Secondhand smoke exposure is associated with smoke-free laws but not urban/rural status.

UNLABELLED: The objective was to determine secondhand smoke (SHS) exposure with and without smoke-free laws in urban and rural communities. The research hypothesis was that SHS exposure in public places could be improved by smoke-free law regardless of urban and rural status. Indoor air quality in hospitality venues was assessed in 53 communities (16 urban and 37 rural) before smoke-free laws; 12 communities passed smoke-free laws during the study period. Real-time measurements of particulate matter with 2.5 µm aerodynamic diameter or smaller (PM2.5) were taken 657 times from 586 distinct venues; about 71 venues had both pre- and post-law measurements. Predictors of log-transformed PM2.5 level were determined using multilevel modeling. With covariates of county-level percent minority population, percent with at least high school education, adult smoking rate, and venue-level smoker density, indoor air quality was associated with smoke-free policy status and venue type and their interaction. The geometric means for restaurants, bars, and other public places in communities without smoke-free policies were 22, 63, and 25 times higher than in those with smoke-free laws, respectively. Indoor air quality was not associated with urban status of venue, and none of the interactions involving urban status were significant. SHS exposure in public places did not differ by urban/rural status. Indoor air quality was associated with smoke-free law status and venue type. IMPLICATIONS: This study analyzed 657 measurements of indoor PM2.5 level in 53 communities in Kentucky, USA. Although indoor air quality in public places was associated with smoke-free policy status and venue type, it did not differ by urban and rural status. The finding supports the idea that population in rural communities can be protected with smoke-free policy. Therefore, it is critical to implement smoke-free policy in rural communities as well as urban areas.

Outdoor tobacco smoke exposure at the perimeter of a tobacco-free university.

There are few studies measuring exposure to outdoor tobacco smoke (OTS). Tobacco users often gather at the boundaries of tobacco-free campuses, resulting in unintended consequences. The objective of this study was to measure exposure levels from OTS on sidewalks bordering a tobacco-free university campus. Data were collected while walking along a sidewalk adjacent to a medium traffic road between May and August 2011. Monitoring occurred during "background," "stop," and "walk-through" conditions at and near hot spot area to measure fine particulate matter (< 2.5 microm; PM2.5) from OTS using a portable aerosol monitor The average PM2.5 levels during stop and walk-through conditions were significantly higher than during background conditions. PM2.5 peak occurrence rate and magnitude of peak concentration were significantly different depending on smoking occurrence. The peak occurrence rate during the stop condition was 10.4 times higher than during the background condition, and 3.1 times higher than during the walk-through condition. Average peak PM2.5 concentrations during the stop condition were 48.7% higher than during the background condition. In conclusion, individuals could be exposed to high levels of PM2.5 when stopping or even passing by smokers outdoors at the perimeter of tobacco-free campuses. The design and implementation of tobacco-free campus policies need to take into account the unintended consequences of OTS exposure at the boundaries. Implications: In this study, outdoor tobacco smoke (OTS) exposure was measured at the perimeter of tobacco-free campus. OTS exposure could be determined by peak analysis. Peak occurrence rate and peak concentration for OTS exposure were identified by using peak analysis. People could be exposed to high levels of PM2.5 when standing or even passing by smokers at the perimeter of tobacco-free campus. OTS exposure measurement in other outdoor locations with smokers is needed to support outdoor smoking regulation.