Abstract
BackgroundIn May 2010, Switzerland introduced a heterogeneous smoking ban in the hospitality sector. While the law leaves room for exceptions in some cantons, it is comprehensive in others. This longitudinal study uses different measurement methods to examine airborne nicotine levels in hospitality venues and the level of personal exposure of non-smoking hospitality workers before and after implementation of the law.MethodsPersonal exposure to second hand smoke (SHS) was measured by three different methods. We compared a passive sampler called MoNIC (Monitor of NICotine) badge, to salivary cotinine and nicotine concentration as well as questionnaire data. Badges allowed the number of passively smoked cigarettes to be estimated. They were placed at the venues as well as distributed to the participants for personal measurements. To assess personal exposure at work, a time-weighted average of the workplace badge measurements was calculated.ResultsPrior to the ban, smoke-exposed hospitality venues yielded a mean badge value of 4.48 (95%-CI: 3.7 to 5.25; n = 214) cigarette equivalents/day. At follow-up, measurements in venues that had implemented a smoking ban significantly declined to an average of 0.31 (0.17 to 0.45; n = 37) (p = 0.001). Personal badge measurements also significantly decreased from an average of 2.18 (1.31-3.05 n = 53) to 0.25 (0.13-0.36; n = 41) (p = 0.001). Spearman rank correlations between badge exposure measures and salivary measures were small to moderate (0.3 at maximum).ConclusionsNicotine levels significantly decreased in all types of hospitality venues after implementation of the smoking ban. In-depth analyses demonstrated that a time-weighted average of the workplace badge measurements represented typical personal SHS exposure at work more reliably than personal exposure measures such as salivary cotinine and nicotine.
Highlights
In May 2010, Switzerland introduced a heterogeneous smoking ban in the hospitality sector
Control Group II consisted of non-smoking hospitality workers who worked in a smoke-free environment at all times, and Control Group III were non-smokers that were regularly exposed to second hand smoke (SHS) without being employed in the hospitality sector
The intervention group comprised 56 persons at baseline, 44 persons at follow-up 1 (79%) and 42 at follow-up 2 (75%). These were compared to the control groups: 6 persons working in smoking venues that did not change their rule, 14 hospitality workers that had always worked in smoke-free environments (Control Group II) and 16 persons that are regularly exposed to SHS privately or at work without being employed in the hospitality sector (Control Group III)
Summary
In May 2010, Switzerland introduced a heterogeneous smoking ban in the hospitality sector. While the law leaves room for exceptions in some cantons, it is comprehensive in others. This longitudinal study uses different measurement methods to examine airborne nicotine levels in hospitality venues and the level of personal exposure of non-smoking hospitality workers before and after implementation of the law. Switzerland is divided into 26 administrative zones called cantons, and each was permitted to implement its own stricter legislation on top of the national law. This has resulted in a patchwork of different laws within a small geographical area
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