Spanish Smoking Law and Exposure to Second-Hand Smoke and Respiratory Health in Hospitality Workers: A Study
– Reported, January19 2013
A smoke-free law came into effect in Spain on 1st January 2006, affecting all enclosed workplaces except hospitality venues, whose proprietors can choose among totally a smoke-free policy, a partial restriction with designated smoking areas, or no restriction on smoking on the premises. We aimed to evaluate the impact of the law among hospitality workers by assessing second-hand smoke (SHS) exposure and the frequency of respiratory symptoms before and one year after the ban.We evaluated biologically assessed and self-reported exposure to SHS and respiratory health in hospitality workers in five regions of Spain before and after the law came into effect. As a control group we studied hospitality workers in Portugal and Andorra, where no ban on smoking was in effect at that time. The European Community Respiratory Health Study (ECRHS) questionnaire was used to assess respiratory health, and considered the eight main symptoms : breathless while wheezing, woken up with a feeling of chest tightness, attack of shortness of breath at rest, woken by attack of shortness of breath, usually cough first thing in the morning in winter, usually cough during the day or night during winter, usually bring up phlegm during day or night in winter, had asthma attack. It was computed the prevalence of each symptom individually and combined all symptoms into a single indicator variable (presence/absence of any of the eight respiratory symptoms. Multivariate adjustment confirmed the lack of significant changes between baseline and follow-up salivary cotinine concentrations in Portugal and Andorra. The presence of any respiratory symptom significantly decreased in hospitality workers in venues where smoking was completely prohibited in Spain, whereas no significant changes were found in the rest of workers in Spain, or in Portugal and Andorra.In summary, the partial smoking ban in Spain does not sufficiently protect hospitality workers against SHS and its effects on respiratory health. These results provide further evidence in support of World Health Organization policy recommendations to protect workers and the population from exposure to SHS by means of total bans. Hence, almost 1 000 000 hospitality workers (approximately half of them nonsmokers) in Spain continue to be unprotected against SHS. Policy makers in other countries currently considering the scope of their smoke-free legislation should not ignore these results. Partial bans, voluntary policies or courtesy of choice programs (promoted by the tobacco industry) do not completely protect workers and others against second-hand smoke.CREDITS:Esteve Fernández, Marcela Fu, José A. Pascual, María J. López, Mónica Pérez-Ríos, Anna Schiaffino, Jose M. Martínez-Sánchez, Carles Ariza,6,7 Esteve Saltó, Manel Nebot, and and the Spanish Smoking Law Evaluation Group http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2621339/
