Impact of Partial and Comprehensive Smoke-Free Regulations on Indoor Air Quality in Bars

Effects of Electronic Cigarettes on Indoor Air Quality and Health

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.

Effects of Electronic Cigarettes on Indoor Air Quality and Health

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.

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

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.

Exposure to tobacco secondhand smoke and its associated factors among non-smoking adults in smoking-restricted and non-restricted areas: findings from a nationwide study in Malaysia

OBJECTIVES

Secondhand smoke (SHS) has been associated with increased morbidity and mortality. Therefore, the aims of the paper are to assess SHS exposure among non-smoking adults in Malaysia attending various smoking-restricted and non-restricted public areas according to the Control of Tobacco Product Regulations (CTPR) as well as its relationship with various sociodemographic variables.

DESIGN

Data were extracted from a cross-sectional study, the Global Adults Tobacco Survey (GATS) 2011 which involved 3269 non-smokers in Malaysia. Data was obtained through face-to-face interviews using a validated pre-tested questionnaire. Factors associated with exposure to SHS were identified via multivariable analysis.

RESULTS

The study revealed that almost two-thirds of respondents were exposed to SHS in at least one public area in the past 1 month, with a significantly higher exposure among males (70.6%), those with higher educational attainment (81.4%) and higher income (quintile 1%-73.9%). Besides, the exposure to SHS was almost four times higher in non-restricted areas compared with restricted areas under the CTPR (81.9% vs 22.9). Multivariable analysis revealed that males and younger adults at non-restricted areas were more likely to be exposed to SHS while no significant associated factors of SHS exposure was observed in restricted areas.

CONCLUSIONS

The study revealed the prevalence of SHS exposure was higher among Malaysian adults. Although smoke-free laws offer protection to non-smokers from exposure to SHS, enforcement activities in restricted areas should be enhanced to ensure strict public abidance. In addition, legislation of restricted areas should also be extended to greatly reduce the SHS exposure among non-smokers in Malaysia.