Secondhand smoke exposure in outdoor settings in Europe
Secondhand smoke (SHS) exposure causes death, disease, and disability among children and non-smoking adults. Total smoking bans have proven effective in preventing and reducing indoor SHS exposures. However, little is known about the extent and magnitude of SHS in outdoor settings, which, in turn, a...
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| Tipo de recurso: | tesis doctoral |
| Estado: | Versión publicada |
| Fecha de publicación: | 2021 |
| País: | España |
| Institución: | CBUC, CESCA |
| Repositorio: | TDR. Tesis Doctorales en Red |
| OAI Identifier: | oai:www.tdx.cat:10803/672882 |
| Acceso en línea: | http://hdl.handle.net/10803/672882 |
| Access Level: | acceso abierto |
| Palabra clave: | Environmental Tobacco Smoke Outdoor Child Smoke-free policy Airborne nicotine Spanish Humo Ambiental de Tabaco Espacios al aire libre Niño/a Políticas para espacios libres de humo Nicotina ambiental 616.2 |
| Sumario: | Secondhand smoke (SHS) exposure causes death, disease, and disability among children and non-smoking adults. Total smoking bans have proven effective in preventing and reducing indoor SHS exposures. However, little is known about the extent and magnitude of SHS in outdoor settings, which, in turn, are barely covered by the smoke-free regulations in Europe. Thus, this thesis aimed to explore the levels and prevalence of SHS in selected outdoor settings in diverse European countries and according to different contextual factors. To this end, four cross-sectional studies were conducted with data from 2017-2018 and within the framework of the TackSHS project. Airborne nicotine measurements, along with the observation of tobacco-related signs, were performed in children’s playgrounds (Study I), entrances to primary school buildings (Study II), and terraces of hospitality venues (Study III) from 11 European countries. The prevalence of SHS presence outdoors (Study IV) was assessed through a survey in a representative sample of the population aged 15 years or older in 12 European countries. In both child-related areas, median nicotine concentrations were below the limit of quantification (0.06 μg/m3). Still, nicotine was present in 41% of the playgrounds and 46% of the schools; and people were smoking in 20% of playgrounds and over 40% of schools. Social inequalities in SHS exposure were observed in playgrounds and schools. Practically all terraces of hospitality venues had presence of nicotine and median nicotine concentrations at these areas were 0.85 (Interquartile Range: 0.30–3.74) μg/m3. In terraces with more than two people smoking, airborne nicotine concentrations were high and did not significantly vary with the venue’s degree of enclosure. More than half the respondents in the survey had witnessed people smoking at parks, stadia, outdoor areas of schools, outdoor areas in hospitals, public transport stops, terraces of hospitality venues, and beaches. Non-compliance with smoking bans was also observed in several outdoor areas. All studies showed an association between higher national smoking prevalence and SHS exposure outdoors. Smoke-free legislation should be implemented or better enforced in child-related areas in Europe. Moreover, in terraces of hospitality venues, total smoking bans should replace smoking restrictions based on the presence of sidewalls and overhead covers. Smoking bans should also be extended to other outdoor areas, such as public transport stops or beaches. Finally, other tobacco demand reduction measures should be considered to better address outdoor SHS exposures. |
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