Secondhand tobacco smoke exposure in selected public places (PM_2.5 and air nicotine) and non-smoking employees (hair nicotine) in Ghana

Background Secondhand tobacco smoke (SHS) exposure is a global public health problem. Ghana currently has no legislation to prevent smoking in public places. To provide data on SHS levels in hospitality venues in Ghana the authors measured (1) airborne particulate matter <2.5 μm (PM_2.5) and nicotine concentrations and (2) hair nicotine concentrations in non-smoking employees. Quantifying SHS exposure will provide evidence needed to develop tobacco control legislation. Method PM_2.5 was measured for 30 min in 75 smoking and 13 non-smoking venues. Air nicotine concentrations were measured for 7 days in 8 smoking and 2 non-smoking venues. Additionally, 63 non-smoking employees provided hair samples for nicotine analysis. Result Compared to non-smoking venues, smoking venues had markedly elevated PM_2.5 (median 553 [IQR 259e1038] vs 16.0 [14.0e17.0] μg/m³) and air nicotine (1.83 [0.91e4.25] vs 0.03 [0.02e0.04] μg/m³) concentrations. Hair nicotine concentrations were also higher in non-smoking employees working in smoking venues (median 2.49 [0.46e6.84] ng/mg) compared to those working in non-smoking venues (median 0.16 [0.08e0.79] ng/mg). Hair nicotine concentrations correlated with self-reported hours of SHS exposure (r1/40.35), indoor air PM_2.5 concentrations (r1/40.47) and air nicotine concentrations (r1/40.63). Conclusion SHS levels were unacceptably high in public places in Ghana where smoking is allowed, despite a relatively low-smoking prevalence in the country. This is one of the first studies to ascertain SHS and hair nicotine in Africa. Levels were comparable to those measured in American, Asian and European countries without or before smoking bans. Implementing a comprehensive smoke-free legislation that protects workers and customers from exposure to secondhand smoke is urgently needed in Ghana.