Secondhand Smoke Concentrations in Hospitality Venues in the Pacific Basin: Findings from American Samoa, Commonwealth of the Northern Mariana Islands, and Guam

King, Brian A;Dube, Shanta R;Ko, Jean Y

  • Published : 20111100

Abstract

Introduction: Secondhand smoke (SHS) from burning tobacco products causes disease and premature death among nonsmokers. Although the number of laws prohibiting smoking in indoor public places continues to increase, millions of nonsmokers in the United States (US) and its territories remain exposed to SHS. This study assessed indoor air pollution from SHS in hospitality venues in three US Pacific Basin territories. Methods: Air monitors were used to assess $PM_{2.5}$, an environmental marker for SHS, in 19 smoke-permitted and 18 smoke-free bars and restaurants in American Samoa, Commonwealth of the Northern Mariana Islands (CNMI), and Guam. Observational logs were used to record smoking and other sources of air pollution. Differences in average $PM_{2.5}$ concentrations were determined using bivariate statistics. Results: The average $PM_{2.5}$ level in venues where smoking was always permitted [arithmetic mean (AM)=$299.98{\mu}g/m^3$; geometric mean (GM)=$200.39{\mu}g/m^3$] was significantly higher (p<0.001) than smoke-free venues [AM=$8.33{\mu}g/m^3$; GM=$6.14{\mu}g/m^3$]. In venues where smoking was allowed only during certain times, the average level outside these times [AM=$42.10{\mu}g/m^3$; GM=$41.87{\mu}g/m^3$] was also significantly higher (p<0.001) than smoke-free venues. Conclusions: Employees and patrons of smoke-permitted bars and restaurants are exposed to dangerous levels of air pollution from SHS, even during periods when active smoking is not occurring. Prohibiting smoking in all public indoor areas, irrespective of the venue type or time of day, is the only way to fully protect nonsmokers from SHS exposure in these environments.

Keywords

References

  1. Allen M, and Clarke D (2007) Reducing tobacco-related harm in the Pacific. Pacific Health Dialog, 14, 115-7.
  2. American Samoa Government and World Health Organization. American Samoa NCD Risk Factors STEP Report. Available at: http://www.who.int/chp/steps/Printed_STEPS_Report_American_Samoa.pdf. Accessed February 15, 2011.
  3. Americans Nonsmokers' Rights Foundation (2011). U.S. 100% Smokefree Laws in Workplaces and Restaurants and Bars. Available at: http://www.no-smoke.org/pdf/WRBLawsMap.pdf. Accessed January 24, 2011.
  4. Centers for Disease Control and Prevention (2010a) State Tobacco Activities Tracking and Evaluation (STATE) System. Available at: http://www.cdc.gov/tobacco/statesystem. Accessed January 24, 2011.
  5. Centers for Disease Control and Prevention (2010b). State-specific prevalence of cigarette and smokeless tobacco use among adults - United States, 2009. Morbid Mort Week Rep, 59, 1400-6.
  6. Centers for Disease Control and Prevention (2010c). Vital signs: current cigarette smoking among adults aged ${\geq}$ 18 years - United States, 2009. Morbid Mort Week Rep, 59, 1135-40.
  7. Connolly GN, Carpenter CM, Travers MJ, et al (2009). How smoke-free laws improve air quality: a global study of Irish pubs. Nicotine & Tobacco Research, 11, 600-5. https://doi.org/10.1093/ntr/ntp038
  8. Eisner MD, Smith AK, Blanc PD (1998). Bartenders' Respiratory Health After Establishment of Smoke-Free Bars and Taverns. JAMA, 280, 1909-14. https://doi.org/10.1001/jama.280.22.1909
  9. Farrelly MC, Nonnemaker JM, Chou R, et al (2005). Changes in hospitality workers' exposure to secondhand smoke following the implementation of New York's smoke-free law. Tobacco Control, 14, 236-41. https://doi.org/10.1136/tc.2004.008839
  10. Fitchtenberg CM and Glantz, SA (2002). Effect of smoke-free workplaces on smoking behavior: systematic review. BMJ, 325, 188. https://doi.org/10.1136/bmj.325.7357.188
  11. Hyland A, Travers MJ, Dresler C, Higbee C, Cummings KM (2008). A 32-country comparison of tobacco smoke derived particle levels in indoor public places. Tobacco Control, 17, 159-65. https://doi.org/10.1136/tc.2007.020479
  12. Institute of Medicine of the National Academies (2009). Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the Evidence. Washington DC; Institute of Medicine.
  13. Lightwood JM and Glantz SA (2009). Declines in acute myocardial infarction after smoke-free laws and individual risk attributable to secondhand smoke. Circulation, 120, 1373-9. https://doi.org/10.1161/CIRCULATIONAHA.109.870691
  14. Rasanathan K and Tukuitonga CF (2007). Tobacco smoking prevalence in Pacific Island countries and territories: a review. NZ Med J, 120, U2742.
  15. Repace J (2004). Respirable particles and carcinogens in the air of Delaware hospitality venues before and after a smoking ban. J Occupational Environmental Med, 46, 887-905. https://doi.org/10.1097/01.jom.0000141644.69355.52
  16. Scollo M, Lal A, Hyland A, Glantz S (2003). Review of the quality of studies on the economic effects of smoke-free policies on the hospitality industry. Tobacco Control, 12, 13-20. https://doi.org/10.1136/tc.12.1.13
  17. Travers MJ, Cummings MJ, Hyland A, et al (2004). Indoor air quality in hospitality venues before and after implementation of a clean indoor air law-Western New York. Morbid Mort Week Rep, 53, 1038-41.
  18. U.S. Department of Health & Human Services (2006). The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Atlanta, GA: USDHHS, CDC and Prevention, CCHP, NCCDPHP, OSH.
  19. U.S. Department of Health and Human Services (2010). How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General. Atlanta, GA: UDHHS, CDC, NCCDPHP, OSH.
  20. U.S. Environmental Protection Agency (2006). Area Designations for 2006 24-Hour Fine Particle (PM2.5) Standards. Available at: http://www.epa.gov/pmdesignations/2006standards/index.htm Accessed February 01, 2011.
  21. Wakefield M, Trotter L, Cameron M, et al (2003). Association between exposure to workplace secondhand smoke and reported respiratory and sensory symptoms: cross-sectional study. J Occupational Environmental Med, 45, 622-7. https://doi.org/10.1097/01.jom.0000069242.06498.86
  22. Widome R, Samet JM, Hiatt RA, et al (2010). Science, prudence, and politics: the case of smoke-free indoor spaces. Annals of Epidemiology, 20, 428-35. https://doi.org/10.1016/j.annepidem.2010.03.004