TY - JOUR
T1 - Evaluation of secondhand smoke using PM2.5 and observations in a random stratified sample in hospitality venues from 12 cities
AU - Kaplan, Bekir
AU - Carkoglu, Asli
AU - Ergor, Gul
AU - Hayran, Mutlu
AU - Sureda, Xisca
AU - Cohen, Joanna E.
AU - Navas Acien, Ana
N1 - Funding Information:
Funding: This study was supported by the Institute for Global Tobacco Control at the Johns Hopkins Bloomberg School of Public Health (#119187) with funding from the Bloomberg Initiative to Reduce Tobacco Use.
Publisher Copyright:
© 2019 by the authors.
PY - 2019/4/2
Y1 - 2019/4/2
N2 - Background: Turkey passed a law banning smoking in all indoor public places in 2008. In response to the indoor smoking restriction, many smokers may have relocated to outdoor areas of venues. The aim of this study was to evaluate air pollution related to SHS exposure in indoor and outdoor areas of hospitality venues in 12 cities in Turkey. Method: In this cross-sectional study, we evaluated hospitality venues in 12 cities in Turkey. In each visited venue, we evaluated a pre-specified number of study locations such as the outdoor area of the main entrance, indoor areas, and patios or other outdoor dining areas, completely or partially covered with window walls. We measured particulate matter 2.5 (PM2.5) in those areas. Results: The fieldworkers visited 72 randomly selected hospitality venues and measured PM2.5 concentrations in 165 different locations (indoor, outdoor, and patios) of those venues. Overall, 2573 people were observed, 909 of them smoking. The median (IQR) PM2.5 concentrations were 95 (39-229) µg/m3 indoors, 25 (13-48) µg/m3 outdoors, and 31 µg/m3 (16-62) in the patios (p < 0.001). After adjustment, each additional smoker was associated with a 2% increase in PM2.5 concentrations in patio air (GMR (95% CI): 1.02 (1.00, 1.05), and a 4% increase in indoor air (GMR (95% CI): 1.04 (1.02, 1.05). Conclusions: There were unhealthy levels of smoking-caused PM2.5 concentrations, not only indoors, but also in the patios of hospitality venues. Legislative efforts to expand the smoke-free legislation to outdoor areas adjacent to indoor public places and an action plan to increase compliance with the smoke-free policy are urgently needed in Turkey.
AB - Background: Turkey passed a law banning smoking in all indoor public places in 2008. In response to the indoor smoking restriction, many smokers may have relocated to outdoor areas of venues. The aim of this study was to evaluate air pollution related to SHS exposure in indoor and outdoor areas of hospitality venues in 12 cities in Turkey. Method: In this cross-sectional study, we evaluated hospitality venues in 12 cities in Turkey. In each visited venue, we evaluated a pre-specified number of study locations such as the outdoor area of the main entrance, indoor areas, and patios or other outdoor dining areas, completely or partially covered with window walls. We measured particulate matter 2.5 (PM2.5) in those areas. Results: The fieldworkers visited 72 randomly selected hospitality venues and measured PM2.5 concentrations in 165 different locations (indoor, outdoor, and patios) of those venues. Overall, 2573 people were observed, 909 of them smoking. The median (IQR) PM2.5 concentrations were 95 (39-229) µg/m3 indoors, 25 (13-48) µg/m3 outdoors, and 31 µg/m3 (16-62) in the patios (p < 0.001). After adjustment, each additional smoker was associated with a 2% increase in PM2.5 concentrations in patio air (GMR (95% CI): 1.02 (1.00, 1.05), and a 4% increase in indoor air (GMR (95% CI): 1.04 (1.02, 1.05). Conclusions: There were unhealthy levels of smoking-caused PM2.5 concentrations, not only indoors, but also in the patios of hospitality venues. Legislative efforts to expand the smoke-free legislation to outdoor areas adjacent to indoor public places and an action plan to increase compliance with the smoke-free policy are urgently needed in Turkey.
KW - Hospitality venue
KW - PM2.5
KW - Secondhand smoke
KW - Turkey
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U2 - 10.3390/ijerph16081381
DO - 10.3390/ijerph16081381
M3 - Article
C2 - 30999605
AN - SCOPUS:85065023370
SN - 1661-7827
VL - 16
JO - International journal of environmental research and public health
JF - International journal of environmental research and public health
IS - 8
M1 - 1381
ER -