Attitudes towards electronic cigarettes regulation in indoor workplaces and selected public and private places: a population-based cross-sectional study.

Jose M Martínez-Sánchez,Constantine I Vardavas,Juan C Martín-Sánchez,Esteve Saltó,Marcela Fu,Esteve Fernández,Richard Daynard,Mark Gottlieb,Montse Ballbè,Gregory N Connolly

doi:10.1371/journal.pone.0114256

Abstract

BackgroundCurrently, there is an intensive debate about the regulation of the use of electronic cigarettes (e-cigarettes) in indoor places. The aim of this study was to assess the attitudes toward e-cigarette use in indoor workplaces and selected public and private venues among the general population in Barcelona (Spain) in 2013–2014.MethodsThis is a cross-sectional study of a representative sample of the population of Barcelona (n = 736). The field work was conducted between May 2013 and February 2014. We computed the prevalence and the adjusted odds ratios (OR) derived from multivariable logistic regression models.ResultsThe awareness of e-cigarettes was 82.3%. Forty five percent of respondents did not agree with the use of e-cigarettes in public places and 52.3% in workplaces. The proportion of disapproval of the use of e-cigarettes in indoor places was higher at 71.5% for schools and 65.8% for hospitals and health care centers; while the prevalence of disapproval of e-cigarette use in homes and cars was lower (18.0% and 32.5%, respectively). Respondents who disagreed on the use of e-cigarettes in indoor workplaces were more likely to be older (OR = 1.64 and 1.97 for groups 45–64 and ≧65 years old, respectively), those with a high educational level (OR = 1.60), and never and former smokers (OR = 2.34 and 2.16, respectively). Increased scores in the Fagerström test for cigarette dependence were also related to increased support for their use.ConclusionsBased on this population based study, half of the general population of Barcelona does not support the use of e-cigarettes in indoor workplaces and public places, with the percentage reaching 65% for use in schools, hospitals and health care centers. Consequently, there is good societal support in Spain for the politicians and legislators to promote policies restricting e-cigarettes use in workplaces and public places, including hospitality venues.

Highlights

Secondhand smoke (SHS) exposure is responsible of 1% (603,000 deaths per year) of mortality worldwide [1]
Approximately half of the general population did not agree with the use of e-cigarettes in any public place and indoor workplaces
The higher percentages of disagreement with their use were found for hospitals and other health care centers, and in schools

Summary

Introduction

Secondhand smoke (SHS) exposure is responsible of 1% (603,000 deaths per year) of mortality worldwide [1]. Several countries have implemented smoke-free bans in all indoor workplaces and public places in order to protect the non-smoker population, including children, from the harmful health effects of the SHS exposure as noted by Article 8 of the World Health organization, Framework Convention on Tobacco Control [2]. Among the general population of the United States (US) [6] the prevalence of ever-use, according to a web-based survey, showed a twofold increase between 2010 and 2011 (from 3.3% to 6.2%). This double increase was observed in US adolescents [7] and in middle and high school students [8] between 2011 and 2012. Respondents who disagreed on the use of e-cigarettes in indoor workplaces were more likely to be older (OR51.64 and 1.97 for groups 45–64 and §65 years old, respectively), those with a high

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