Workplace Secondhand Smoke Exposure Research Articles

Impact of workplace smoke-free policy on secondhand smoke exposure from cigarettes and exposure to secondhand heated tobacco product aerosol during COVID-19 pandemic in Japan: the JACSIS 2020 study

ObjectivesPromoting smoke-free policies is a key intervention for reducing secondhand smoke (SHS) exposure. During the COVID-19 pandemic in Japan, many indoor smoking spaces in workplaces were closed. This study aimed...

Social Predictors of Continued and Indoor Smoking Among Partners of Non-smoking Pregnant Women: The TMM BirThree Cohort Study.

BackgroundSecondhand smoke (SHS) from partners is a major source of exposure for non-smoking women. However, epidemiological studies have rarely examined social factors associated with continued and indoor smoking among pregnant women’s partners.MethodsWe analyzed data on 6,091 partners of non-smoking pregnant women in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Partners’ age, education, income, workplace SHS exposure (almost never or sometimes, almost every day), and pregnant women’s smoking history (never, quit before pregnancy awareness, quit after pregnancy awareness) were used as social factors. Multiple logistic regression analyses were conducted to examine the associations of social factors with partners’ continued smoking and indoor smoking.ResultsAmong 2,432 smoking partners, 2,237 continued to smoke after pregnancy awareness. Workplace SHS exposure was associated with increased risk of partners’ continued smoking: the odds ratio of workplace SHS exposure almost every day compared with almost never or sometimes was 2.08 (95% confidence interval, 1.52–2.83). Women’s quitting smoking after—but not before—pregnancy awareness was associated with decreased risk of partners’ continued smoking: the odds ratio of women’s quitting after pregnancy awareness compared with never smoking was 0.57 (95% confidence interval, 0.40–0.80). About one-third of partners who continued to smoke did so indoors. Older age, lower education, workplace SHS exposure, and women’s quitting smoking after pregnancy awareness were associated with increased risk of partners’ indoor smoking.ConclusionsWorkplace SHS exposure and pregnant women’s smoking history were associated with continued smoking and indoor smoking among partners of non-smoking pregnant women.

Factors Associated With Postpartum Smoking Relapse Among Women Who Quit in Early Pregnancy: The Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study.

While a wide range of predictors of postpartum smoking relapse have been suggested, population-based studies have rarely examined these factors exclusively among women who quit in early pregnancy. Furthermore, workplace secondhand smoke (SHS) exposure has never been examined. We analyzed data from 10,466 pregnant women who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Age, education, parity, breastfeeding, postpartum depression, SHS exposure at home, and SHS exposure at work (not working, working without SHS exposure, working with SHS exposure) were evaluated as possible predictors. Multiple logistic regression analyses were conducted to examine the associations between these factors and smoking relapse by 1 year postpartum among women who quit in early pregnancy. Analyses stratified by SHS exposure at home were also conducted. About one-fourth of early-pregnancy quitters had relapsed into smoking by 1 year postpartum. Lower education, multiparity, not breastfeeding, postpartum depression, and SHS exposure at home were associated with increased risks of smoking relapse. Working with SHS exposure was associated with an increased risk of smoking relapse; the multivariate-adjusted odds ratios of working without SHS exposure and working with SHS exposure compared with not working were 1.14 (95% confidence interval [CI], 0.82-1.59) and 2.18 (95% CI, 1.37-3.46), respectively. The significant association of workplace SHS exposure was observed only among women without SHS exposure at home. SHS exposure at work, as well as education, multiparity, breastfeeding, postpartum depression, and SHS exposure at home were associated with postpartum smoking relapse among early-pregnancy quitters.

Smoke-Free Laws and Disparities in Secondhand Smoke Exposure Among Nonsmoking Adults in the United States, 1999-2014.

Little is known about the relationship between smoke-free laws and persistent disparities in secondhand smoke (SHS) exposure among nonsmoking adults in the United States. We constructed time-varying smoke-free law measures representing whether or not at least 50% of each US county's population was covered by smoke-free laws in workplaces and hospitality venues (restaurants/bars). We merged these data with restricted data on cotinine-derived SHS exposure among nonsmokers from the National Health and Nutrition Examination Survey, 1999-2014 (N = 25 444). Using logistic regression, we estimated associations between smoke-free law coverage and SHS exposure among all nonsmokers, and within age strata (25-39, 40-59, 60+). We explored differential associations by gender, race/ethnicity, education, and poverty-income ratio (PIR) by testing the significance of interactions terms for the full sample and within age strata. In adjusted models, hospitality coverage was associated with lower odds of SHS exposure in the full sample (odds ratio [OR] = 0.62; 95% confidence interval [CI] = 0.51-0.76), and within each age group, with ORs ranging from 0.58 (ages 25-39) to 0.67 (ages 60+). Workplace coverage was associated with lower SHS exposure only among younger adults (OR = 0.81; 95% CI = 0.65-0.99). Within the full sample and among adults ages 40-59, hospitality laws were associated with narrowing SHS exposure differentials between males and females. Among adults ages 40-59, workplace laws were associated with narrowing exposure differentials between males and females, but worsening exposure disparities by PIR. Smoke-free laws may reduce SHS exposure among adult nonsmokers, but may be insufficient to improve disparities in SHS exposure. In a repeated cross-sectional sample of adult nonsmokers, smoke-free laws in hospitality venues were consistently associated with lower odds of SHS exposure and appeared to narrow exposure differentials between males and females. Associations between workplace smoke-free laws and SHS exposure were variable by age. Among adults ages 40-59, workplace laws were associated with narrowing exposure differentials between males and females while exacerbating exposure differentials by PIR. Differential patterns of association highlight the need to examine the impacts of tobacco control policies on downstream health equity.

Secondhand smoke (SHS) exposure before and after the implementation of the Tobacco Free Cities (TFC) initiative in five Chinese cities: a pooled cross-sectional study

ObjectivesTo assess the levels of secondhand smoke (SHS) exposure before and after the implementation of the Tobacco Free Cities (TFC) initiative.DesignCity-wide representative, cross-sectional surveys (Tobacco Questions for Surveys, TQS) were...

Alcohol drinking as a mediator of the influence of smoking prevalence on second-hand smoke exposure in workplaces: a mediation analysis

ObjectiveBoth alcohol drinking and second-hand smoke (SHS) exposure have shown a strong association with smoking behaviour. This study uses mediation analysis to clarify the process underlying the relationship between smoking prevalence and SHS exposure and the extent to which this relationship is mediated by alcohol use in the workplace.MethodA total of 14,195 employees from 81 companies in China participated in this survey. Mediation analysis was used to establish the mediation effect of alcohol drinking. Structural equation modelling (SEM) was used to evaluate the role of alcohol drinking when a smoke-free (SF) workplace policy was imposed.ResultsFor males, approximately 6.3% of the effects on SHS exposure were mediated through the channel of alcohol use. For females, this channel mediated 14.1% of the total effects. SF policy was negatively associated with smoking prevalence and SHS exposure. The indirect effect of the SF policy on reducing SHS exposure by controlling smoking behaviour was significant. For smokers, worksite smoking bans were negatively associated with the smoking amount and drinking behaviour, and the indirect effect of this policy on promoting smokers’ intention to quit by reducing the smoking amount and controlling drinking behaviour was significant.ConclusionThis study confirmed that alcohol drinking is among the channels that mediate the association between smoking prevalence and SHS exposure in workplaces. Our results also find a spillover effect of SF workplace policy and call for effective interventions for alcohol use, which may influence the outcomes of SF policy implementation.

The Effects of Smoke-Free Workplace Policies on Individual Smoking Behaviors in China.

Studies have shown that smoke-free (SF) workplace policies can create an SF environment, but most of them have focused only on reducing secondhand smoke (SHS) exposure or changing smoking behavior. Our study aims to explore the effects of SF workplace policies and the pathway between workplace SF policies and SHS exposure. 14 195 employees from 79 companies in China participated in this survey. Binary logistic regression is used to examine the direct effects of SF workplace policies. Structured Equation Modeling approach is used to test other indirect effects. The Sobel test is used to estimate the mediation effect. Working in a company with SF policies was associated with lower SHS exposure (odds ratio = 0.56; 95% confidence interval = 0.51 to 0.60). Such policy were associated with lower smoking prevalence (Coef. = -0.05, p < .05) and positively associated with smoking harm awareness (Coef. = 0.07, p < .05) and SHS harm awareness (Coef. = 0.05, p < .05). Sobel test suggests that approximately 16.3% of the effects on SHS exposure reduction are mediated through the channel of lower smoking prevalence for males. For smokers, we did not identify a direct effect of such policies on quitting intentions, but a significant indirect effect via increased smoking harm awareness (Coef. = 0.07, p < .05) and lower smoking consumption (Coef. = -0.10, p < .05) were found. This study finds that SF workplace policies are not only associated with lower SHS exposure but also related to some indirect effects. Further mediation analyses for males confirmed that the effect on SHS exposure reduction is mediated through the channel of lower smoking prevalence. This study joins the debate in recent years on the effects of workplace SF policies and provides evidence with more comprehensive data from Asia Best Workplace Mainland China program. It shows that SF workplace policies not only can reduce SHS exposure but also are associated with lower smoking prevalence, fewer cigarettes smoked, and higher smoking harm-related awareness. These findings provide valuable evidence to promote such policies in all workplaces and underline the need for more stringent SF policies to be enacted in all countries.

Secondhand smoke exposure at home and public places among smokers and non-smokers in India: findings from the Global Adult Tobacco Survey 2016-17.

Secondhand smoke (SHS) accounts for 0.9 million deaths and 24 million disability adjusted life years (DALYs) annually. Nearly 30% of adults in India are exposed to SHS in India. To reduce SHS exposure, India enacted a smoke-free law in 2003 under which smoking in public places is banned. However, the compliance to this law has been variable in several assessments in the country. A better understanding of the nature and extent of SHS exposure can help inform better implementation of national smoke-free policies. The Global Adult Tobacco Survey (GATS) India 2016-17 collects information on the self-reported prevalence of SHS exposure in homes, workplaces, government buildings, restaurants, public transportation and health care facilities among adults (>15years of age).The present study utilized the GATS India 2016-17 dataset to provide estimates of SHS exposure among adults in India in homes, workplace and other public places, across gender and age groups and among the overall population and non-smokers. Weighted analysis was carried out. In the overall population, exposure to SHS in the home was 29.2%, more among young females. In workplaces, exposure to SHS was 29.2% overall, significantly higher among males (32.5%) compared to females (17.8%). In public buildings such as health care facilities and government offices, SHS exposure was less with 15.6% and 21.2% respectively. SHS exposure was high in restaurants with 39.3% overall, significantly higher among males (43.2%) compared to females (22.2%). Similar results were also seen among non-smokers. A large proportion of adults in India, both smokers and non-smokers are exposed to SHS in their homes, workplaces and other public places, especially restaurants, workplaces and public transportation. Females are more exposed to SHS at home, whereas males are more exposed in public places including workplaces. High SHS exposure among youths is also a concern. Stricter enforcement of legislation is required to ensure 100% smoke-free homes, public places and workplaces and reduce SHS exposure.

Population-level estimates of workplace exposure to secondhand smoke in Canada.

Secondhand smoke (SHS) is a known lung carcinogen that is also associated with cardiovascular disease and premature death. An important source of exposure to SHS is the workplace. In the past, efforts have been made to reduce workplace SHS exposure across Canada, with corresponding benefits to public health. This study estimated the number of workers exposed to SHS in Canada in 2006 and 2016 and their level of exposure. The proportion of workers exposed to SHS and the proportion of workers reporting specific workplace smoking restrictions by occupation and province, acquired from the 2007-2009 and 2010-2012 Canadian Tobacco Use Monitoring Surveys, were applied to 2006 and 2016 Canadian census data to estimate population-level exposure. Workers were assigned to exposure levels (possible, moderate, high) using workplace smoking restrictions. Only moderately and highly exposed workers were considered exposed. The number of exposed workers decreased by 20% from 520,000 in 2006 to 418,000 in 2016. Workers were equally split between moderate and high exposure groups. Trades, transport and equipment operators, and workers in primary industry had the highest rates of overall exposure. The proportion of workers exposed varied by province, with the lowest rates in Ontario (approximately 2% in both years), and the highest in Saskatchewan in 2006 (6%) and Newfoundland in 2016 (4%). Workplace SHS exposure persists. The findings can help prioritize high-risk groups for interventions and inform studies of the burden of occupational disease. Further characterization of exposure is needed to better inform enforcement and prevention.

Partial Smoking Ban and Secondhand Smoke Exposure in Japan.

Implementing smoking bans is a worldwide common practice for tobacco control. However, if the policy prohibits smoking partially rather than comprehensively, it may increase nonsmokers’ exposure to secondhand smoke (SHS) in nonprohibited places. This paper investigates how a partial smoking ban affected nonsmokers’ SHS exposure (measured by frequency of having exposure to SHS in days per month) in households, workplaces, and restaurants by examining the case of a partial smoking ban introduced in a large Japanese prefecture in 2013. Using data from the National Health and Nutrition Survey (NHNS) in 2010, 2013, and 2016 (n = 30,244) and the Comprehensive Survey of Living Conditions (CSLC) from 2001 to 2016 (n = 2,366,896), this paper employs a difference-in-differences (DID) approach. We found that the partial smoking ban significantly increased their SHS exposure in households and workplaces by 2.64 days and 4.70 days per month, respectively, while it did not change nonsmokers’ SHS exposure in restaurants. The results imply that the smoking ban displaced smokers from public places to private places. We also found that neither smokers’ smoking status nor smoking intensity changed significantly after implementing the partial smoking ban. Comprehensive smoking bans are needed to better protect nonsmokers from SHS exposure.

The association between second-hand smoke exposure and depressive symptoms among pregnant women

Tobacco smoking and depression are strongly associated, but the possible association between second-hand smoke (SHS) exposure and depression is unclear. This study aimed to examine the possible relation between SHS exposure and depressive symptoms among pregnant women. A cross-sectional survey was conducted in Shenzhen, China, using a multistage sampling method. The univariable and multivariable logistic regression models were used to explore the associations between SHS exposure and depressive symptoms. Among 2176 pregnant women, 10.5% and 2.0% were classified as having probable and severe depressive symptoms. Both binary and multinomial logistic regression revealed that there were significantly increased risks of severe depressive symptoms corresponding to SHS exposure in homes or regular SHS exposure in workplaces using no exposure as reference. In addition, greater frequency of SHS exposure was significantly associated with the increased risk of severe depressive symptoms. Our findings suggest that SHS exposure is positively associated with depressive symptoms in a dose-response manner among the pregnant women.

Workplace secondhand smoke exposure: a lingering hazard for young adults in California

ObjectiveTo examine occupational differences in workplace exposure to secondhand smoke (SHS) among young adults in California.MethodsData are taken from the 2014 Bay Area Young Adult Health Survey, a probabilistic multimode...

Disparity and Trends in Secondhand Smoke Exposure among Japanese Employees, Particularly Smokers vs. Non-Smokers.

BackgroundMonitoring disparities in secondhand smoke (SHS) exposure is important for tailoring smoke-free policies to the needs of different groups. We examined disparity and trends in SHS exposure among both nonsmokers and smokers at Japanese workplaces between 2002 and 2012.MethodsA total of 32,940 employees in nationally representative, population-based, repeated cross-sectional surveys in 2002, 2007 and 2012 in Japan was analyzed. Adjusted rate ratios for workplace SHS exposure from other people (“everyday” and “everyday or sometimes”) were calculated according to covariates, using log-binomial regression models with survey weights. In this survey, employees who do not smoke at workplace are defined as workplace-nonsmokers; and those smoke at workplace are used as workplace-smokers. SHS exposure for smokers does not involve their own SHS.ResultsWhile everyday SHS exposure prevalence in workplace-nonsmokers decreased markedly (33.2% to 11.4%), that in workplace-smokers decreased only slightly (63.3% to 55.6%). Workplace-smokers were significantly more likely to report everyday SHS exposure than workplace-nonsmokers, and the degree of association increased over time: compared with the nonsmokers (reference), covariates-adjusted rate ratio (95% confidence interval) for the smokers increased from 1.70 (1.62–1.77) in 2002 to 4.16 (3.79–4.56) in 2012. Similar results were observed for everyday or sometimes SHS exposure. Compared with complete workplace smoking bans, partial and no bans were consistently and significantly associated with high SHS exposure among both nonsmokers and smokers. We also observed disparities in SHS exposure by employee characteristics, such as age group and worksite scale.ConclusionsAlthough overall SHS exposure decreased among Japanese employees between 2002 and 2012, the SHS exposure disparity between nonsmokers and smokers widened. Because smokers reported more frequent SHS exposure than nonsmokers, subsequent mortality due to SHS exposure may be higher in smokers than in nonsmokers. This information may be useful for advocating workplace smoke-free policies.

Disparities in exposure to tobacco smoke pollution at Romanian worksites.

Differences in the risk of being exposed to second-hand smoke (SHS) in the workplace may occur not only between countries, but also within a country among socio-economic groups. The aim of the study was to examine the associations of exposure to SHS at worksites with selected factors in non-smoking Romanian employees. Data on exposure to SHS at worksites and other characteristics of respondents came from the Global Adult Tobacco Survey (GATS). GATS is a nationally representative household survey of adults 15 years of age or older, using a standard protocol. Among 4,517 respondents who completed the questionnaire there were 1,333 subjects, including 859 non-smokers who worked in an indoor area outside the home. The prevalence of exposure to SHS was 31.2% among non-smoking male and 23.9% among non-smoking female employees (p<0.05). Employees with primary education had odds of exposure to SHS at work nearly twice as high, compared to the respondents having high education attainment (OR=1.9; 95% CI: 1.2-2.9). Moreover, exposure to SHS at worksites was significantly associated with a low level of support for tobacco control policies among workers (OR = 1.8; 95% CI: 1.2-2.8). In spite of the increasing presence of smoking bans in public and workplaces, enforcement still seems to be unsuccessful in the occupational space in Romania. In order to reduce SHS exposure in workplaces, strengthening support for tobacco control policies is essential.

Tobacco Use and Exposure to Second-Hand Smoke among Urban Residents: A Community-Based Investigation.

Objectives: In 2005, China acceded to the World Health Organization Framework Convention on Tobacco Control (WHO FCTC), the foundation for the global fight against tobacco. Certain cities in China have established local regulations to control tobacco use ahead of national policy; however, without the enforcement of statutory law, some of these regulations are merely lip service. The aim of the study was to assess the effects of city policy on smoking prevalence and on second-hand smoke (SHS) exposure status among non-smokers in Changchun City. Methods: A cross-sectional survey covering a multiple-stage, representative sample of the urban population aged ≥15 years was conducted between 1 Dec 2013 and 31 Jan 2014. The WHO and the US Centers for Disease Control and Prevention developed the questionnaires used, which included demographic characteristics, smoking behaviors and SHS exposure status. Results: Overall cigarette smoking prevalence was 23.5%; daily cigarette smoking prevalence was 21.2%. Smoking prevalence and cigarettes consumed per day was higher among men (p < 0.05) and those aged 45–64 years (p < 0.05). Among current smokers, 8.1% planned to quit within 12 months; 53.4% had no intention of quitting. Overall SHS exposure prevalence was 41.9% (workplace) and 34.1% (at home) over the previous 30 days. The weighted workplace SHS exposure prevalence increased with age. Conclusions: The high proportion of smokers with no intention of quitting and the high level of SHS exposure may constitute one of the most significant barriers to successful smoking cessation in the city. A continued drive to promote full implementation of the WHO FCTC is still needed.

Inequities in workplace secondhand smoke exposure among nonsmoking women of reproductive age.

We characterized workplace secondhand smoke exposure among nonsmoking women of reproductive age as a proxy for workplace secondhand smoke exposure during pregnancy. We included nonsmoking women aged 18 to 44 years employed during the past 12 months who participated in the 2010 National Health Interview Survey. We estimated the prevalence of workplace secondhand smoke exposure and its associations with sociodemographic and workplace characteristics. Nine percent of women reported workplace secondhand smoke exposure. Prevalence decreased with increasing age, education, and earnings. Workplace secondhand smoke exposure was associated with chemical exposure (prevalence odds ratio [POR] = 3.3; 95% confidence interval [CI] = 2.3, 4.7); being threatened, bullied, or harassed (POR = 3.2; 95% CI = 2.1, 5.1); vapors, gas, dust, or fume exposure (POR = 3.1; 95% CI = 2.3, 4.4); and worrying about unemployment (POR = 3.0; 95% CI = 1.8, 5.2), among other things. Comprehensive smoke-free laws covering all workers could eliminate inequities in workplace secondhand smoke exposure, including during pregnancy.

Exposure to secondhand smoke and attitudes toward smoke-free workplaces among employed U.S. adults: findings from the National Adult Tobacco Survey.

This study assessed the prevalence and correlates of secondhand smoke (SHS) exposure and attitudes toward smoke-free workplaces among employed U.S. adults. Data came from the 2009-2010 National Adult Tobacco Survey, a landline and cellular telephone survey of adults aged ≥18 years in the United States and the District of Columbia. National and state estimates of past 7-day workplace SHS exposure and attitudes toward indoor and outdoor smoke-free workplaces were assessed among employed adults. National estimates were calculated by sex, age, race/ethnicity, education, annual household income, sexual orientation, U.S. region, and smoking status. Among employed adults who did not smoke cigarettes, 20.4% reported past 7-day SHS exposure at their workplace (state range: 12.4% [Maine] to 30.8% [Nevada]). Nationally, prevalence of exposure was higher among males, those aged 18-44 years, non-Hispanic Blacks, Hispanics, and non-Hispanic American Indians/Alaska natives compared to non-Hispanic Whites, those with less education and income, those in the western United States, and those with no smoke-free workplace policy. Among all employed adults, 83.8% and 23.2% believed smoking should never be allowed in indoor and outdoor areas of workplaces, respectively. One-fifth of employed U.S. adult nonsmokers are exposed to SHS in the workplace, and disparities in exposure exist across states and subpopulations. Most employed adults believe indoor areas of workplaces should be smoke free, and nearly one-quarter believe outdoor areas should be smoke free. Efforts to protect employees from SHS exposure and to educate the public about the dangers of SHS and benefits of smoke-free workplaces could be beneficial.

Association between current asthma and secondhand smoke exposure in vehicles among adults living in four US states

ObjectiveMany states have implemented laws prohibiting tobacco smoking in indoor public places. However, private settings remain a major source of secondhand smoke (SHS) exposure for many people. We assessed the...

Evaluation of a Smoke-Free Law on Indoor Air Quality and on Workers’ Health in Portuguese Restaurants

Workplace bans on smoking are interventions to reduce exposure to secondhand smoke (SHS) to try to prevent harmful health effects. The Portuguese Government on January 1, 2008, introduced the first national law banning smoking in public workplaces, including restaurants. The main aim of this study was to examine the impact of this law on indoor air quality (IAQ) in restaurants and on the respiratory and sensory health of restaurant workers. Concentrations of respirable suspended particulate matter (RSP), total volatile organic compounds (TVOC), carbon monoxide (CO), and carbon dioxide (CO2) in 10 restaurants were measured and compared before and after the ban. Benzene (C6H6) concentrations were also measured in all restaurants. Fifty-two and twenty-eight restaurant workers, respectively, answered questionnaires on exposure to SHS, and respiratory and sensory symptoms in the pre- and post-ban phases. There was a statistically significant decrease in RSP, CO, TVOC, and C6H6 concentrations after the ban. Additionally, in both phases the monitored CO2 concentrations greatly exceeded 1800 mg.m−3, suggesting inefficient ventilation of the indoor spaces. Between pre- and post-ban phases a significant reduction in self-reported workplace SHS exposure was also observed after the enforcement of the law, as well as a significant marked reduction in dry, itching, irritated, or watery eyes, nasal problems, sore or dry throat, cough, wheeze, and headache. This study provides, in a single investigation, comparison of IAQ and respiratory health in Portugal before and after the introduction of the smoke-free law, the first data reported in the literature to our knowledge. Our findings suggest that a total workplace smoking ban results in a significant reduction in indoor air pollution and an improvement in the respiratory health of restaurant workers. These observations may have implications for policymakers and legislators currently considering the nature and extent of their smoke-free workplace legislation and could provide a useful contribution to the implementation of public health prevention programs.

Tobacco smoke exposure in public places and workplaces after smoke-free policy implementation: a longitudinal analysis of smoker cohorts in Mexico and Uruguay.

Objective: To determine the prevalence, correlates and changes in secondhand smoke (SHS) exposure over the period after comprehensive smoke-free policy implementation in two Latin American countries.Methods: Data were analysed from population-based representative samples of adult smokers and recent quitters from the 2008 and 2010 waves of the International Tobacco Control Policy Evaluation Survey in Mexico (n = 1766 and 1840, respectively) and Uruguay (n = 1379 and 1411, respectively). Prevalence of SHS exposure was estimated for regulated venues, and generalized estimating equations were used to determine correlates of SHS exposure.Results: Workplace SHS exposure in the last month was similar within and across countries (range: Mexico 20–25%; Uruguay 14–29%). At the most recent restaurant visit, SHS exposure was lower where comprehensive smoke-free policies were implemented (range: Uruguay 6–9%; Mexico City 5–7%) compared with Mexican cities with weaker policies, where exposure remained higher but decreased over time (32–17%). At the most recent bar visit, SHS exposure was common (range: Uruguay 8–36%; Mexico City 23–31%), although highest in jurisdictions with weaker policies (range in other Mexican cities: 74–86%). In Uruguay, males were more likely than females to be exposed to SHS across venues, as were younger compared with older smokers in Mexico.Conclusions: Comprehensive smoke-free policies are more effective than weaker policies, although compliance in Mexico and Uruguay is not as high as desired.