Reduced secondhand smoke exposure after implementation of a comprehensive statewide smoking ban--New York, June 26, 2003-June 30, 2004

dSecondhand smoke (SHS) causes premature disease and death in nonsmokers, including heart disease and lung cancer. The Surgeon General has concluded that no risk-free level of SHS exposure exists; the only way to fully protect nonsmokers is to completely eliminate smoking in indoor spaces. Studies have determined that levels of airborne particulate matter in restaurants, bars, and other hospitality venues and levels of SHS exposure among nonsmoking hospitality employees decrease substantially and rapidly after implementation of laws that prohibit smoking in indoor workplaces and public places. To assess changes in indoor SHS exposure in a general population, the New York State Department of Health analyzed data on observations of indoor smoking by respondents to the New York Adult Tobacco Survey (NYATS) and measured levels of cotinine in saliva among nonsmoking NYATS respondents before and after implementation of the 2003 New York state ban on smoking in indoor workplaces and public places. This report describes the results of that analysis, which determined that reports of indoor smoking among restaurant and bar patrons decreased significantly after the law took effect; moreover, saliva cotinine levels in nonsmoking NYATS participants decreased by 47.4% over the same period. These findings suggest that comprehensive smoking bans can reduce SHS exposure among nonsmokers.     

Differential impacts of smoke-free laws on indoor air quality

The authors assessed the impacts of two different smoke-free laws on indoor air quality. They compared the indoor air quality of 10 hospitality venues in Lexington and Louisville, Kentucky, before and after the smoke-free laws went into effect. Real-time measurements of particulate matter with aerodynamic diameter of 2.5 microm or smaller (PM2.5) were made. One Lexington establishment was excluded from the analysis of results because of apparent smoking violation after the law went into effect. The average indoor PM2.5 concentrations in the nine Lexington venues decreased 91 percent, from 199 to 18 microg/m3. The average indoor PM2.5 concentrations in the 10 Louisville venues, however, increased slightly, from 304 to 338 microg/m3. PM2.5 levels in the establishments decreased as numbers of burning cigarettes decreased. While the Louisville partial smoke-free law with exemptions did not reduce indoor air pollution in the selected venues, comprehensive and properly enforced smoke-free laws can be an effective means of reducing indoor air pollution.     

Preemptive state smoke-free indoor air laws--United States, 1999-2004

Exposure to secondhand smoke results in approximately 3,000 lung cancer deaths and 35,000 heart disease deaths in the United States each year. Policies establishing smoke-free environments are the most effective method for reducing exposure to secondhand smoke. Restrictions on where smoking is allowed are also associated with decreased cigarette consumption and possibly with increased cessation rates among workers and the general public. Local laws often impose more stringent smoking restrictions than state laws. Preemptive legislation prohibits communities from enacting laws that are more stringent than or vary from the state law. One of the national health objectives for 2010 is to eliminate laws that preempt stronger tobacco-control laws (objective no. 27-19). In 1999, CDC published a list of states that, as of December 31, 1998, had laws that preempted stronger local smoking restrictions in one or more of three environments: government worksites, private-sector worksites, and restaurants. This report updates that list and summarizes changes in preemptive state smoke-free indoor air laws during 1999--2004 for these three environments. The findings indicate that almost no progress is being made toward the 2010 goal of eliminating all preemptive state smoke-free indoor air laws, resulting in the potential for lesser health protection.     

Smoking restrictions in large-hub airports --- United States, 2002 and 2010

Secondhand smoke (SHS) exposure causes death and disease in both nonsmoking adults and children, including cancer, cardiovascular and respiratory diseases. SHS exposure causes an estimated 46,000 heart disease deaths and 3,400 lung cancer deaths among U.S. nonsmoking adults annually. Adopting policies that completely eliminate smoking in all indoor areas is the only effective way to eliminate involuntary SHS exposure. In 2009, an estimated 696 million aircraft passenger boardings occurred in the United States. A 2002 survey of airport smoking policies found that 42% of 31 large-hub U.S. airports had policies requiring all indoor areas to be smoke-free. To update that finding, CDC analyzed the smoking policies of airports categorized as large-hub in 2010. This report summarizes the results of that analysis, which found that, although 22 (76%) of the 29 large-hub airports surveyed were smoke-free indoors, seven airports permitted smoking in certain indoor locations, including three of the five busiest airports. Although a majority of airports reported having specifically designated smoking areas outdoors in 2010 (79%) and/or prohibiting smoking within a minimum distance of entryways (69%), no airport completely prohibited smoking on all airport property. Smoke-free policies at the state, local, or airport authority level are needed for all airports to protect air travelers and workers at airports from SHS.     

Restaurant and bar owners' exposure to secondhand smoke and attitudes regarding smoking bans in five Chinese cities

Despite the great progress made towards smoke-free environments, only 9% of countries worldwide mandate smoke-free restaurants and bars. Smoking was generally not regulated in restaurants and bars in China before 2008. This study was designed to examine the public attitudes towards banning smoking in these places in China. A convenience sample of 814 restaurants and bars was selected in five Chinese cities and all owners of these venues were interviewed in person by questionnaire in 2007. Eighty six percent of current nonsmoking subjects had at least one-day exposure to secondhand smoke (SHS) at work in the past week. Only 51% of subjects knew SHS could cause heart disease. Only 17% and 11% of subjects supported prohibiting smoking completely in restaurants and in bars, respectively, while their support for restricting smoking to designated areas was much higher. Fifty three percent of subjects were willing to prohibit or restrict smoking in their own venues. Of those unwilling to do so, 82% thought smoking bans would reduce revenue, and 63% thought indoor air quality depended on ventilation rather than smoking bans. These results showed that there was support for smoking bans among restaurant or bar owners in China despite some knowledge gaps. To facilitate smoking bans in restaurants and bars, it is important to promote health education on specific hazards of SHS, provide country-specific evidence on smoking bans and hospitality revenues, and disseminate information that restricting smoking and ventilation alone cannot eliminate SHS hazards.     

State smoke-free laws for worksites, restaurants, and bars--United States, 2000-2010

Secondhand smoke (SHS) exposure causes lung cancer and cardiovascular and respiratory diseases in nonsmoking adults and children, resulting in an estimated 46,000 heart disease deaths and 3,400 lung cancer deaths among U.S. nonsmoking adults each year. Smoke-free laws that prohibit smoking in all indoor areas of a venue fully protect nonsmokers from involuntary exposure to SHS indoors. A Healthy People 2010 objective (27-13) called for enacting laws eliminating smoking in public places and worksites in all 50 states and the District of Columbia (DC); because this objective was not met by 2010, it was retained for Healthy People 2020 (renumbered as TU-13). To assess progress toward meeting this objective, CDC reviewed state laws restricting smoking in effect as of December 31, 2010. This report summarizes the changes in state smoking restrictions for private-sector worksites, restaurants, and bars that occurred from December 31, 2000 to December 31, 2010. The number of states (including DC) with laws that prohibit smoking in indoor areas of worksites, restaurants, and bars increased from zero in 2000 to 26 in 2010. However, regional disparities remain in policy adoption, with no southern state having adopted a smoke-free law that prohibits smoking in all three venues. The Healthy People 2020 target on this topic is achievable if current activity in smoke-free policy adoption is sustained nationally and intensified in certain regions, particularly the South.     

Global air monitoring study: a multi-country comparison of levels of indoor air pollution in different workplaces results from Tunisia

BACKGROUND: In 1986, a report of the U.S. Surgeon General concluded that second hand smoke is a cause of disease in healthy non smokers. Subsequent many nations including Tunisia implement smoke-free worksite regulations. The aim of our study is to test air quality in indoor ambient air venues in Tunisia. METHODS: A TSI SidePak AM510 Personal Aerosol Monitor was used to sample, record the levels of respirable suspended particles (RSP) in the air and to assess the real-time concentration of particles less than 2.5 microm in micrograms per cubic meter, or PM2.5. Thirty three venues were sampled in Tunis. The venues were selected to get a broad range of size, location and type of venue. Venues included restaurants and cafés, bars, bus stations, hospitals, offices, and universities. RESULTS: The mean level of indoor air pollution was 296 microg/m3 ranged from 11 microg/m3 to 1,499 microg/m3. The level of indoor air pollution was 85% lower in venues that were smoke-free compared to venues where smoking was observed (p<0.001). Averaged across each type of venue, the lowest levels of indoor air pollution were found in hospitals, offices and universities (52 microg/m3) and the highest level was found in a bar (1,499 micro/m3). CONCLUSION: Hospitality venues allowing indoor air smoking in Tunisia are significantly more polluted than both indoor smoke-free sites and outdoor air in Tunisia. This study demonstrates that workers and patrons are exposed to harmful levels of a known carcinogen and toxin. Policies that prohibit smoking in public worksites dramatically reduce second hand smoke exposure and improve worker and patron health.     

Secondhand smoke exposures in indoor public places in seven Asian countries

Exposure to secondhand smoke (SHS) is a major threat to public health. Asian countries having the highest smoking prevalence are seriously affected by SHS. The objective of the study was to measure SHS levels in hospitality venues in seven Asian countries and to compare the SHS exposure to the levels in Western countries. The study was carried out in four types of related hospitality venues (restaurant, café, bar/club and entertainment) in China, India, Japan, Korea, Malaysia, Pakistan and Sri Lanka. Real-time measurement of particulate matter of <2.5 μm aerodynamic diameter (PM_2.5) was made during business hour using a handheld laser operated monitor. A total of 168 venues were measured in seven countries. The average indoor PM_2.5 level was 137 μg/m³, ranging from 46 μg/m³ in Malaysia to 207 μg/m³ in India. Bar/club had the highest PM_2.5 level of 191 μg/m³ and restaurants had the lowest PM_2.5 level of 92 μg/m³. The average indoor PM_2.5 level in smoking venues was 156 μg/m³, which was 3.6 times higher than non-smoking venues (43 μg/m³). Indoor PM_2.5 levels were significantly associated with country, type of venue, smoking density and air exchange rate (p < 0.05). In the seven Asian countries, PM_2.5 levels were high due to SHS in public places. The current levels are comparable to the levels in Western countries before the adoption of smoke-free policy. Since Asian country has high prevalence of SHS in public places, there is an urgent need for comprehensive smoke-free regulation in Asian countries.     

中国五城市餐饮业顾客对被动吸烟的认知和态度

目的 了解中国城市餐饮业顾客对被动吸烟的认知、态度.方法 2007年7-10月采用方便抽样的方法,对北京、西安、武汉、昆明、贵阳5个城市405家不同类型餐馆/酒吧的2109名顾客进行问卷调查.结果 43.1%的顾客对烟草危害有较全面的认识;近60%的顾客表示不曾主动反对他人在面前吸烟,近三分之一的顾客曾因接触"二手烟"感到不适而选择中途离开;支持餐馆/酒吧全部禁烟的比例分别为30.0%和19.8%;二项logistic回归模型分析表明,北京市顾客、≥25岁年龄组、大专及以上学历和非吸烟者更倾向于支持餐馆/酒吧禁烟;而北京市顾客、女性、大专及以上学历和非吸烟者更愿意去有禁烟规定的餐馆/酒吧消费.结论 尽管5个城市餐饮业顾客对烟草烟雾的认知还有待提高,但餐馆/酒吧禁烟符合广大顾客的意愿,是公共场所控烟的趋势之一.     

Comprehensive US Statewide Smoke-Free Indoor Air Legislation and Secondhand Smoke Exposure,Asthma Prevalence,and Related Doctor Visits: 2007–2011

Objectives. We evaluated the impact of comprehensive statewide smoke-free indoor air laws on secondhand smoke (SHS) exposure, asthma prevalence, and asthma-related doctor visits.Methods. We used the 2007–2011 Behavioral Risk Factor Surveillance System data sets. We employed a paired t test to determine whether comprehensive statewide smoke-free indoor air laws reduced SHS exposure. We performed weighted logistic and Poisson regressions to obtain likelihood of reporting asthma symptoms and incidence rate ratio (IRR) of doctor visits owing to severe asthma symptoms.Results. After such laws were enacted, people in states with comprehensive smoke-free indoor air laws had a lower level of SHS exposure (P < .01), decreased odds of reporting current asthma symptoms (adjusted odds ratio [AOR] = 0.57; 95% confidence interval [CI] = 0.51, 0.63), and a decreased frequency of doctor’s visits owing to severe asthma symptoms (IRR = 0.80; 95% CI = 0.69, 0.92) than did their counterparts in fully adjusted models.Conclusions. Comprehensive statewide smoke-free indoor air laws appear to be effective in reducing SHS exposure and improving asthma outcomes. Regulations requiring smoke-free indoor environments and public areas are beneficial, and smoke-free indoor air laws should be enforced in all states.There is an increasing body of literature indicating that secondhand smoke (SHS) exposure has an adverse effect on health. SHS appears to be associated with a high risk of heart disease,1 acute stroke,2 and lung cancer.3 As the harmful consequences of SHS exposure have become increasingly recognized, the US federal government is urging state governments to establish policies to eliminate exposure to SHS. Accordingly, many states have enacted comprehensive statewide smoke-free indoor air laws to improve Americans’ public health by eliminating SHS exposure in 3 indoor locations: worksites, restaurants, and bars. However, not all states have comprehensive smoke-free laws that require the 3 locations to be smoke-free. In 2014, it was reported that only 26 states and the District of Columbia had comprehensive smoke-free laws, whereas 5 states had smoking bans in 2 of the 3 locations, 5 other states had smoking bans in 1 of the locations, and 14 states had no smoking restrictions, designated areas, or separate ventilation laws (

Impact of a smoking ban on restaurant and bar revenues--El Paso, Texas, 2002

Smoke-free indoor air ordinances protect employees and customers from secondhand smoke exposure, which is associated with increased risks for heart disease and lung cancer in adults and respiratory disease in children. As of January 2004, five states (California, Connecticut, Delaware, Maine, and New York) and 72 municipalities in the United States had passed laws that prohibit smoking in almost all workplaces, restaurants, and bars. On January 2, 2002, El Paso, Texas (2000 population: 563,662), implemented an ordinance banning smoking in all public places and workplaces, including restaurants and bars. The El Paso smoking ban is the strongest smoke-free indoor air ordinance in Texas and includes stipulations for enforcement of the ban by firefighting and law enforcement agencies, with fines of up to $500 for ordinance violations. To assess whether the El Paso smoking ban affected restaurant and bar revenues, the Texas Department of Health (TDH) and CDC analyzed sales tax and mixed-beverage tax data during the 12 years preceding and 1 year after the smoking ban was implemented. This report summarizes the results of that analysis, which determined that no statistically significant changes in restaurant and bar revenues occurred after the smoking ban took effect. These findings are consistent with those from studies of smoking bans in other U.S. cities. Local public health officials can use these data to support implementation of smokefree environments as recommended by the Task Force on Community Preventive Services.     

Exposure to secondhand smoke at work: a survey of members of the Australian Liquor, Hospitality and Miscellaneous Workers Union

OBJECTIVE: To measure workers' attitudes towards and experiences of exposure to secondhand smoke (SHS) in the workplace. METHOD: A stratified random sample of members from the Victorian Branch of the Australian Liquor, Hospitality and Miscellaneous Workers Union (LHMU) was interviewed by telephone in September 2001. Of the 1,078 respondents surveyed (77% response rate), hospitality workers comprised 49% of the sample, while the remainder comprised community services, property services and manufacturing workers. RESULTS: Overall, 54% of union members were employed in workplaces that did not completely ban smoking and 34% reported being exposed to SHS during their typical working day. Workplaces with total smoking bans had a high level of compliance with these restrictions, with no workers in these settings indicating exposure to SHS at work. Compared with other workers, hospitality workers reported working in environments that had more permissive smoking policies. Consistent with this, 56% of hospitality workers said they were exposed to SHS during a typical day at work compared with 11% of other workers. Overall, 79% of workers expressed concern about exposure to SHS, including 66% of smokers. Compared with other workers, hospitality workers reported a higher level of concern about exposure to SHS at work. CONCLUSION: These findings provide evidence that many workers, and especially those employed in the hospitality sector, are exposed to SHS during their working day and are concerned about the effects of such exposure on their health. IMPLICATIONS: These findings indicate that workplace smoke-free policies are effective in reducing worker exposure to SHS and demonstrate support for the extension of smoke-free policies to hospitality workplaces.     

State-specific prevalence of current cigarette smoking among adults and secondhand smoke rules and policies in homes and workplaces--United States, 2005

Smoking causes premature death and disease in children and adults who do not smoke but are exposed to secondhand smoke (SHS). To assess the state-specific prevalence of current smoking among adults in the United States and the proportions of adults who report having smoke-free home rules and smoke-free policies in their workplace, CDC analyzed data from the 2005 Behavioral Risk Factor Surveillance System (BRFSS). This report summarizes the results of that analysis, which indicated a threefold difference (from lowest to highest) in self-reported cigarette smoking prevalence in 50 states, the District of Columbia (DC), Puerto Rico (PR), and the U.S. Virgin Islands (USVI) (range: 8.3%-28.7%). Wide variations also were observed in USVI and the 14 states that assessed prevalence of smoke-free home rules (from 63.6% [Kentucky] to 82.9% [Arizona]) and smoke-free workplace policies (from 54.8% [Nevada] to 85.8% [West Virginia]). Evidence-based, comprehensive tobacco prevention and control programs that focus on decreasing smoking initiation, increasing smoking cessation, and establishing smoke-free workplaces, homes, and other venues should be continued and expanded to reduce smoking prevalence, exposure of nonsmokers to SHS, and smoking-related morbidity and mortality.     

Air Nicotine Monitoring for Second Hand Smoke Exposure in Public Places in India

Background:

Air nicotine monitoring is an established method of measuring exposure to second hand smoke (SHS). Not much research has been done in India to measure air nicotine for the purpose of studying exposure to SHS. It is a risk factor and many diseases are known to occur among non smokers if they are exposed to second hand smoke.

Objective:

To conduct monitoring of air nicotine for second hand smoke exposure in public places across major cities in India.

Materials and Methods:

A cross sectional survey was conducted across four cities across the country, using passive air monitoring. The buildings included hospitals, secondary schools, Governmental offices, bars and restaurants. The buildings were selected through convenience sampling method keeping in view specific sentinel locations of interest.

Result:

The presence of air nicotine was recorded in most of the buildings under the study, which included government buildings, hospitals, schools, restaurants and entertainment venues (bars) in all four cities under the study. The highest median levels of air nicotine were found in entertainment venues and restaurants in cities.

Conclusion:

The presence of air nicotine in indoor public places indicates weak implementation of existing smoke free law in India. The findings of this study provide a baseline characterization of exposure to SHS in public places in India, which could be used to promote clean indoor air policies and programs and monitor and evaluate the progress and future smoke-free initiatives in India.     

中国城市地区成年人二手烟暴露水平及相关知识和态度调查

目的 了解中国城市地区成年人二手烟暴露水平及其相关知识态度.方法 利用全球成人烟草调查中国调查(GATS)、国际烟草控制政策评估项目中国调查(ITC)中有关二手烟暴露、禁烟规定、二手烟相关知识态度的变量,使用SAS软件计算率及其95％CI.结果 2项调查中调查对象报告的工作场所室内全面禁烟的比例均低于40％.调查对象报告在餐厅看到吸烟现象比例在各类场所中最高(83.4％ ～ 95.6％),其次为工作场所(53.3％ ～ 84.0％),在医疗卫生机构、学校、公共交通工具看到吸烟现象的比例较低.GATS调查中60.6％的吸烟者和68.5％的非吸烟者知晓二手烟导致肺癌,但只有三分之一的调查对象知晓二手烟导致成年人心脏病.ITC调查对象对二手烟危害的知晓率高于GATS,但知晓二手烟导致成年人心脏病的比例仅有58.2％.ITC调查对象对学校、出租车、医院、政府机构全面禁烟的支持率较高(＞70％),但对工作场所全面禁烟的支持率仅有50.9％和60.9％.结论 中国城市地区室内工作场所全面禁烟的比例较低,二手烟暴露情况严重,公众对二手烟危害的认识以及对工作场所全面禁烟的支持率有待提高.     

The New York City Smoke-Free Air Act: second-hand smoke as a worker health and safety issue

BACKGROUND: Despite the provisions of a Smoke-Free Air Act (SFAA) enacted in 1995, more than 415,000 non-smoking New York City workers reported exposure to second-hand smoke in the workplace all or most of the time in 2002. Continued exposure to second-hand smoke in New York City prompted a renewed debate about a broader smoke-free air law. METHODS: The approach taken by the New York City Department of Health and Mental Hygiene to make the case for workplace protection from second-hand smoke, counter the opposition's arguments, and ultimately win the support of policymakers and the public for comprehensive smoke-free workplace legislation is described. RESULTS: On December 30, 2002, New York City's Mayor signed the SFAA of 2002 into law, making virtually all workplaces, including restaurants and bars, smoke-free. CONCLUSIONS: Proponents for a stronger law prevailed by defining greater protection from second-hand smoke as a matter of worker health and safety. Efforts to enact smoke-free workplace laws will inevitably encounter strong opposition, with the most common argument being that smoke-free measures will harm businesses. These challenges, however, can be effectively countered and public support for these measures is likely to increase over time by focusing the debate on worker protection from second-hand smoke exposure on the job.     

Evaluation of a Smoke-Free Law on Indoor Air Quality and on Workers’ Health in Portuguese Restaurants

Workplace bans on smoking are interventions to reduce exposure to secondhand smoke (SHS) to try to prevent harmful health effects. The Portuguese Government on January 1, 2008, introduced the first national law banning smoking in public workplaces, including restaurants. The main aim of this study was to examine the impact of this law on indoor air quality (IAQ) in restaurants and on the respiratory and sensory health of restaurant workers. Concentrations of respirable suspended particulate matter (RSP), total volatile organic compounds (TVOC), carbon monoxide (CO), and carbon dioxide (CO₂) in 10 restaurants were measured and compared before and after the ban. Benzene (C₆H₆) concentrations were also measured in all restaurants. Fifty-two and twenty-eight restaurant workers, respectively, answered questionnaires on exposure to SHS, and respiratory and sensory symptoms in the pre- and post-ban phases. There was a statistically significant decrease in RSP, CO, TVOC, and C₆H₆ concentrations after the ban. Additionally, in both phases the monitored CO₂ concentrations greatly exceeded 1800 mg.m^?3, suggesting inefficient ventilation of the indoor spaces. Between pre- and post-ban phases a significant reduction in self-reported workplace SHS exposure was also observed after the enforcement of the law, as well as a significant marked reduction in dry, itching, irritated, or watery eyes, nasal problems, sore or dry throat, cough, wheeze, and headache. This study provides, in a single investigation, comparison of IAQ and respiratory health in Portugal before and after the introduction of the smoke-free law, the first data reported in the literature to our knowledge. Our findings suggest that a total workplace smoking ban results in a significant reduction in indoor air pollution and an improvement in the respiratory health of restaurant workers. These observations may have implications for policymakers and legislators currently considering the nature and extent of their smoke-free workplace legislation and could provide a useful contribution to the implementation of public health prevention programs.     

Prevalence and predictors of smoking in "smoke-free" bars. Findings from the International Tobacco Control (ITC) Europe Surveys

National level smoke-free legislation is implemented to protect the public from exposure to second-hand tobacco smoke (SHS). The first aim of this study was to investigate how successful the smoke-free hospitality industry legislation in Ireland (March 2004), France (January 2008), the Netherlands (July 2008), and Germany (between August 2007 and July 2008) was in reducing smoking in bars. The second aim was to assess individual smokers' predictors of smoking in bars post-ban. The third aim was to examine country differences in predictors and the fourth aim was to examine differences between educational levels (as an indicator of socioeconomic status). This study used nationally representative samples of 3147 adult smokers from the International Tobacco Control (ITC) Europe Surveys who were surveyed pre- and post-ban. The results reveal that while the partial smoke-free legislation in the Netherlands and Germany was effective in reducing smoking in bars (from 88% to 34% and from 87% to 44%, respectively), the effectiveness was much lower than the comprehensive legislation in Ireland and France which almost completely eliminated smoking in bars (from 97% to 3% and from 84% to 3% respectively). Smokers who were more supportive of the ban, were more aware of the harm of SHS, and who had negative opinions of smoking were less likely to smoke in bars post-ban. Support for the ban was a stronger predictor in Germany. SHS harm awareness was a stronger predictor among less educated smokers in the Netherlands and Germany. The results indicate the need for strong comprehensive smoke-free legislation without exceptions. This should be accompanied by educational campaigns in which the public health rationale for the legislation is clearly explained.     

Secondhand Smoke Exposure Among Young Adult Sexual Minority Bar and Nightclub Patrons

Objectives. We compared exposure to secondhand smoke (SHS) and attitudes toward smoke-free bar and nightclub policies among patrons of lesbian, gay, bisexual, and transgender (LGBT) and non-LGBT bars and nightclubs.Methods. We conducted randomized time–location sampling surveys of young adults (aged 21–30 years) in 7 LGBT (n = 1113 patrons) and 12 non-LGBT (n = 1068 patrons) venues in Las Vegas, Nevada, in 2011, as part of a cross-sectional study of a social branding intervention to promote a tobacco-free lifestyle and environment in bars and nightclubs.Results. Compared with non-LGBT bars and nightclubs, patrons of LGBT venues had 38% higher adjusted odds of having been exposed to SHS in a bar or nightclub in the past 7 days but were no less likely to support smoke-free policies and intended to go out at least as frequently if a smoke-free bar and nightclub law was passed.Conclusions. The policy environment in LGBT bars and nightclubs appears favorable for the enactment of smoke-free policies, which would protect patrons from SHS and promote a smoke-free social norm.Secondhand smoke (SHS) exposure increases the risk of cardiovascular disease, respiratory conditions, and cancer.1 Bars and nightclubs are tobacco-friendly environments that the tobacco industry uses as marketing and promotional venues.2–4 In the absence of a smoke-free law that covers bars and nightclubs, these venues can also have particularly high levels of SHS.5,6Bars and nightclubs have played an important role historically in the lesbian, gay, bisexual, and transgender (LGBT) rights movement, and they serve as a welcoming social venue.7,8 However, compared with non-LGBT venues, LGBT bars and nightclubs may be particularly tobacco friendly, because smoking rates are higher among LGBT than heterosexual individuals.9,10 According to the 2009 to 2010 National Adult Tobacco Use Survey, prevalence of tobacco use was significantly higher among LGBT than heterosexual participants (38.5% vs 25.3%).10 Also, the tobacco industry has targeted LGBT individuals and young adults with bar and nightclub advertisements and promotions.2,11,12 Previous studies with men who have sex with men conducted in Tucson, Arizona; Portland, Oregon; and Los Angeles, California, indicated an association between frequency of LGBT bar attendance and smoking.13,14 Although it is well established that LGBT individuals have high smoking rates,9,15 less is known about exposure to SHS in LGBT bars and nightclubs.Smoke-free laws, which restrict smoking in certain areas, are an important intervention to reduce or eliminate SHS exposure.5,6,16 Smoke-free policies have been shown to reduce asthma exacerbations and heart attacks17,18 and to contribute to smoking reduction or cessation.19 Smoke-free bar and nightclub environments might contribute to lowering rates of smoking among the LGBT population.Pizacani et al. examined attitudes about SHS in Oregon and Washington among heterosexual and LGB individuals and found no significant differences by sexual orientation among individuals living in Washington.20 However, among Oregon residents, gay smokers were more likely than heterosexual male smokers to support banning smoking in bars. In addition, lesbian nonsmokers living in Oregon were more likely than heterosexual female nonsmokers to support such a ban. McElroy et al. found that a lower percentage of LGBT than non-LGBT individuals in Missouri supported smoke-free bar policies; however, this difference was not significant after adjustment for other demographic factors.21 Kelly et al. found no difference in support for the New York state smoke-free law between LGBT and heterosexual individuals in New York City nightclubs.22 However, in a nationwide study, King et al. found significantly higher prevalence of support for smoke-free bars, casinos, and clubs among heterosexual than LGBT participants. (49.5% vs 43.0%)23Nevada has historically lagged behind the nation in enacting smoke-free policies.24 In 2001, Nevada ranked last in percentage of employees covered by a smoke-free policy. Between 1993 and 1999, the percentage of employees covered ranged from 33.3% to 48.7%. By 1999, Nevada was the only state with fewer than half of employees covered by a smoke-free policy.24 In 2006, Nevada passed a state smoke-free law that exempted bars, nightclubs, and gaming areas. This law also removed preemption, allowing local communities to pass stronger smoke-free policies.25 As of January 2013, bars and nightclubs in Nevada were still exempt from the smoke-free law.26We compared SHS exposure and attitudes toward smoke-free bars and nightclubs among patrons of LGBT and non-LGBT bars and nightclubs in Las Vegas, Nevada, in 2011. We assessed (1) whether being present in an LGBT venue (vs a non-LGBT venue) was an independent predictor of past-7-day exposure to SHS in a bar or nightclub, (2) whether frequently going out to LGBT venues was an independent predictor of 7-day exposure to SHS in a bar or nightclub, (3) whether being present in an LGBT venue (vs a non-LGBT venue) was an independent predictor of intention to continue to go out as frequently as before if a smoke-free law was enacted, and (4) whether being present in an LGBT venue (vs a non-LGBT venue) was an independent predictor of opposition to smoke-free bar and nightclub policies.     

Survey of airport smoking policies--United States, 2002

Exposure to secondhand smoke (SHS) causes approximately 38,000 deaths among nonsmokers each year in the United States. The Task Force on Community Preventive Services has documented strong scientific evidence that smoking bans and restrictions are effective in reducing exposure to SHS. In 2002, an estimated 1.9 million workers had jobs at U.S. airports, and more than 1.9 million passengers per day passed through these airports. During the fall of 2002, the Center for Health Promotion and Disease Prevention at the Henry Ford Health System (Detroit, Michigan) conducted the Airport Smoking Policy Survey. This report summarizes the key findings from that survey, which indicated that 61.9% of airports reported being smoke-free in 2002 and that larger airports, which account for the majority of passenger boardings, were less likely than smaller airports to have a smoke-free policy. Increased adoption and enforcement of smoke-free policies are needed to protect the health of workers and travelers at U.S. airports.