Levels of second hand smoke in pubs and bars by deprivation and food-serving status: a cross-sectional study from North West England.

BACKGROUND: The UK government proposed introducing partial smokefree legislation for England with exemptions for pubs and bars that do not prepare and serve food. We set out to test the hypothesis that pubs from more deprived areas and non food-serving pubs have higher levels of particulate air pollution. METHODS: We conducted a cross sectional study in four mainly urban areas of the North West of England. We recruited a stratified random sample of 64 pubs divided into four groups based on whether their local population was affluent or deprived (using a UK area based deprivation measure), and whether or not they served food. The timing of air quality monitoring stratified to ensure similar distribution of monitoring by day of the week and time of evening between groups. We used a portable air quality monitor to collect fine particle (PM2.5) levels over a minimum of 30 minutes in areas where smoking was allowed,, and calculated mean time-time weighted average PM2.5 levels. RESULTS: Mean PM2.5 was 285.5 microg/m3 (95% CI 212.7 to 358.3). Mean levels in the four groups were: affluent food-serving pubs (n = 16) 188.1 microg/m3 (95%CI 128.1 to 248.1); affluent non food-serving (n = 16) 186.8 microg/m3 (95%CI 118.9 to 254.3); deprived food-serving (n = 17) 399.4 microg/m3 (95%CI 177.7 to 621.2); and deprived non food-serving (n = 15) 365.7 microg/m3 (195.6 to 535.7). Levels were higher in pubs in deprived communities: mean 383.6 microg/m3 (95% CI 249.2 to 518.0) vs 187.4 microg/m3 (144.8 to 229.9); geometric mean 245.2 microg/m3 vs 151.2 microg/m3 (p = 0.03). There was little difference in particulate levels between food and non food-serving pubs. CONCLUSION: This study adds to the evidence that the UK government's proposals for partial smokefree legislation in England would offer the least protection to the most heavily exposed group--bar workers and customers in non food-serving pubs in deprived areas. The results suggest these proposals would work against the UK government's stated aim to reduce health inequalities.

Potential impacts on the incidence of fatal heroin-related overdose in Western Australia: a time-series analysis.

In response to the rising concerns about the rate of heroin-related fatalities, overdose prevention campaigns, run by both users' organizations and government agencies, have been implemented in a number of states across Australia. In Western Australia (WA) in mid-1997, various overdose prevention initiatives were implemented. These included the implementation of a protocol limiting police presence at overdose events; the commencement of naloxone administration by ambulance staff; and the establishment of the Opiate Overdose Prevention Strategy (OOPS) which provided follow-up for individuals treated for overdose in emergency departments. This paper reports the results of a multiple linear regression analysis of 60 months of time-series data, both prior to and following the implementation of these interventions, to determine their impact on the number of fatal heroin overdoses inWA. The model employed in the analysis controlled for changes over time in proxy indicators of use and community concerns about heroin, as well as market indicators. The results suggest that, although the interventions implemented have managed to reduce the expected number of fatalities, they have become less successful in doing so as time passes. This has implications for both existing and potential interventions to reduce fatal heroin-related overdose.