Secondhand smoke exposure in bars and restaurants in Guatemala City: before and after smoking ban evaluation.

OBJECTIVE: In February 2009, Guatemala implemented a comprehensive smoking ban. We assessed air nicotine levels in bars and restaurants 6 months after the ban (post-ban) and compared them with levels found in 2006 (pre-ban). METHODS: Exposure was estimated by passive sampling of vapor-phase nicotine using samplers (n=50) placed for 7 working days in 10 bars and 11 restaurants in Guatemala City. Air nicotine was measured by gas chromatography, and the time-weighted average concentration in µg/m(3) was estimated. Employees answered a survey about smoke-free workplaces (n = 32) and compared with pre-ban (n = 37) results. RESULTS: Nicotine was detectable in all bars pre- and post-ban. In restaurants, it was detectable in all pre- and 73% post-ban. Median nicotine concentrations in bars significantly decreased from 4.58 µg/m(3) (IQR, 1.71, 6.45) pre-ban to 0.28 µg/m(3) (IQR 0.17, 0.66) post-ban (87% decrease). In restaurants, concentrations significantly decreased from 0.58 µg/m(3) (IQR, 0.44, 0.71) to 0.04 µg/m(3) (IQR 0.01, 0.11) (95% decrease). Employees' support for a smoke-free workplace increased in the post-ban survey (from 32 to 81%, p < 0.001). CONCLUSION: Six months after the implementation of a smoke-free law in Guatemala, nicotine levels were significantly decreased in bars and restaurants and workers' support for the law substantially increased.