Cheryl Higbee

In 1986, a report of the U.S. Surgeon General concluded that second hand smoke is a cause of disease in healthy non smokers. Subsequent many nations including Tunisia implement smoke-free worksite regulations. The aim of our study is to test air quality in indoor ambient air venues in Tunisia. A TSI SidePak AM510 Personal Aerosol Monitor was used to sample, record the levels of respirable suspended particles (RSP) in the air and to assess the real-time concentration of particles less than 2.5 microm in micrograms per cubic meter, or PM2.5. Thirty three venues were sampled in Tunis. The venues were selected to get a broad range of size, location and type of venue. Venues included restaurants and cafés, bars, bus stations, hospitals, offices, and universities. The mean level of indoor air pollution was 296 microg/m3 ranged from 11 microg/m3 to 1,499 microg/m3. The level of indoor air pollution was 85% lower in venues that were smoke-free compared to venues where smoking was observed (p<0.001). Averaged across each type of venue, the lowest levels of indoor air pollution were found in hospitals, offices and universities (52 microg/m3) and the highest level was found in a bar (1,499 micro/m3). Hospitality venues allowing indoor air smoking in Tunisia are significantly more polluted than both indoor smoke-free sites and outdoor air in Tunisia. This study demonstrates that workers and patrons are exposed to harmful levels of a known carcinogen and toxin. Policies that prohibit smoking in public worksites dramatically reduce second hand smoke exposure and improve worker and patron health.

Second hand smoking is still a great challenge in every country. Every tobacco transnational companies try to destroy all the evidence of the consequences of this kind of exposure. Now in many countries there are surveillance studies looking for evidence. One of this study (organized in 20 countries) is this one where Romania was counterpart. We tested with the TSI SidePak AM510 Personal Aerosol Monitor the level of exposure in 41 pubs, restaurants and bars and the results demonstrate that there are high level of particles coming from active smoking. In the same time the authors are making a comparison of different levels form other countries where this kind of monitor was used.

Secondhand smoke (SHS) is the third leading cause of preventable death in the United States. It is responsible for an estimated 3,000 lung cancer deaths annually in never-smokers in the US. It also accounts for over 35,000 deaths annually from coronary heart disease in never-smokers. It increases the number and severity of asthmatic attacks in over 300,000 asthmatic children each year, and is associated with Sudden Infant Death Syndrome and middle ear infections, in addition to other illnesses in children. The purpose of this study was to examine indoor air quality in a sample of hospitality venues in Paducah, Kentucky. The relation between indoor air pollution and the presence of on premises smoking was assessed. A Personal Aerosol Monitor was used to sample and record the levels of respirable suspended particles in the air. The SidePak uses a built-in sampling pump that draws air through the device and the particulate matter in the air scatters the light from a laser. Based on this light scattering, the device determines to assess the real-time concentration of particles smaller than 2.5 microm in micrograms per cubic meter, or PM2.5. The average PM2.5 concentration in the eleven locations sampled in Paducah, Kentucky, was 177 microg/m3. The average fine particle pollution level in the non-smoking sections tested was 87 microg/m3, which is 29 times higher than the average fine particle pollution level in smoke-free air or 6 times higher than outdoor air in Paducah. The average PM2.5 level across all nine smoking-permitted hospitality locations sampled in Paducah was 200 microg/m3. For a full-time employee in the venues sampled in this study, the average annual PM2.5 exposure would be 46 microg/m3 (assuming exposure to 200 microg/m3 on the job, exposure to zero particles off the job, and a 40-hour work week). The EPA average annual PM2.5 limit is exceeded by 3.1 times due solely to occupational exposure. Of the ten locations visited that permit indoor smoking, the air monitoring was done in the non-smoking section of six of them. These locations included five restaurants and one public government office. The average fine particle pollution level in these non-smoking sections was 87 microg/m3, which is 29 times higher than the average fine particle pollution level in smoke-free air or 6 times higher than outdoor air in Paducah. It is also interesting to note that the average fine particle pollution level in the smoking section of one restaurant was actually less than the average fine particle pollution level in the "no smoking" section of two other restaurants. The effects of secondhand smoke are substantial and rapid, explaining the relatively large health risks associated with secondhand smoke exposure that have been reported in epidemiological studies. This study shows that physically separating smokers and non-smokers is not an effective way to protect non-smoking patrons from tobacco smoke pollution. "No smoking" sections provided protection to nonsmokers that can be characterized as trivial at best. In fact, patrons in Paducah cannot be certain that their exposure will not be higher in the "no smoking" sections of certain venues when compared to the smoking sections of other venues. It is imperative that physicians and other healthcare providers actively and aggressively lobby local policymakers to pass regulatory and/or public health ordinances, which have been demonstrated to be effective in controlling exposure to secondhand smoke.

The objective of this study was to assess the relationship between exposure to state-sponsored anti-tobacco advertising and smoking cessation. Cessation rates in 2001 among a cohort of 2061 smokers who participated in the Community Intervention Trial for Smoking Cessation between 1988 and 1993 and completed a follow-up survey in 2001 were merged with 2000–01 television advertising exposure data from Nielsen Media Research. The relative risk for quitting was estimated to be 10% higher for every 5000 units of exposure to state anti-tobacco television advertising over the 2-year period, although this did not quite achieve statistical significance. The association was even larger among those who reported that the level of information in the media about the dangers of smoking had increased ‘a lot’ between 1993 and 2001 (RR = 1.19, 95% CI = 1.03–1.38). These data are consistent with the finding that increased exposure to state anti-tobacco media increases smoking cessation rates.

The objective of this study was to assess the relationship between exposure to state-sponsored anti-tobacco advertising and smoking cessation. Cessation rates in 2001 among a cohort of 2061 smokers who participated in the Community Intervention Trial for Smoking Cessation between 1988 and 1993 and completed a follow-up survey in 2001 were merged with the 2000–01 television advertising exposure data from Nielsen Media Research. The relative risk for quitting was estimated to be 10% higher for every 5000 units of exposure to state anti-tobacco television advertising over the 2-year period, although this did not quite achieve statistical significance. The association was even larger among those who reported that the level of information in the media about the dangers of smoking had increased ‘a lot’ between 1993 and 2001 (RR = 1.19, 95% CI = 1.03–1.38). These data are consistent with the finding that increased exposure to state anti-tobacco media increases smoking cessation rates.