of Environmental Health, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 151-742, Korea.
- Department of Environmental Health Research, Seoul Medical Center, 156 Sinnae-ro, Jungnang-gu, Seoul 131-795, Korea.
| | - Hyunkyung Ban
- Department of Environmental Health, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 151-742, Korea.
| | - Yunhyung Hwang
- Department of Environmental Health, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 151-742, Korea.
| | - Kwonchul Ha
- Department of Health Science & Biochemistry, Changwon National University, 20 Changwondaehak-ro Uichang-gu Changwon-si, Gyeongsangnam-do 641-773, Korea.
| | - Kiyoung Lee
- Department of Environmental Health, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 151-742, Korea.
- Institute of Health and Environment, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 151-742, Korea.
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Barnoya J, Monzon JC, Briz P, Navas-Acien A. Compliance to the smoke-free law in Guatemala 5-years after implementation. BMC Public Health 2016; 16:318. [PMID: 27138959 PMCID: PMC4852414 DOI: 10.1186/s12889-016-2960-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2015] [Accepted: 03/15/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Smoke-free environments decrease smoking prevalence and consequently the incidence of heart disease and lung cancer. Due to issues related to poor enforcement, scant data is currently available from low/middle income countries on the long-term compliance to smoke-free laws. In 2006, high levels of secondhand smoke (SHS) were found in bars and restaurants in Guatemala City. Six months after a smoking ban was implemented in 2009, levels significantly decreased. However, in 2010, poor law compliance was observed. Therefore, we sought to assess long-term compliance to the ban using SHS measurements. METHODS In 2014 we assessed SHS exposure using airborne nicotine monitors in bars (n = 9) and restaurants (n = 12) for 7 days using the same protocol as in 2006 and in 2009. Nicotine was measured using gas-chromatography (μg/m(3)) and compared to levels pre- (2006) and post-ban (2009). Employees responded to a survey about SHS exposure, perceived economic impact of the ban and customers' electronic cigarette use. In addition, we estimated the fines that could have been collected for each law infringement. RESULTS Most (71 %) venues still have a smoking section, violating the law. The percentage of samples with detectable nicotine concentrations was 100, 85 and 43 % in 2006, 2009 and 2014, respectively. In bars, median (25(th) and 75(th) percentiles) nicotine concentrations were 4.58 μg/m(3) (1.71, 6.45) in 2006, 0.28 (0.17, 0.66) in 2009, and 0.59 (0.01, 1.45) in 2014. In restaurants, the corresponding medians were 0.58 μg/m(3) (0.44, 0.71), 0.04 (0.01, 0.11), and 0.01 (0.01, 0.09). Support for the law continues to be high (88 %) among bar and restaurant employees. Most employees report no economic impact of the law and that a high proportion of customers (78 %) use e-cigarettes. A total of US$50,012 could have been collected in fines. CONCLUSIONS Long-term compliance to the smoking ban in Guatemala is decreasing. Additional research that evaluates the determinants of non-compliance is needed and could also contribute to improve enforcement and implementation of the smoke-free law in Guatemala.
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Affiliation(s)
- Joaquín Barnoya
- Research Department, Cardiovascular Surgery Unit of Guatemala, 9th Avenue, 8-00, Zone 11, 01011, Guatemala City, Guatemala. .,Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 660 S Euclid Ave., St. Louis, MO, 63110, USA.
| | - Jose C Monzon
- Research Department, Cardiovascular Surgery Unit of Guatemala, 9th Avenue, 8-00, Zone 11, 01011, Guatemala City, Guatemala
| | - Paulina Briz
- Research Department, Cardiovascular Surgery Unit of Guatemala, 9th Avenue, 8-00, Zone 11, 01011, Guatemala City, Guatemala
| | - Ana Navas-Acien
- Department of Environmental Health Sciences and Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
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