Open Access Research article

Impact of a smoking ban in hospitality venues on second hand smoke exposure: a comparison of exposure assessment methods

Sarah Rajkumar12, Cong Khanh Huynh3, Georg F Bauer4, Susanne Hoffmann4 and Martin Röösli12*

Author Affiliations

1 Swiss Tropical and Public Health Institute, Basel, Switzerland

2 University of Basel, Basel, Switzerland

3 Institute for Work and Health, Lausanne, Switzerland

4 Institute of Social and Preventive Medicine, University of Zürich and Center for Organizational and Occupational Sciences, ETH Zurich, Switzerland

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BMC Public Health 2013, 13:536  doi:10.1186/1471-2458-13-536

Published: 4 June 2013

Abstract

Background

In May 2010, Switzerland introduced a heterogeneous smoking ban in the hospitality sector. While the law leaves room for exceptions in some cantons, it is comprehensive in others. This longitudinal study uses different measurement methods to examine airborne nicotine levels in hospitality venues and the level of personal exposure of non-smoking hospitality workers before and after implementation of the law.

Methods

Personal exposure to second hand smoke (SHS) was measured by three different methods. We compared a passive sampler called MoNIC (Monitor of NICotine) badge, to salivary cotinine and nicotine concentration as well as questionnaire data. Badges allowed the number of passively smoked cigarettes to be estimated. They were placed at the venues as well as distributed to the participants for personal measurements. To assess personal exposure at work, a time-weighted average of the workplace badge measurements was calculated.

Results

Prior to the ban, smoke-exposed hospitality venues yielded a mean badge value of 4.48 (95%-CI: 3.7 to 5.25; n = 214) cigarette equivalents/day. At follow-up, measurements in venues that had implemented a smoking ban significantly declined to an average of 0.31 (0.17 to 0.45; n = 37) (p = 0.001). Personal badge measurements also significantly decreased from an average of 2.18 (1.31-3.05 n = 53) to 0.25 (0.13-0.36; n = 41) (p = 0.001). Spearman rank correlations between badge exposure measures and salivary measures were small to moderate (0.3 at maximum).

Conclusions

Nicotine levels significantly decreased in all types of hospitality venues after implementation of the smoking ban. In-depth analyses demonstrated that a time-weighted average of the workplace badge measurements represented typical personal SHS exposure at work more reliably than personal exposure measures such as salivary cotinine and nicotine.

Keywords:
Smoking ban; Hospitality workers; Second hand smoke; Passive sampler; Prospective study