RESUMO
The smoke-free legislation implemented in Spain in 2006 imposed a partial ban on smoking in public and work places, but the result did not meet expectations. Therefore, a more restrictive anti-smoking law was passed five years later in 2011 prohibiting smoking in all public places, on public transport, and the workplace. With the objective of assessing the impact of the latter anti-smoking legislation on children's exposure to second-hand smoke (SHS), we assessed parent's smoking habits and children's urine cotinine (UC) concentrations in 118 boys before (2005-2006) and after (2011-2012) the introduction of this law. Repeated cross-sectional follow-ups of the "Environment and Childhood Research Network" (INMA-Granada), a Spanish population-based birth cohort study, at 4-5 years old (2005-2006) and 10-11 years old (2011-2012), were designed. Data were gathered by ad-hoc questionnaire, and median UC levels recorded as an objective indicator of overall SHS exposure. Multivariable logistic regression was used to examine the association between parent's smoking habits at home and SHS exposure, among other potential predictors. An increase was observed in the prevalence of families with at least one smoker (39.0% vs. 50.8%) and in the prevalence of smoking mothers (20.3% vs. 29.7%) and fathers (33.9% vs. 39.0%). Median UC concentration was 8.0ng/mL (interquartile range [IQR]: 2.0-21.8) before legislation onset and 8.7ng/mL (IQR: 2.0-24.3) afterwards. In the multivariable analysis, the smoking status of parents and smoking habits at home were statistically associated with the risk of SHS exposure and with UC concentrations in children. These findings indicate that the recent prohibition of smoking in enclosed public and workplaces in Spain has not been accompanied by a decline in the exposure to SHS among children, who continue to be adversely affected. There is a need to target smoking at home in order to avoid future adverse health effects in a population that has no choice in the acceptance or not of SHS exposure-derived risk.
Assuntos
Poluição do Ar em Ambientes Fechados/análise , Exposição por Inalação , Fumar/legislação & jurisprudência , Poluição por Fumaça de Tabaco/análise , Poluição do Ar em Ambientes Fechados/legislação & jurisprudência , Criança , Pré-Escolar , Cotinina/urina , Estudos Transversais , Seguimentos , Humanos , Exposição por Inalação/legislação & jurisprudência , Masculino , Prevalência , Fumar/epidemiologia , Espanha/epidemiologia , Inquéritos e Questionários , Fatores de Tempo , Poluição por Fumaça de Tabaco/legislação & jurisprudênciaRESUMO
OBJECTIVE: To compare air nicotine concentrations according to the smoking policy selected by bars/restaurants in Santiago, Chile before and after the enactment of partial smoking ban legislation in 2007 (establishments could be smoke free, have segregated (mixed) smoking and non-smoking areas, or allow smoking in all areas). METHODS: The study measured air nicotine concentrations over 7 days to characterise secondhand smoke exposure in 30 bars/restaurants in 2008. Owner/manager interviews and physical inspections were conducted. RESULTS: Median IQR air nicotine concentrations measured in all venues were 4.38 (0.61-13.62) µg/m(3). Air nicotine concentrations were higher in bars (median 7.22, IQR 2.48-15.64 µg/m(3)) compared to restaurants (1.12, 0.15-9.22 µg/m(3)). By smoking status, nicotine concentrations were higher in smoking venues (13.46, 5.31-16.87 µg/m(3)), followed by smoking areas in mixed venues (9.22, 5.09-14.90 µg/m(3)) and non-smoking areas in mixed venues (0.99, 0.19-1.27 µg/m(3)). Air nicotine concentrations were markedly lower in smoke-free venues (0.12, 0.11-0.46 µg/m(3)). After adjustment for differences in volume and ventilation, air nicotine concentrations were 3.2, 35.5 and 56.2 times higher in non-smoking areas in mixed venues, smoking areas in mixed venues and smoking venues, respectively, compared to smoke-free venues. CONCLUSIONS: Exposure to secondhand smoke remains high in bars and restaurants in Santiago, Chile. These findings demonstrate that the partial smoking ban legislation enacted in Chile in 2007 provides no protection to employees working in those venues. Enacting a comprehensive smoke-free legislation which protects all people from exposure to secondhand smoke in all public places and workplaces is urgently needed.
Assuntos
Poluição do Ar em Ambientes Fechados/análise , Exposição por Inalação/análise , Nicotina/análise , Restaurantes , Fumar/legislação & jurisprudência , Poluição por Fumaça de Tabaco/análise , Local de Trabalho/legislação & jurisprudência , Ar/análise , Ar/legislação & jurisprudência , Poluição do Ar em Ambientes Fechados/legislação & jurisprudência , Chile , Humanos , Exposição por Inalação/legislação & jurisprudência , Políticas , Restaurantes/legislação & jurisprudência , Prevenção do Hábito de Fumar , Poluição por Fumaça de Tabaco/legislação & jurisprudênciaRESUMO
BACKGROUND: Smoke-free legislation eliminating tobacco smoke in all indoor public places and workplaces is the international standard to protect all people from exposure to secondhand smoke. Uruguay was the first country in the Americas and the first middle-income country in the world to enact a comprehensive smoke-free national legislation in March 2006. OBJECTIVE: To compare air nicotine concentrations measured in indoor public places and workplaces in Montevideo, Uruguay before (November 2002) and after (July 2007) the implementation of the national legislation. METHODS: Air nicotine concentrations were measured for 7-14 days using the same protocol in schools, a hospital, a local government building, an airport and restaurants and bars. A total of 100 and 103 nicotine samples were available in 2002 and 2007, respectively. RESULTS: Median (IQR) air nicotine concentrations in the study samples were 0.75 (0.2-1.54) microg/m(3) in 2002 compared to 0.07 (0.0-0.20) microg/m(3) in 2007. The overall nicotine reduction comparing locations sampled in 2007 to those sampled in 2002 was 91% (95% CI 85% to 94%) after adjustment for differences in room volume and ventilation. The greatest nicotine reduction was observed in schools (97% reduction), followed by the airport (94% reduction), the hospital (89% reduction), the local government building (86% reduction) and restaurants/bars (81% reduction). CONCLUSION: Exposure to secondhand smoke has decreased greatly in indoor public places and workplaces in Montevideo, Uruguay, after the implementation of a comprehensive national smoke-free legislation. These findings suggest that it is possible to successfully implement smoke-free legislations in low and middle-income countries.