Abstract
INTRODUCTIONDespite the growing number of smoke-free spaces, many non-smokers continue to be involuntarily exposed to secondhand smoke outdoors and on public streets. Both theory and research suggest that people living in densely populated urban areas are more likely to smoke than those living in less densely populated areas. Consequently, non-smokers in densely populated urban areas might be more likely to be exposed and feel annoyed by secondhand smoke outdoors. We investigated whether the extent to which non-smokers feel annoyed by secondhand smoke exposure in outdoor public spaces is related to urban population density.METHODSWe used cross-sectional survey data from the Netherlands ‘Module Substance Use’ survey (2020 data, n=9375). This is a nationally representative sample of the adult population in the Netherlands. Using logistic regression models, we investigated whether urban population density predicts both smoking and non-smokers’ annoyance to secondhand smoke exposure outdoors.RESULTSWe found that smoking rates were associated with urban population density. In the Netherlands, people living in extremely population-dense urban areas were more likely to smoke than those living in non-urban areas (AOR=1.59; 95% CI: 1.25–2.02, p<0.001). Feeling annoyed by secondhand smoke outdoors was also associated with urban population density: non-smokers living in extremely population-dense urban areas were more likely to be annoyed than respondents living in non-urban areas (AOR=1.65; 95% CI: 1.34–2.02, p<0.001).CONCLUSIONSThese cross-sectional data highlight the importance of comprehensive local tobacco control policy programs that include creating smoke-free outdoor public spaces. This need for such smoke-free outdoor public spaces might be particularly strong in densely populated areas.
Highlights
Despite the growing number of smoke-free spaces, many non-smokers continue to be involuntarily exposed to secondhand smoke outdoors and on public streets
We found that urban density is positively associated with the percentage of non-smokers feeling annoyed by secondhand smoke outdoors or on the streets
Non-smokers living in highly dense urban areas were much more likely to feel annoyed by secondhand smoke outdoors than non-smokers living in less dense areas
Summary
Despite the growing number of smoke-free spaces, many non-smokers continue to be involuntarily exposed to secondhand smoke outdoors and on public streets. Both theory and research suggest that people living in densely populated urban areas are more likely to smoke than those living in less densely populated areas. Research conducted on the effect of short-term exposure on lung function revealed that exposure to secondhand smoke for one hour could result in inflammatory reactions in the lungs and in decreased lung function[3] It is recommended by the WHO and tobacco control scientists that policymakers implement smoke-free policies to protect non-smokers from the harms of exposure to tobacco smoke[4,5].
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