Is passive smoking in the workplace hazardous to health?

Apart from evidence on the acute effects of passive smoking, there is relatively little information available on whether breathing other people's smoke at work causes disease. However, exposure does commonly occur at work, and it does not differ qualitatively from passive smoking occurring in other settings. Therefore it appears sensible to extrapolate from what is known about health risks in settings such as the home. There is too little known to quantify precisely workplace risks due to passive smoking. However, the weight and consistency of the epidemiologic evidence, backed up by the data from active smoking, favor a causal link between passive smoking and serious disease, especially lung cancer. In the light of this evidence, enough is known to justify action to reduce smoking at work.     

Why the tobacco industry fears the passive smoking issue

The tobacco industry has identified the passive smoking issue as the single most important problem confronting its economic future. During the 1980s, the industry has been engaged in an elaborate and expensive international campaign seeking to refute the evidence against passive smoking's effects on health and to position the issue as one essentially concerned with civil liberties and smokers' "rights." There are three main reasons for the industry's concern: first, the passive smoking issue allows a widening of the definition of smoking beyond its discussion as a personal habit, legitimizing it as a social problem; second, successful cases of litigation against employers by workers with histories of chronic exposure to environmental tobacco smoke have created an industrial climate of concern leading to workplace smoking restrictions and bans, and third, the proliferation of smoking restrictions reduces smoking opportunities and thus reduces total cigarette consumption and hence financial returns to the industry. Based on the results of a large Australian study of a workplace smoking ban, an estimated 654.88 million cigarettes with a retail value of $A6,549 thousand would be forgone annually in Australia alone if 50 percent of white-collar worksites were to ban smoking. Finally, the passive smoking issue can be considered a Trojan horse to its less discussed effects: the reduced morbidity and mortality likely to result in smokers from the significant reductions in smoking frequency that occur with the proliferation of smoking restrictions introduced in the name of concern for the health of nonsmokers.     

Multi-level,cross-sectional study of workplace social capital and smoking among Japanese employees

Background  

Social capital is hypothesized to be relevant to health promotion, and the association between community social capital and cigarette smoking has been examined. Individual-level social capital has been found to be associated with smoking cessation, but evidence remains sparse on the contextual effect of social capital and smoking. Further, evidence remains sparse on the association between smoking and social capital in the workplace, where people are spending an increasing portion of their daily lives. We examined the association between workplace social capital and smoking status among Japanese private sector employees.     

The short-term impact of national smoke-free workplace legislation on passive smoking and tobacco use

OBJECTIVES: This study sought to evaluate the short-term impact of national smoke-free workplace legislation on employee exposure to environmental tobacco smoke at work and on employee smoking habits. METHODS: We performed 2 cross-sectional studies in 9 medium-sized and large Finnish workplaces, before and after implementation of national smoke-free workplace legislation. We assessed tobacco smoke exposure via questionnaire and indoor air nicotine measurements. RESULTS: Exposure to environmental tobacco smoke declined considerably after the legislation was implemented.Tobacco consumption among smokers diminished. Nicotine concentrations fell significantly. CONCLUSIONS: Legislation was more efficient than voluntary workplace-specific smoking restrictions in reducing passive smoking and cigarette consumption.     

Workplace smoking policies in Taiwan and their association with employees' smoking behaviours

BACKGROUND: The implementation of worksite smoking policies has shown significant effects on reducing employees' smoking consumption and protecting non-smoking workers. However, there are no data about workplace smoking policies in Taiwan. The purpose of this study was to document the status of worksite smoking policies in Taiwan and its potential impact on employees' smoking behaviours. METHODS: A two-stage investigation was conducted. The first stage was to examine the current status of workplace smoking policies and the second was to evaluate the relationship between workplace smoking policies and employees' smoking behaviours. After two follow-ups in each stage, 264 companies and 1141 employees returned their questionnaires. RESULTS: Workplace smoking policies were associated with types of businesses and size of workplaces. Only approximately half of manufacturing and service companies have implemented a prohibitive smoking policy. Large facilities (>750 employees) were more likely to implement a prohibitive policy (57%). Employees in workplaces with a prohibitive policy had lower prevalence of smoking and cigarette consumption, and less exposure to passive smoking. Although most smokers agreed with banning smoking in their work environment, no difference in interest in participating in cessation programs was found. CONCLUSIONS: Significant associations were found between workplace smoking policies and employees' smoking behaviours. Results of the study provide basic information for designing more refined smoking policies in the workplace in Taiwan.     

10家医学社团工作人员吸烟现状调查

目的了解10家医学社团工作人员对吸烟和被动吸烟的相关知识、态度和行为,为制定控烟干预活动方案和评价干预效果提供基线结果和理论依据。方法通过问卷调查了解10家医学社团工作人员的控烟知识、态度和行为。结果 10家医学社团工作人员现在吸烟率为14.6%,其中男性现在吸烟率为46.3%,女性现在吸烟率为0.6%,吸烟者平均每天吸烟11支。51.3%的工作人员自报在工作场所有被动吸烟暴露,95.2%的吸烟者自报有时或经常在上班时吸烟。77.3%的工作人员认为烟中的尼古丁是引起大多数癌症的化学物质。84.3%的医学社团工作人员支持室内全面禁烟。结论大部分医学社团都开展了控烟相关工作,且工作人员对吸烟和被动吸烟相关疾病的认识较高。但仍有46.3%的男性工作人员吸烟,吸烟者在上班时吸烟现象常见。应加强医学社团控烟能力的建设,并积极开展控烟知识和技能培训。     

Evaluation of exposure to carbon monoxide associated with passive smoking

The current study measured breath carbon monoxide (CO) concentrations prior to and at prescribed time intervals after exposure to passive smoking under controlled conditions, along with the air CO concentration in the exposure room during the exposure periods. The postexposure breath CO levels were 1.4-2.7 times higher than the background breath CO levels after 30 min of exposure, yet only slightly higher after 10 min of exposure, thereby confirming that exposure to CO from passive smoking causes a significant body burden of CO. The air CO concentration gradually increased during the burning of a cigarette(s), regardless of the exposure duration, whereas it slightly decreased after burning. However, the pattern of breath CO decay was similar for the two different types of exposure (during and after a cigarette(s)) in each subject. The decrease in the postexposure alveolar CO concentrations was slow even in the early phase of the decay curves, indicating a monocompartment uptake and elimination model for the human body. The half-lives (78-277 min) estimated in the present study were comparable to those reported in previous studies associated with CO exposure from active smoking or other activities. The current study also evaluated the CO exposure of visitors and workers at three different types of recreation facility (bars, Internet cafes, and billiard halls) typically associated with passive smoking. The results confirmed that passive smoking is the major contributor to the CO exposure of nonsmoking visitors in a recreation environment. In addition, workplace exposure to CO from passive smoking was found to be the most important contributor to the daily CO exposure of nonsmoking recreation workers.     

Exposure of pre-school children to passive cigarette and narghile smoke in Beirut

BACKGROUND: Narghile is a resurging smoking device. However, little research has been done to assess passive smoking exposure. The objective of the present study is to evaluate the exposure of pre-school age children in Beirut to parental passive smoking from cigarette and/or narghile. METHODS: Data were collected from 1057 pre-school age children attending 16 day cares and 7 nursery schools in the city of Beirut. RESULTS: The overall prevalence of parental smoking (cigarette and/or narghile) was 53.3%. Ten per cent of respondents reported smoking only narghile. Fathers were significantly more likely than mothers to smoke cigarettes. However, there was no significant difference between fathers and mothers with respect to smoking narghile only. Education was a significant predictor for smoking cigarettes but not for smoking narghile. CONCLUSION: Narghile smoking appears to follow different gender and social patterns than cigarette smoking. Further research is needed to establish the determinants of narghile smoking, in order to develop adequate prevention policies.     

青岛市成年人吸烟、被动吸烟行为及认知现状调查

目的 了解2014年青岛市 ≥ 15岁成人吸烟、二手烟暴露状况及对烟草危害知识的认知水平。方法 采用2014年中国成人烟草调查问卷,抽取青岛市4 349名 ≥ 15岁非集体居住的常住居民,使用复杂抽样设计方法对吸烟率、二手烟暴露率、烟草危害认知情况等指标进行统计学分析。结果 青岛市 ≥ 15岁成人现在吸烟率为21.31%,现在每日吸烟率为18.18%;男性高于女性,农村高于城市;在公共场所、工作场所和家三类场所的二手烟暴露率分别为42.39%、26.62%、40.53%;暴露率在性别、教育水平等方面差异有统计学意义;吸烟引起中风、心肌梗塞、肺癌和阴茎勃起障碍四种疾病的总体知晓率仅为21.72%,被动吸烟引起的成人心脏病、成人肺癌和儿童肺部疾病三种疾病的总体知晓率为45.19%。结论 青岛市 ≥ 15岁成人吸烟和二手烟暴露均低于2010年和2015年全国水平,但流行现状仍较严重,对烟草烟雾危害知识认识不足,烟草控制面临挑战。     

Effects of a restricted work-site smoking policy on employees who smoke.

OBJECTIVES. This study evaluated the biological and subjective consequences observed in individual smokers after implementation of a workplace smoking-restriction policy. METHODS. Employees were evaluated for 4 weeks before and 4 weeks after their workplace became smoke-free (n = 34). A comparison group of smokers whose work-site smoking was unrestricted served as controls (n = 33). Daily exposure to tobacco constituents and withdrawal effects were measured. RESULTS. Smokers at the restricted site had verified smoking reduction (mean = four cigarettes per day) and significantly reduced nicotine and carbon monoxide during the work shift. There were increases in ratings of some common withdrawal symptoms (cravings/urges, concentration difficulties, increased eating, depression). No evidence of compensatory smoking during nonwork hours was found. Overall tobacco exposure, as measured in saliva cotinine, showed a nonsignificant 15% decline. CONCLUSIONS. Workplace smoking restriction markedly altered smoking patterns (i.e., reduced daytime smoking) and reduced cotinine levels to an amount consistent with cigarette reduction. Thus, work-site smoking restriction may promote meaningful, albeit limited, reductions in tobacco exposure and consequent health risks.     

Quantitative aspects of passive smoking and lung cancer

The exposure of passive smokers to cigarette smoke is estimated to be equivalent to 0.1-1.0 cigarette/day actively smoked. According to the reported relationships of dose and time, lung cancer incidence and other relative risk figures relating to nonsmokers have been calculated for ages 40, 50, 60, 70, and 79. Risks for smokers with a daily consumption of 0.1-1.0 cigarette were found to be in the range of R = 1.03 to 1.36. As it applies to passive smokers, this range of exposure may be neglected because it has no major effect on lung cancer incidence. The results of four previous studies dealing with passive smoking and lung cancer are compared with the current calculated risks, and the differences are discussed.     

北京市成年人吸烟及被动吸烟情况分析

目的 了解北京市成年人群吸烟和被动吸烟情况。方法 于2008年10-11月采用多阶段分层随机整群抽样方法对北京市18～79岁的常住居民22206人,进行问卷调查。结果 全人群的吸烟率为33.2%,现在吸烟率为29.0%,男女性现在吸烟率分别为54.0%和2.9%,郊区与城区现在吸烟率分别为28.6%和25.6%;吸烟者以吸机制卷烟为主,人均吸烟量为14.7支/d,41.7%的人每天至少吸20支;吸第1支烟平均年龄为18.5岁,开始每天吸烟平均年龄为20.4岁;全市吸烟者戒烟率为15.4%,>50%吸烟者在2000年之后戒烟;43.4%的非吸烟者或戒烟者暴露于二手烟,其中40%的人每天被动吸烟,主要场所是家庭和工作场所。结论 北京市成年人吸烟状况严重,控烟下降不明显。     

Cost effectiveness of workplace smoking policies

This study reviews the motivations of companies to set out a policy for controlling smoking, the economic benefits for the company resulting from such a policy and the costs, broken down by European Union countries. The literature on the costs of implementing a policy related to smoking at the workplace is reviewed. The main objective of policies related to smoking at the workplace is that of safeguarding employees from environmental tobacco smoke. Other reasons are cutting costs, improving the company image, and reducing absenteeism, occupational accidents, internal quarrels and extra costs due to cigarette smoking, protection against environmental tobacco smoke does not entail any higher costs for companies, and economic advantages are visible. The benefits are by far greater than the costs involved, particularly on a long-range basis, and seem to be greater when smoking at the workplace is completely prohibited and no smoking areas are set.     

Employee's perceived exposure to environmental tobacco smoke, passive smoking risk beliefs and attitudes towards smoking: a case study in a university setting

Despite the growing literature on workplace smoking policies, few studies have focused on the implementation of such policies in university settings. Smoking in the workplace is still very common in many countries, including Spain. While the law is about to change and more non-smoking policies are to be implemented, it is not clear what kind of restrictions Spanish workers would find acceptable. This study investigated perceived exposure to environmental tobacco smoke (ETS), passive smoking risks beliefs and attitudes towards smoking at the University of Navarra (Spain). A questionnaire was sent by E-mail to 641 randomly selected employees and a response rate of 70.4% was obtained. The survey results suggest that 27.3% of the university employees were smokers and 26.6% were exposed to ETS on a daily basis. The majority of respondents (81.7%) supported a restrictive non-smoking policy. Acceptance among active smokers was significantly lower (59.2 versus 89.3%). Smoking prohibition with the provision of smoking areas was the most favored option (46.9%). Results suggest that employees are ready to restrict smoking in the university, but there was not enough support for a total ban. Employers considering adopting a ban on smoking should be encouraged to conduct a similar survey to identify potential barriers to policy implementation.     

Smoking habits and smoking cessation among North Carolina nurses

A 1987 questionnaire survey of a 1% random sample (n = 356) of registered nurses in North Carolina provided data on the smoking habits and smoking cessation. Fifty-six percent were never smokers; 19% were current smokers. Among the ever smokers, 31% had quit smoking for at least one year. Twenty-two percent of the former smokers had smoked less than 5 years and 39% less than 10 years before quitting. Anecdotal notes from never smokers suggested that their major deterrent to smoking was their own parents smoking. Concerns about the addictive smoking behavior and health effects of smoking observed in their parents as well as concerns about potential health risks to themselves deterred them from smoking. Concerns about the adverse consequences of smoking was the most influential factor influencing smoking cessation and reduction of cigarette smoking. Friends' and family's encouragement to stop smoking was the most influential external factor motivating nurses to quit or reduce cigarette consumption. Fifty-seven percent of the former smokers quit smoking after one or two attempts while 53 of the current smokers had tried to quit 3 or more times - 90% had tried at least once to quit smoking; however, only 18% of the current smokers had abstained for more than one year during any of their attempts to quit. Implications of the results include: (1) smoking cessation programs for nurses in the workplace may have considerable impact since the majority of nurses who smoke are tying to quit; (2) relapse prevention strategies need to be an integral part of such smoking cessation programs including involvement of family and friends to support the smokers in their cessation efforts.     

孕妇被动吸烟与小于胎龄儿关系的Meta分析

目的 探讨孕妇孕期被动吸烟与小于胎龄儿之间的关系,分析不同孕期和不同地点被动吸烟的效应.方法 利用Meta分析方法综合分析国内外8篇关于孕妇孕期被动吸烟与小于胎龄儿关系的回顾性研究文献.结果 孕妇孕期被动吸烟与小于胎龄儿之间的粗合并效应值OR=1.45(95%CI:1.05～2.01),调整合并效应值OR=1.76(95%CI:1.15～2.69);孕妇孕早期被动吸烟的合并效应值OR=1.85(95%CI:1.25～2.72),孕中晚期被动吸烟的合并效应值OR=2.12(95%CI:1.43～3.13);家庭和工作中被动吸烟与小于胎龄儿之间的关系均没有统计学意义.结论 孕妇孕期被动吸烟可增加发生小于胎龄儿的危险性.除了家庭和工作环境外,还应注意其他环境的被动吸烟.     

Smoking and reproduction

2 of the 5 health warnings that must now appear on American cigarette packs and cigarette advertising refer to some of the increased hazards smoking entails for the woman and her unborn child. Yet, the myriad reproductive risks associated with smoking are little known or considered by the general public--or even by physicians--when compared with the dangers of lung cancer, heart attacks and emphysema. In an attempt to remedy that deficit, 8 government agencies sponsored the 1st International Conference on Smoking and Reproductive Health, held October 15-17, 1985 in San Francisco. Speaker after expert speaker connected smoking during pregnancy with increased risks of low birth weight, miscarriage, infant mortality and morbidity--including poorer health of surviving children up to at least age 3--ectopic pregnancy, infertility, menstrual disorders, early menopause, osteoporosis, cervical cancer and dysplasia, cardiovascular disease and placental abnormalities. Similarly, the conference participants documented the association of smoking among men with lower sperm count and increased prevalence of abnormal sperm. The following measures were urged at the closing statements of the conference: 1) an increased effort to inform doctors and health professionals of these findings; 2) increasing the tax on cigarettes, so that smokers would pay for their own health costs; 3) decreasing or eliminating government subsidies for growing tobacco, while helping growers make the transition to nontobacco crops; 4) making smoking cessation programs more widely available; 5) prohibiting the sale of cigarettes through vending machines; and 6) banning all smoking in the workplace.     

Passive smoking and the risk of coronary heart disease

Over the past 10 years it has become clear that passive smoking is correlated with an increased risk of coronary heart disease. The relative risk of 25-30% is comparable to that of lung cancer due to passive smoking. Since coronary heart disease is the most common cause of death, it is likely that passive smoking causes many more deaths from coronary heart disease than from lung cancer. For the Netherlands, yearly figures of 2,500 to 4,000 deaths from coronary heart disease due to passive smoking are estimated. In other words, of every 10 deaths from coronary heart disease due to cigarette smoke, one is caused by passive smoking. A rigorous ban on smoking is advocated, both in public places and at home.     

宜昌市居民被动吸烟状况的横断面调查

目的 :通过对城市居民被动吸烟状况及被动吸烟影响因素的系统研究 ,为政府组织和控烟机构实施有效的宣传和健康教育提供科学依据。方法 :对 6 5 0 0名 18周岁以上的宜昌市城区居民采用多阶段分层随机抽样问卷调查方法。结果 :被动吸烟率为 2 8.6 8% ,男、女性被动吸烟率分别为 2 3.4 7%和 31.39% ;影响被动吸烟率的因素有年龄、性别、职业、经济收入、及对相关知识的知晓程度。被动吸烟的场所以工作场所、公共场所和家中为主 ,其构成比分别为 34.15 %、 32 .74 %、32 .32 % ;被动吸烟者自报和确诊粗患病率均显著高于无被动吸烟的人 (χ2 =2 2 .36、 10 .84 ,P<0 .0 1)。结论 :我国城市居民被动吸烟状况不容乐观 ,应该增强居民的自我保护意识 ,改善社会环境 ,以减少被动吸烟在人群中所造成的危害。     

Respiratory symptoms and lung function effects of domestic exposure to tobacco smoke and cooking by gas in non-smoking women in Singapore.

STUDY OBJECTIVES--To investigate the effects of passive exposure to tobacco smoke and gas cooking at home on respiratory symptoms and lung function of non-smoking women. SETTING--Evidence on the effects of passive smoking and exposure to nitrogen dioxide from gas cooking on the respiratory health of adults is limited and variable. Over 97% of women in Singapore do not smoke, and a principal source of indoor air pollution for housewives is passive smoking and gas cooking. DESIGN--This was a cross sectional (prevalence) study of a population based sample of 2868 adults aged 20 to 74 years in Singapore. A structured questionnaire administered by trained interviewers was used to collect data on passive smoking, gas cooking, respiratory symptoms, and other relevant variables. Passive smoking was defined as exposure to cigarette smoke from one or more members of the household who had ever smoked. Gas cooking was defined in terms of the weekly frequency of gas cooking, as well as the frequency with which the respondent's kitchen was filled with heavy cooking fumes (rarely, occasionally, often). Forced expiratory volume in one second (FEV1) was measured by using a portable Micro-spirometer. Multivariate analyses were used to estimate relative odds of association for respiratory symptoms and FEV1 effect, with adjustment for potential confounding variables. PARTICIPANTS--Of a total of 1438 women in the sample, 1282 women who had never smoked provided questionnaire data and 1008 women provided acceptable readings of FEV1 for analysis. MAIN RESULTS--Passive smoking was significantly associated with greater relative odds of usual or chronic cough and phlegm, wheezing, and breathlessness on exertion, as well as lower FEV1. Greater relative odds of respiratory symptoms were also associated with the weekly frequency of gas cooking, although these results were statistically insignificant. Chronic cough and phlegm and breathlessness on exertion, however, were significantly associated with the frequency with which the kitchen was filled with heavy cooking fumes. A lower FEV1 was found in women who cooked frequently (more than thrice a week). CONCLUSION--Domestic exposure to cigarette smoke and gas cooking is associated with increased risks of respiratory symptoms and impairment of lung function in non-smoking women in Singapore.