Implementation Of Smoke-free Legislation Research Articles

Changes in the salivary cotinine cut-offs to discriminate smokers and non-smokers before and after Spanish smoke-free legislation

IntroductionHigh levels of cotinine in non-smokers indicate passive exposure to tobacco smoke. This study aims to evaluate variations in salivary cotinine cut-offs to discriminate smokers and non-smokers before and after the implementation of smoke-free legislation (Law 28/2005 and Law 42/2010) in a sample of the adult population of Barcelona, Spain. MethodsThis longitudinal study analyzes salivary cotinine samples and self-reported information from a representative sample (n = 676) of the adult population from Barcelona before and after the approval of smoke-free legislation. We calculated the receiver operating characteristic (ROC) curves, to obtain optimal cotinine cut-off points to discriminate between smokers and non-smokers overall, by sex and age, and their corresponding sensitivity, specificity, and area under the curve. We used linear mixed-effects models, with individuals as random effects, to model the percentage change of cotinine concentration before and after the implementation of both laws. ResultsThe mean salivary cotinine concentration was significantly lower post-2010 law (−85.8%, p < 0.001). The ROC curves determined that the optimal cotinine cut-off points for discriminating non-smokers and smokers were 10.8 ng/mL (pre-2005 law) and 5.6 ng/mL (post-2010 law), with a post-2010 law sensitivity of 92.6%, specificity of 98.4%, and an area under the curve of 97.0%. The post-2010 law cotinine cut-off points were 5.6 ng/mL for males and 1.9 ng/mL for females. ConclusionThe implementation of Spanish smoke-free legislation was effective in reducing secondhand smoke exposure and, therefore, also in reducing the cut-off point for salivary cotinine concentration. This value should be used to better assess tobacco smoke exposure in this population.

Status and correlates of home smoking bans after the implementation of the smoke-free legislation in public places: A survey in Chongqing.

INTRODUCTIONSecondhand smoke exposure in many countries decreased dramatically after the implementation of smoke-free legislation in public places, but the exposure at home did not change to the same degree. The aim of this study was to describe the status and correlates of a home smoking ban in Chongqing, China.METHODSFrom June to August 2021, we selected two healthcare centers in the East, West, North, South and Middle regions of Chongqing. We investigated the family smoke-free situation in the selected region using a stratified random sampling method. A chi-squared test was performed to compare the totally and partially smoke-free homes, and a binary logistic regression model was used to analyze the correlates of smoke-free rules at home.RESULTSThe study investigated 2121 families, among which 884 (41.7%) implemented a total ban on smoking at home. The covariates included age (OR=1.54; 95% CI: 1.18–2.01), living with children aged <14 years (OR=1.51; 95% CI: 1.20–1.90), no smokers in the family (OR=2.37; 95% CI: 1.78–3.17), awareness of the hazards of secondhand smoke (OR=1.30; 95% CI: 1.07–1.59), worrying about the impact of smoking in the presence of children on health (OR=1.92; 95% CI: 1.25–2.95), no difficulty (OR=1.34; 95% CI: 1.07–1.67) and confidence (OR=1.73; 95% CI: 1.41–2.13) in stopping others from smoking, no smoking rules in cars (OR=3.67; 95% CI: 2.58–5.22), and frequency of entertaining guests with cigarettes (OR=0.41; 95% CI: 0.28–0.59).CONCLUSIONSIt is common for households in Chongqing to have smoking bans, especially those with children. If a family has members that are smokers, education researchers should pay more attention to the hazards of secondhand smoke on the health of family members, and to adopt more tobacco control measures and enhance the self-efficacy of implementing a home smoking ban. Helping smokers to quit is a vital way to decrease the hazards of cigarettes.

The impact of changing cigarette smoking habits and smoke-free legislation on orofacial cleft incidence in the United Kingdom: Evidence from two time-series studies.

Both active and passive cigarette smoking have previously been associated with orofacial cleft aetiology. We aimed to analyse the impact of declining active smoking prevalence and the implementation of smoke-free legislation on the incidence of children born with a cleft lip and/or palate within the United Kingdom. We conducted regression analysis using national administrative data in the United Kingdom between 2000-2018. The main outcome measure was orofacial cleft incidence, reported annually for England, Wales and Northern Ireland and separately for Scotland. First, we conducted an ecological study with longitudinal time-series analysis using smoking prevalence data for females over 16 years of age. Second, we used a natural experiment design with interrupted time-series analysis to assess the impact of smoke-free legislation. Over the study period, the annual incidence of orofacial cleft per 10,000 live births ranged from 14.2-16.2 in England, Wales and Northern Ireland and 13.4-18.8 in Scotland. The proportion of active smokers amongst females in the United Kingdom declined by 37% during the study period. Adjusted regression analysis did not show a correlation between the proportion of active smokers and orofacial cleft incidence in either dataset, although we were unable to exclude a modest effect of the magnitude seen in individual-level observational studies. The data in England, Wales and Northern Ireland suggested an 8% reduction in orofacial cleft incidence (RR 0.92, 95%CI 0.85 to 0.99; P = 0.024) following the implementation of smoke-free legislation. In Scotland, there was weak evidence for an increase in orofacial cleft incidence following smoke-free legislation (RR 1.16, 95%CI 0.94 to 1.44; P = 0.173). These two ecological studies offer a novel insight into the influence of smoking in orofacial cleft aetiology, adding to the evidence base from individual-level studies. Our results suggest that smoke-free legislation may have reduced orofacial cleft incidence in England, Wales and Northern Ireland.

Smoke-free legislation and child health.

In this paper, we aim to present an overview of the scientific literature on the link between smoke-free legislation and early-life health outcomes. Exposure to second-hand smoke is responsible for an estimated 166 ,000 child deaths each year worldwide. To protect people from tobacco smoke, the World Health Organization recommends the implementation of comprehensive smoke-free legislation that prohibits smoking in all public indoor spaces, including workplaces, bars and restaurants. The implementation of such legislation has been found to reduce tobacco smoke exposure, encourage people to quit smoking and improve adult health outcomes. There is an increasing body of evidence that shows that children also experience health benefits after implementation of smoke-free legislation. In addition to protecting children from tobacco smoke in public, the link between smoke-free legislation and improved child health is likely to be mediated via a decline in smoking during pregnancy and reduced exposure in the home environment. Recent studies have found that the implementation of smoke-free legislation is associated with a substantial decrease in the number of perinatal deaths, preterm births and hospital attendance for respiratory tract infections and asthma in children, although such benefits are not found in each study. With over 80% of the world’s population currently unprotected by comprehensive smoke-free laws, protecting (unborn) children from the adverse impact of tobacco smoking and SHS exposure holds great potential to benefit public health and should therefore be a key priority for policymakers and health workers alike.

Has Childhood Smoking Reduced Following Smoke-Free Public Places Legislation? A Segmented Regression Analysis of Cross-Sectional UK School-Based Surveys.

Introduction:Smoke-free legislation has been a great success for tobacco control but its impact on smoking uptake remains under-explored. We investigated if trends in smoking uptake amongst adolescents differed before and after the introduction of smoke-free legislation in the United Kingdom.Methods:Prevalence estimates for regular smoking were obtained from representative school-based surveys for the four countries of the United Kingdom. Post-intervention status was represented using a dummy variable and to allow for a change in trend, the number of years since implementation was included. To estimate the association between smoke-free legislation and adolescent smoking, the percentage of regular smokers was modeled using linear regression adjusted for trends over time and country. All models were stratified by age (13 and 15 years) and sex.Results:For 15-year-old girls, the implementation of smoke-free legislation in the United Kingdom was associated with a 4.3% reduction in the prevalence of regular smoking (P = .029). In addition, regular smoking fell by an additional 1.5% per annum post-legislation in this group (P = .005). Among 13-year-old girls, there was a reduction of 2.8% in regular smoking (P = .051), with no evidence of a change in trend post-legislation. Smaller and nonsignificant reductions in regular smoking were observed for 15- and 13-year-old boys (P = .175 and P = .113, respectively).Conclusions:Smoke-free legislation may help reduce smoking uptake amongst teenagers, with stronger evidence for an association seen in females. Further research that analyses longitudinal data across more countries is required.Implications:Previous research has established that smoke-free legislation has led to many improvements in population health, including reductions in heart attack, stroke, and asthma. However, the impacts of smoke-free legislation on the rates of smoking amongst children have been less investigated. Analysis of repeated cross-sectional surveys across the four countries of the United Kingdom shows smoke-free legislation may be associated with a reduction in regular smoking among school-aged children. If this association is causal, comprehensive smoke-free legislation could help prevent future generations from taking up smoking.

Hardcore smoking after comprehensive smoke-free legislation and health warnings on cigarette packets in Hong Kong

ObjectiveTo examine if there were changes in the proportion of hardcore smokers and factors associated with hardcore smoking before and after implementation of smoke-free legislation, and warning labels on cigarette packets in Hong Kong in January 2007. Study designRepeated cross-sectional surveys of the general population in Hong Kong. MethodsData from all daily smokers aged ≥15 years in the population-based Thematic Household Surveys from 2005 (n = 3740) and 2008 (n = 2958) were used to estimate the prevalence of hardcore smokers before and after implementation of smoke-free legislation. A logistic regression model was used to identify the factors associated with hardcore smoking, and to examine if there were any changes in their associations with the likelihood of hardcore smoking after implementation of smoke-free legislation. ResultsThe proportion of hardcore smokers among current daily smokers increased significantly from 22.5% [95% confidence interval (CI) 21.1–23.8%] in 2005 to 28.3% (95% CI 26.7–29.9%) in 2008. Change in the strength of the association of hardcore smoking with three factors was observed. The strength of the association between hardcore smoking and ‘necessity in social functions’ [odds ratio (OR) 0.54, 95% CI 0.31–0.95) and ‘necessity for killing time’ (OR 0.56, 95% CI 0.36–0.89) decreased, while the association between hardcore smoking and ‘necessity as refreshment’ increased (OR 3.02, 95% CI 1.43–6.39) after implementation of smoke-free legislation and warning labels on cigarette packets. ‘Smoking had become a habit’ was the factor associated most strongly with hardcore smoking (OR 4.88, 95% CI 4.02–5.93). ConclusionsThe proportion of hardcore smokers remained stable in Hong Kong from 2005 to 2008. While the implementation of the two tobacco control measures may have provided an environment to reduce social smoking in hardcore smokers, addiction appeared to be the most important factor associated with hardcore smoking. More effective and tailor-made cessation services that target this group of smokers are needed.

Methods in Epidemiology Symposium.

Objective In Belgium, smoke-free legislation was implemented in different phases: in public places and most workplaces in January 2006, in restaurants in January 2007, and in bars serving food in January 2010. We investigated the impact of these smoking bans on the incidence of preterm delivery and mortality of acute myocardial infarction (AMI) in Flanders. The stepwise implementation of smoke-free legislation gave us the opportunity to investigate potential successive changes in health outcomes.

Implementation of smoke-free legislation in Malaysia: are adolescents protected from respiratory health effects?

This study aimed to examine the relationship between respiratory health of Malaysian adolescents with secondhand smoke (SHS) exposure and smoke-free legislation (SFL) implementation. A total of 898 students from 21 schools across comprehensive- and partial-SFL states were recruited. SHS exposures and respiratory symptoms were assessed via questionnaire. Prenatal and postnatal SHS exposure information was obtained from parental-completed questionnaire. The prevalence of respiratory symptoms was: 11.9% ever wheeze, 5.6% current wheeze, 22.3% exercise-induced wheeze, 12.4% nocturnal cough, and 13.1% self-reported asthma. SHS exposure was most frequently reported in restaurants. Hierarchical logistic regression indicates living in a comprehensive-SFL state was not associated with a lower risk of reporting asthma symptoms. SHS exposure in public transport was linked to increased risk for wheeze (Adjusted Odds Ratio (AOR) 16.6; 95%confidence interval (CI), 2.69-101.7) and current wheezing (AOR 24.6; 95%CI, 3.53-171.8). Adolescents continue to be exposed to SHS in a range of public venues in both comprehensive- and partial-SFL states. Respiratory symptoms are common among those reporting SHS exposure on public transportation. Non-compliance with SFL appears to be frequent in many venues across Malaysia and enforcement should be given priority in order to reduce exposure.

Impact of a Stepwise Introduction of Smoke-Free Legislation on the Rate of Preterm Births

Objective To investigate the incidence of preterm delivery in the Belgian population after implementation of smoke-free legislation in three phases (in public places and most workplaces January 2006, in restaurants January 2007, and in bars serving food January 2010). Design Logistic regression analyses on routinely collected birth data from January 2002 to December 2011. Setting Flanders, Belgium. Population All live born singleton births delivered at 24–44 weeks of gestation (n=606 877, with n=448 520 spontaneous deliveries). Main outcome measures Preterm birth (gestational age Results We found reductions in the risk of preterm birth after the introduction of each phase of the smoking ban. No decreasing trend was evident in the years or months before the bans. We observed a step change in the risk of spontaneous preterm delivery of −3.13% (95% CI −4.37% to −1.87%; P Conclusion Our study shows a consistent pattern of reduction in the risk of preterm delivery with successive population interventions to restrict smoking. This finding is not definitive but it supports the notion that smoking bans have public health benefits from early life.

Second-hand smoke exposure in different types of venues: before and after the implementation of smoke-free legislation in Guangzhou, China

ObjectivesSmoke-free legislation was implemented in Guangzhou on 1 September 2010. However, the smoke-free policy did not cover all indoor areas and smoking rooms can be set in some public places....

The effect of the smoke-free law in Spain on quit ratio and inequalities in smoking cessation: an observational study

BackgroundSmoke-free policies have reduced the exposure to environmental tobacco. Smoke-free policies might also have important side-effects on smokers' behaviour, inducing them to either quit altogether or reduce the number of cigarettes smoked. Population-level interventions might increase smoking inequalities. However, very few studies have assessed the effect of nationwide smoke-free policies by socioeconomic status. Socioeconomic differences in quitting smoking after the implementation of the smoke-free policy remained unchanged in England, but they were reduced in Scotland. However, in Italy educational differences in quit ratios widened over time after the implementation of a smoke-free policy. On Jan 1, 2006, Spain introduced a comprehensive smoke-free law covering workplaces, bars, and restaurants. The objective of this study was to assess whether Spain's smoke-free legislation provide a strong incentive to quit smoking and to investigate whether the possible changes associated with the ban differ according to social class. MethodsNational health surveys were undertaken in Spain between 2001 and 2011. About 21 000 adults aged 16 years or older were interviewed in each survey. With regard to smoking, participants were classified as never smokers, former smokers, or present smokers. The smoking cessation (quit ratio) was defined as the proportion of ever smokers who were former smokers. The measure of socioeconomic position used was the head-of-household occupational social class—the one who provided the most income to the household. Socioeconomic position was grouped in manual and non-manual workers. The analysis was restricted to men and women aged 25–64 years. In each year and in both social classes age-adjusted quit ratios were estimated. Then the quit ratio rate was calculated in non-manual versus manual social classes. FindingsBetween 2001 and 2006, the quit ratio increased in both social classes in men and women, but between 2006 and 2011 the quit ratio hardly changed in men and decreased in women. In men, the quit ratios in 2001, 2006, and 2011 were 29·3% (95% CI 26·3–32·3), 36·7% (34·1–39·2), and 36·5% (33·0–39·9), respectively, in the manual social class and 36·4% (32·5–40·2), 42·5% (39·6–45·3), and 43·5% (40·4–46·7), respectively, in the non-manual social class. In women, the quit ratios in 2001, 2006, and 2011 were 27·5% (95% CI 22·4–32·7), 33·0% (29·4–36·5), and 29·9% (25·7–34·1), respectively, in the manual social class and 31·6% (26·5–36·8), 43·0% (39·3–46·7), and 41·7% (38·0–45·3), respectively, in the non-manual social class. The quit ratio rate in non-manual versus manual social classes was 1·16 in 2006 and 1·19 in 2011 in men and 1·31 in 2006 and 1·39 in 2011 in women (appendix). InterpretationIn Spain, smoke-free legislation interrupted the upward trend in quit ratio reported in manual and non-manual social classes in the previous years. This effect was slightly lower in the non-manual social class and therefore inequalities in quit ratio increased. Although a possible effect of the economic crisis since 2008 cannot be excluded, these results were noted in Italy after the implementation of the smoke-free policy in 2005 and support other studies in Spain showing that the downward trend in smoking prevalence rapidly reversed after the implementation of the law in 2006. The findings suggest a different response in northern countries, such as Scotland or England, compared with southern European countries after the implementation of smoke-free legislation. FundingThis work was undertaken by the project “Tackling socioeconomic inequalities in smoking: learning from natural experiments by time trend analyses and cross-national comparison (SILNE)”, funded by the European Union.

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The efficacy of different models of smoke-free laws in reducing exposure to second-hand smoke: A multi-country comparison

Exposure to second-hand tobacco smoke is a serious public health concern and while all EU Member States have enacted some form of regulation aimed at limiting exposure, the scope of these regulations vary widely and many countries have failed to enact comprehensive legislation creating smoke-free workplaces and indoor public places. To gauge the effectiveness of different smoke-free models we compared fine particles from second-hand smoke in hospitality venues before and after the implementation of smoking bans in France, Greece, Ireland, Italy, Portugal, Turkey, and Scotland.Data on PM2.5 fine particle concentration levels were recorded in 338 hospitality venues across these countries before and after the implementation of smoke-free legislation. Changes in mean PM2.5 concentrations during the period from pre- to post-legislation were then compared across countries.While a reduction in PM2.5 was observed in all countries, those who had enacted and enforced more fully comprehensive smoke-free legislation experienced the greatest reduction in second-hand tobacco smoke.Comprehensive smoke-free laws are more effective than partial laws in reducing exposure to second-hand tobacco smoke. Also, any law, regardless of scope must be actively enforced in order to have the desired impact. There is continued need for surveillance of smoke-free efforts in all countries.

Impact of a stepwise introduction of smoke-free legislation on the rate of preterm births: analysis of routinely collected birth data

Objective To investigate the incidence of preterm delivery in the Belgian population after implementation of smoke-free legislation in three phases (in public places and most workplaces January 2006, in restaurants...

Impacto de la nueva legislación sobre tabaquismo (Ley 42/2010) en los niveles de humo ambiental de tabaco en locales de hostelería

ObjectiveTo evaluate pollution by second-hand smoke in a sample of hospitality venues before and after the implementation of smoke-free legislation. MethodsA cross sectional, before-after study was conducted in 2008 and 2011 after the total ban. A SidePack Aerosol monitor was used both inside and outside the hospitality venues to measure fine breathable particles (PM2.5). A total of 43 places with pre- and post-legislation measurements were included. ResultsThe median indoor pollution in hospitality venues was 204.2μg/m3 in 2008 and 18.82μg/m3 in 2011; the average outdoor PM2.5 concentration was 47.04μg/m3 in 2008 and 18.82μg/m3 in 2011. Pollution was higher in bars and cafeterias, followed by pubs and discos. Before the law was implemented, pollution was 4.34 times higher indoors than outdoors; in 2011 the average indoor PM2.5 concentration decreased by 90.88%. ConclusionsOnly a complete ban is able to protect workers and customers against the health risks of second-hand smoke exposure

Public support for smoke-free areas in Israel: A case for action

ObjectiveSecondhand smoke exposure (SHSe) harms adults and children. Though most governments are obliged by international health treaty to protect nonsmokers from SHSe, few adequately do so. Public opinion can provide a powerful mandate for smoke-free policies, but a representative public voice is often absent from the political discussion. For example, following Cabinet approval of a national tobacco control plan, Israel remains embroiled in stormy debate about smoke-free legislation. This debate has unfolded without benefit of current empirical evidence on nationwide public support. The present study reports and assesses public opinion regarding smoke-free places. MethodsA nationally representative survey (n=505) was conducted in December, 2010. The response rate was 61%. ResultsPublic opinion supports smoke-free air in many places. There was broad consensus among current, former, and never-smokers for smoke-free cars carrying children (94.4%), and smoke-free healthcare facility entrances (92.6%). A clear majority (67.0%) supportedcompletely smoke-free bars and pubs. Nearly half (47.3%) supported eliminating school staff smoking rooms. ConclusionsThese data strengthen the case for the recent government-approved tobacco control plan. Valid data regarding public opinion on tobacco control can facilitate passage and implementation of smoke-free legislation, thus speeding transition to smoke-free societies.

IMPACT OF SMOKE-FREE LEGISLATION ON CHILDREN’S SECONDHAND SMOKE EXPOSURE

Background: Exposure to secondhand smoke (SHS) is a serious health hazard for children. Thus, protecting children from SHS is an important public health target. However, smoking bans in public places may lead to changes in parental smoking behaviour and subsequently to even increased SHS exposure of children at home. Aim: To determine whether smoke-free legislation in Bavaria, Germany, is associated with changes in parental smoking behaviour at home and children’s SHS exposure. Methods: Cross-sectional surveys were performed before and after implementation of smoke-free legislation at 01.01.2008. The study population comprised parents with children aged 5-6 years in three urban and three rural districts. Data were collected with self-administered questionnaires. The response rates were 78% (N=6350, first survey 2004-2005), 73% (N=6206, second survey 2005-2006), and 60% (N=5336, third survey 2008-2009). Exposure to SHS at home was defined as smoking of any person within the home excluding smoking exclusively on the balcony or terrace. Results: Before smoke-free legislation, 14% (first and second survey) of children were exposed to SHS at home. After implementation of smoke-free legislation, 13% of children were exposed (third survey). SHS exposure in cars slightly decreased from 11% (first survey) and 9% (second survey), respectively, to 6% (third survey). As expected, there was a considerable decrease in children’s SHS exposure at hospitality venues from 72% and 68%, respectively, to 24%. Among families with at least one smoking parent, the majority (74%) had smoke-free homes independent of smoking bans in public places. Further 17% reported no change in their smoking behaviour at home since smoke-free legislation and 8% a decrease in the amount or even a stop of smoking at home. Only 1% reported increased smoking. Conclusions: Restriction of smoking in public places in Germany did not increase children’s SHS exposure in their homes or in cars.

O5-1.2 Can smoking bans lead to sustained improvements in population health? An overview of the evidence

Over the past decade, bans on smoking in enclosed public places have been introduced in many states in the US and provinces in Canada, and a growing number of European...

Socioeconomic Patterning in Changes in Child Exposure to Secondhand Smoke After Implementation of Smoke-Free Legislation in Wales

Introduction:Secondhand smoke (SHS) exposure is higher among children from lower socioeconomic status (SES) households. Legislation banning smoking in public places has been linked with reduced SHS exposure in children. However, socioeconomic patterning in responses to legislation has been little explored.Methods:A total of 3,083 children aged 10–11 years, within 75 Welsh primary schools, completed questionnaires either before legislation or 1 year later. Saliva samples were provided by 2,787 of these children for cotinine assay. Regression analyses assessed socioeconomic differences in SHS exposure, and associations of legislation with exposure among children from low, medium, and high SES households. Changes in parental smoking in the home, car-based exposure, and perceived norms were assessed.Results:SHS exposure was highest among children from lower SES households. The likelihood of providing a sample containing an undetectable level of cotinine increased significantly after legislation among children from high [relative risk ratio (RRR) = 1.44, 95% CI = 1.04–2.00] and medium SES households (RRR = 1.66, 95% CI = 1.20–2.30), while exposure among children from lower SES households remained unchanged. Parental smoking in the home, car-based SHS exposure, and perceived smoking prevalence were highest among children from low SES households. Parental smoking in the home and children’s estimates of adult smoking prevalence declined only among children from higher SES households.Conclusions:Post-legislation reductions in SHS exposure were limited to children from higher SES households. Children from lower SES households continue to have high levels of exposure, particularly in homes and cars, and to perceive that smoking is the norm among adults.

Exposure to Particulate Matters (PM2.5) and Airborne Nicotine in Computer Game Rooms After Implementation of Smoke-Free Legislation in South Korea

In South Korea, computer game rooms are subject to regulations mandating a designated nonsmoking area pursuant to Article 7 of the Enforcement Rules of the National Health Promotion Act; nonsmoking areas must be enclosed on all sides by solid and impermeable partitions. Using PM(2.5) monitors (SidePak AM510) and airborne nicotine monitors, we measured concentrations in smoking and nonsmoking areas to examine whether separation of the nonsmoking areas as currently practiced is a viable way to protect the nonsmoking area from secondhand smoke exposure. Convenient samplings were conducted at 28 computer game rooms randomly selected from 14 districts in Seoul, South Korea between August and September 2009. The medians (interquartile range) of PM(2.5) concentrations in smoking and nonsmoking areas were 69.3 μg/m(3) (34.5-116.5 μg/m(3)) and 34 μg/m(3) (15.0-57.0 μg/m(3)), while those of airborne nicotine were 0.41 μg/m(3) (0.25-0.69 μg/m(3)) and 0.12 μg/m(3) (0.06-0.16 μg/m(3)), respectively. Concentrations of airborne nicotine and PM(2.5) in nonsmoking areas were substantially positively associated with those in smoking areas. The Spearman correlation coefficients for them were 0.68 (p = .02) and 0.1 (p = 0.7), respectively. According to our modeling result, unit increase of airborne nicotine concentration in a smoking area contributed to 7 (95% CI = 2.5-19.8) times increase of the concentration in the adjacent nonsmoking area after controlling for the degree of partition left closed and the indoor space volume. Our study thus provides evidence for the introduction of more rigorous policy initiatives aimed at encouraging a complete smoking ban in such venues.