Abstract

BackgroundSecondhand smoke (SHS) exposure is a well-established health hazard. To determine the effectiveness of existing smoke-free policies and adoption of smoke-free rules in South Africa, we assessed exposure to SHS from several sources among non-smoking adults during 2010.MethodsData were analyzed for 3,094 adults aged ≥16 years who participated in the 2010 South African Social Attitudes Survey. Descriptive statistics and multivariate analyses were used to assess presence of smoke-free rules among all South Africans, and prevalence and correlates of SHS exposure at work, at home, and at hospitality venues among non-smokers.ResultsOverall, 70.6% of all South African adults had 100% smoke-free rules in their private cars, 62.5% in their homes, while 63.9% worked in places with 100% smoke-free policies. Overall, 55.9% of all non-smokers reported exposure to SHS from at least one source (i.e., in the home, workplace or at a hospitality venue). By specific source of exposure, 18.4% reported being exposed to SHS at work, 25.2% at home, 33.4% in a restaurant, and 32.7% at a bar. Presence of work bans on indoor smoking conferred lower likelihood of SHS exposure at work among non-smokers (adjusted odds ratio [aOR] = 0.23; 95% CI: 0.09-0.60). Similarly, smoke-free home rules decreased the odds of being exposed to SHS at home among non-smokers (aOR =0.16; 95% CI: 0.09-0.30).ConclusionOver half of South African adults reported SHS exposure in the home or at public places such as the workplace and at hospitality venues. This underscores the need for comprehensive smoke-free laws that prohibit smoking in all public indoor areas without exemptions.

Highlights

  • Secondhand smoke (SHS) exposure is a well-established health hazard

  • During 2010, 62.5% of South African adults had 100% smoke-free policies in their homes, 63.9% worked in places with 100% smoke-free policies, and 70.6% of all adults had 100% smoke-free policies in their private cars

  • There were no significant differences in the prevalence of 100% smoke-free policies in the home, workplace or private cars when stratified by age, sex, education level, residence type or marital status

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Summary

Introduction

To determine the effectiveness of existing smoke-free policies and adoption of smoke-free rules in South Africa, we assessed exposure to SHS from several sources among non-smoking adults during 2010. On April 19, 2005, South Africa became a party to the World Health Organization’s (WHO) Framework Convention on Tobacco Control (FCTC) [1]. Under this international Treaty which has been ratified by 175 countries, South Africa has a legal obligation to implement and enforce policies that protect non-smokers from involuntary exposure to tobacco smoke. Article 8 of the WHO FCTC requires parties to make enhanced and sustained efforts to protect nonsmoking children and adults from secondhand advances have the potential to strengthen smoke-free laws in South Africa. The proposed law regulates smoking in selected outdoor areas, with increased fines for violations of indoor smoke-free laws

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