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December, 2011:

WHO Targets for Member states to comment

http://www.who.int/nmh/events/2011/consultation_dec_2011/en/index.html

Monitoring framework and targets for the prevention and control of NCDs

Consultation on a comprehensive global monitoring framework for NCDs and voluntary global targets for the prevention and control of NCDs

20 December ׀ 2011 Geneva — In response to paragraphs 61 and 62 of the Political Declaration of the General Assembly on the Prevention and Control of Noncommunicable Diseases (resolution 66/2), WHO has developed a discussion paper outlining a comprehensive global monitoring framework and the technical background for developing a set of voluntary global targets for the prevention and control of NCDs, for consideration by Member States.

The proposed framework is expected to be applicable across regional and country settings, including through multisectoral approaches, to monitor trends and to assess progress made in the implementation of national strategies and plans on NCDs.

The suggested targets will be measured in 2025 against a baseline in 2010. The proposed indicators are intended to be used to assess progress and achievement towards the targets. The proposed data sources describe the origins of information for the indicators. The examples of targets have been developed by WHO following scientific review of the current situation and trends of NCDs, combined with a critical assessment of the evidence base for interventions and feasibility, based upon demonstrated country achievement.

This work responds to a call to action included in the Political Declaration to develop, with the participation of Member States, and through the WHO Governing Bodies in 2012, a comprehensive global monitoring framework and prepare recommendations for a set of voluntary global targets for the prevention and control of NCDs.

WHO Member States are invited to submit their views by sending an email to ncdmonitoring@who.int.

An informal consultation with Member States will take place on Monday, 9 January 2012 and Tuesday, 10 January 2012 to review WHO’s ongoing work to develop a comprehensive global monitoring framework and recommendations for a set of voluntary global targets for the prevention and control of noncommunicable diseases. WHO invites Member States to send an email to Ms Karina Wolbang-Sakulin (wolbangk@who.int) confirming their participation, including the coordinates of the delegate(s) who will attend the informal consultation.

Following this consultation, a proposal on the global monitoring framework and voluntary global targets will be developed for consideration by Member States at the World Health Assembly in May 2012.

A COMPREHENSIVE GLOBAL MONITORING FRAMEWORK AND VOLUNTARY GLOBAL TARGETS FOR THE PREVENTION AND CONTROL OF NCDS

Introduction
Noncommunicable diseases (NCDs) are currently the leading global cause of
death worldwide. Of the 57 million deaths that occurred globally in 2008, 36 million
deaths – almost two thirds- were due to NCDs, comprising mainly cardiovascular
diseases, cancers, diabetes and chronic lung diseases (1). The combined burden of these
diseases is rising fastest among lower income countries. About one fourth of global
NCD-related deaths take place before the age of 60 (2).
A large proportion of NCDs are preventable. These NCDs share modifiable
behavioural risk factors like tobacco use, unhealthy diet, lack of physical activity, and the
harmful use of alcohol, which, in turn, lead to overweight and obesity, raised blood
pressure, and raised cholesterol. The cost of doing nothing over the next three decades
amounts to trillions of dollars of lost resources (3). Feasible and cost-effective
interventions exist to reduce the burden and impact of NCDs and sustained action to
prevent risk factors and improve health care can avert millions of preventable premature
deaths (4).
The global strategy for the prevention and control of NCDs (5) has three key
components: surveillance, prevention, and health care. Surveillance aims to monitor
NCDs and to analyse their social, economic, behavioural and political determinants in
order to provide guidance for policy, legislative and financial measures.

IntroductionNoncommunicable diseases (NCDs) are currently the leading global cause ofdeath worldwide. Of the 57 million deaths that occurred globally in 2008, 36 milliondeaths – almost two thirds- were due to NCDs, comprising mainly cardiovasculardiseases, cancers, diabetes and chronic lung diseases (1). The combined burden of thesediseases is rising fastest among lower income countries. About one fourth of globalNCD-related deaths take place before the age of 60 (2).A large proportion of NCDs are preventable. These NCDs share modifiablebehavioural risk factors like tobacco use, unhealthy diet, lack of physical activity, and theharmful use of alcohol, which, in turn, lead to overweight and obesity, raised bloodpressure, and raised cholesterol. The cost of doing nothing over the next three decadesamounts to trillions of dollars of lost resources (3). Feasible and cost-effectiveinterventions exist to reduce the burden and impact of NCDs and sustained action toprevent risk factors and improve health care can avert millions of preventable prematuredeaths (4).The global strategy for the prevention and control of NCDs (5) has three keycomponents: surveillance, prevention, and health care. Surveillance aims to monitorNCDs and to analyse their social, economic, behavioural and political determinants inorder to provide guidance for policy, legislative and financial measures.

Download full PDF : WHO_Discussion_Paper_FINAL

Big tobacco accused of legal trick

http://www.theage.com.au/national/big-tobacco-accused-of-legal-trick-20111221-1p5qv.html

Philip Morris is fighting the government's plain packaging laws.

Philip Morris says the plain packaging laws will adversely affect its investment in the company’s Australian operation. Photo: Reuters

THE Gillard government has accused tobacco giant Philip Morris of engaging in corporate restructuring as a ”trick” to find new legal avenues to challenge plain cigarette packaging laws.

The company has launched a multibillion-dollar compensation claim against the government through its Hong Kong arm, Philip Morris Asia, claiming the packaging laws breach a trade treaty between Hong Kong and Australia.

Philip Morris Asia says the laws adversely affect its investment in the company’s Australian operation, which was supposed to be protected under the 20-year-old trade treaty.

Illustration: Ron Tandberg.

Illustration: Ron Tandberg.

But the government has hit back, saying the challenge should be thrown out because Philip Morris Asia did not acquire its shareholding in the Australian operation until almost a year after the packaging policy was announced.

Attorney-General Nicola Roxon said the government’s response, filed last night, showed Philip Morris Australia had engaged in corporate restructuring to use the treaty to challenge the plain packaging laws after they had been announced.

Canberra’s response says: ”Philip Morris Asia acquired its shares in Philip Morris Australia on 23 February, 2011, both in the full knowledge that the decision had been announced by the Australian government to introduce plain packaging, and also in circumstances where various other members of the Philip Morris group had repeatedly made clear their objections … [which] had not been accepted by the government.”

Accusing ”big tobacco” of using ”every trick in the playbook”, Ms Roxon said she was confident the plain packaging laws would be upheld.

The government announced its plain packaging plan in April last year, and the legislation was passed last month. On the same day, Philip Morris Asia lodged a notice of arbitration with the United Nations Commission on International Trade Law, seeking suspension of the laws and compensation for losses flowing from them. At the time, the company said it was seeking damages ”of the order of billions of Australian dollars”.

In its response, the government says ”pre-existing disputes” cannot be ”repackaged” as claims under the treaty ”many months after the measure has been announced”. It also contends that even under the treaty, it is able to make laws to protect public health.

Alongside its complaint under international trade law, Philip Morris this week joined three other tobacco companies in taking High Court action against the laws.

Philip Morris, which has a 37 per cent market share in Australia with brands including Marlboro and Alpine, said the law effectively acquired its ”valuable brands and intellectual property” without compensation. The world-first legislation will from next December strip all branding from cigarette packs and force them to be drab green in colour, with large, graphic health warnings.

Tobacco companies are fighting the laws through every possible means because they are seen as an international test case. The government says smoking costs billions of dollars in health and lost productivity.

“Let there be no mistake, big tobacco is fighting the government for one very simple reason – because it knows, as we do, that plain packaging will work,” Ms Roxon said.

The government has appointed Canadian professor Don McRae as its representative on the tribunal that will hear the case, with another appointment to be made by the company and one by the tribunal itself. The case could take years.

Read more: http://www.theage.com.au/national/big-tobacco-accused-of-legal-trick-20111221-1p5qv.html#ixzz1hBOwEAHs

Australia’s Response to the Notice of Arbitration

Download (PDF, 558KB)

The Toxic Effects of Cigarette Additives. Philip Morris’ Project Mix Reconsidered: An Analysis of Documents Released through Litigation

Abstract
Background: In 2009, the promulgation of US Food and Drug Administration (FDA) tobacco regulation focused attention on
cigarette flavor additives. The tobacco industry had prepared for this eventuality by initiating a research program focusing
on additive toxicity. The objective of this study was to analyze Philip Morris’ Project MIX as a case study of tobacco industry
scientific research being positioned strategically to prevent anticipated tobacco control regulations.
Methods and Findings: We analyzed previously secret tobacco industry documents to identify internal strategies for
research on cigarette additives and reanalyzed tobacco industry peer-reviewed published results of this research. We
focused on the key group of studies conducted by Phillip Morris in a coordinated effort known as ‘‘Project MIX.’’ Documents
showed that Project MIX subsumed the study of various combinations of 333 cigarette additives. In addition to multiple
internal reports, this work also led to four peer-reviewed publications (published in 2001). These papers concluded that
there was no evidence of substantial toxicity attributable to the cigarette additives studied. Internal documents revealed
post hoc changes in analytical protocols after initial statistical findings indicated an additive-associated increase in cigarette
toxicity as well as increased total particulate matter (TPM) concentrations in additive-modified cigarette smoke. By
expressing the data adjusted by TPM concentration, the published papers obscured this underlying toxicity and particulate
increase. The animal toxicology results were based on a small number of rats in each experiment, raising the possibility that
the failure to detect statistically significant changes in the end points was due to underpowering the experiments rather
than lack of a real effect.
Conclusion: The case study of Project MIX shows tobacco industry scientific research on the use of cigarette additives
cannot be taken at face value. The results demonstrate that toxins in cigarette smoke increase substantially when additives
are put in cigarettes, including the level of TPM. In particular, regulatory authorities, including the FDA and similar agencies
elsewhere, could use the Project MIX data to eliminate the use of these 333 additives (including menthol) from cigarettes.

AbstractBackground: In 2009, the promulgation of US Food and Drug Administration (FDA) tobacco regulation focused attention oncigarette flavor additives. The tobacco industry had prepared for this eventuality by initiating a research program focusingon additive toxicity. The objective of this study was to analyze Philip Morris’ Project MIX as a case study of tobacco industryscientific research being positioned strategically to prevent anticipated tobacco control regulations.Methods and Findings: We analyzed previously secret tobacco industry documents to identify internal strategies forresearch on cigarette additives and reanalyzed tobacco industry peer-reviewed published results of this research. Wefocused on the key group of studies conducted by Phillip Morris in a coordinated effort known as ‘‘Project MIX.’’ Documentsshowed that Project MIX subsumed the study of various combinations of 333 cigarette additives. In addition to multipleinternal reports, this work also led to four peer-reviewed publications (published in 2001). These papers concluded thatthere was no evidence of substantial toxicity attributable to the cigarette additives studied. Internal documents revealedpost hoc changes in analytical protocols after initial statistical findings indicated an additive-associated increase in cigarettetoxicity as well as increased total particulate matter (TPM) concentrations in additive-modified cigarette smoke. Byexpressing the data adjusted by TPM concentration, the published papers obscured this underlying toxicity and particulateincrease. The animal toxicology results were based on a small number of rats in each experiment, raising the possibility thatthe failure to detect statistically significant changes in the end points was due to underpowering the experiments ratherthan lack of a real effect.Conclusion: The case study of Project MIX shows tobacco industry scientific research on the use of cigarette additivescannot be taken at face value. The results demonstrate that toxins in cigarette smoke increase substantially when additivesare put in cigarettes, including the level of TPM. In particular, regulatory authorities, including the FDA and similar agencieselsewhere, could use the Project MIX data to eliminate the use of these 333 additives (including menthol) from cigarettes.

Download full PDF : journal.pmed.1001145[1]

Singapore Considers Widening Smoking Ban

Dec. 19, 2011
http://www.thejakartaglobe.com/international/singapore-considers-widening-smoking-ban/485613

Smoking is banned in the majority of indoor locations in Singapore. Among them are shopping malls, cinemas and night spots.

Smoking is also not allowed in places such as bus stops, swimming pools and basement carparks. Designated smoking areas are allowed in certain premises such as eating establishments and entertainment outlets.

The authorities are now considering extending a smoking ban to public spaces such as common corridors and staircase landings in HDB blocks, parks and park connectors, and beaches.

Smoking corners in entertainment outlets, hawker centers and food establishments may also have to go. All these areas have been flagged as problem spots based on public feedback gathered by the National Environment Agency (NEA).

It launched an islandwide consultation exercise last month seeking views from the public whether they want smoking at these places banned.

The proposal to widen the smoking ban comes after the NEA caught an increasing number of people flouting the law. In the first 10 months of this year, it issued 4,462 tickets to errant smokers. Last year, the figure was 4,646. Offenders can be fined up to $1,000.

Reprinted courtesy of Straits Times Indonesia. To subscribe to Straits Times Indonesia and/or the Jakarta Globe call 021 2553 5055.

European governments should stop subsidizing films with tobacco imagery

The European Commission has recently completed a public consultation
on the future provision of state aid for audiovisual works.
Although not its main aim, the consultation provided an
important opportunity to challenge the way that EU governments
currently subsidize US and domestic films with tobacco imagery.
Given the growing evidence, initially from the USA but now from
seven European countries, of a causal link between exposure to
tobacco imagery in films and smoking initiation among youth,
recently brought together in updated WHO guidance,1 we call
on EU governments to end their subsidies that now amount to
E263 million over 2008–11 for films with tobacco imagery.

The European Commission has recently completed a public consultationon the future provision of state aid for audiovisual works.Although not its main aim, the consultation provided animportant opportunity to challenge the way that EU governmentscurrently subsidize US and domestic films with tobacco imagery.Given the growing evidence, initially from the USA but now fromseven European countries, of a causal link between exposure totobacco imagery in films and smoking initiation among youth,recently brought together in updated WHO guidance,1 we callon EU governments to end their subsidies that now amount toE263 million over 2008–11 for films with tobacco imagery.

Download PDF : eurpub.ckr183.full

Fine particle air pollution and secondhand smoke exposures and risks inside 66 US casinos.

Source

Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA. repace@comcast.net

Abstract

Smoking bans often exempt casinos, exposing occupants to fine particles (PM(2.5)) from secondhand smoke. We quantified the relative contributions to PM(2.5) from both secondhand smoke and infiltrating outdoor sources in US casinos. We measured real-time PM(2.5), particulate polycyclic aromatic hydrocarbons (PPAH), and carbon dioxide (CO(2)) (as an index of ventilation rate) inside and outside 8 casinos in Reno, Nevada. We combined these data with data from previous studies, yielding a total of 66 US casinos with smoking in California, Delaware, Nevada, New Jersey, and Pennsylvania, developing PM(2.5) frequency distributions, with 3 nonsmoking casinos for comparison. Geometric means for PM(2.5) were 53.8 μg/m(3) (range 18.5-205 μg/m(3)) inside smoking casinos, 4.3 μg/m(3) (range 0.26-29.7 μg/m(3)) outside those casinos, and 3.1 μg/m(3) (range 0.6-9 μg/m(3)) inside 3 nonsmoking casinos. In a subset of 21 Reno and Las Vegas smoking casinos, PM(2.5) in gaming areas averaged 45.2 μg/m(3) (95% CI, 37.7-52.7 μg/m(3)); adjacent nonsmoking casino restaurants averaged 27.2 μg/m(3) (95% CI, 17.5-36.9 μg/m(3)), while PM(2.5) outside the casinos averaged 3.9 μg/m(3) (95% CI, 2.5-5.3 μg/m(3)). For a subset of 10 Nevada and Pennsylvania smoking casinos, incremental (indoor-outdoor) PM(2.5) was correlated with incremental PPAH (R(2)=0.79), with ventilation rate-adjusted smoker density (R(2)=0.73), and with smoker density (R(2)=0.60), but not with ventilation rates (R(2)=0.15). PPAH levels in 8 smoking casinos in 3 states averaged 4 times outdoors. The nonsmoking casinos’ PM(2.5) (n=3) did not differ from outdoor levels, nor did their PPAH (n=2). Incremental PM(2.5) from secondhand smoke in approximately half the smoking casinos exceeded a level known to produce cardiovascular morbidity in nonsmokers after less than 2h of exposure, posing acute health risks to patrons and workers. Casino ventilation and air cleaning practices failed to control secondhand smoke PM(2.5). Drifting PM(2.5) from secondhand smoke contaminated unseparated nonsmoking areas. Smoke-free casinos reduced PM(2.5) to the same low levels found outdoors.

Copyright © 2011 Elsevier Inc. All rights reserved.

PMID:

21440253

[PubMed – indexed for MEDLINE]

WHO warns Chinese public of misleading tobacco industry research

http://news.xinhuanet.com/english/health/2011-12/19/c_131315480.htm

BEIJING, Dec. 19 (Xinhua) — Research indicating that some cigarettes are less harmful is tobacco industry hype meant to mislead the public, a World Health Organization official warned on Monday as a heated debate rages in China over the credibility of tobacco science.

“Low-tar cigarettes, for example, don’t reduce the harm at all,” said Sarah England, a technical officer on tobacco control with the WHO Representative Office in China.

She said tar, nicotine and other smoke emission yields derived from smoking-machine testing do not provide valid estimates of human exposure and there is no conclusive epidemiological or scientific evidence that cigarettes with lower machine-generated smoke yields are less harmful.

The debate on tobacco science flared up in China after Xie Jianping, a researcher known for his studies on low-tar cigarettes, was honored with a seat in the elite Chinese Academy of Engineering earlier this month.

Xie’s accreditation was challenged by Chinese health experts, but some scientists and smokers also came out to defend the 52-year-old researcher, who has spent decades working with a tobacco research institute under the China National Tobacco Corporation (China Tobacco) — the world’s largest cigarette company.

Neither Xie nor authorities with the Chinese Academy of Engineering have publicly commented since the controversy heated up.

“The marketing of cigarettes with stated tar and nicotine yields has resulted in the mistaken belief that those cigarettes are less harmful. It is just a tobacco industry tactic. It is very misleading,” England said.

The WHO official compared low-tar cigarettes to a green bullet and cigarettes with standard tar levels to a red one, and said, “It is meaningless to say which is better, to be killed by a red or green bullet.”

“I recommend not going near the bullets. Quit smoking instead,” she added.

Yang Gonghuan, head of the China Tobacco Control Office under the Chinese Center for Disease Control and Prevention (China CDC), had previously blamed the tobacco companies’ low-tar promotion strategy for the 41.15 percent growth in cigarette sales in China from 2000 to 2010.

China is the world’s largest consumer of cigarettes. The country has 300 million smokers, and more than 740 million non-smokers are regularly exposed to second-hand smoke, according to experts’ estimates. About 1.2 million people die each year in China from smoking-related illnesses ranging from lung cancer to heart disease.

China is a signatory of the World Health Organization-initiated tobacco control treaty, the Framework Convention on Tobacco Control (FCTC), but implementation has been slow mainly due to interference from the country’s powerful tobacco industry, health experts have said. The FCTC requires nations to ban deceptive and misleading descriptions such as “low-tar” labels, they said.

Jonathan Samet, who chairs the Tobacco Products Scientific Advisory Committee of the U.S. Food and Drug Administration (FDA), told reporters in Beijing that he found Xie’s accreditation unusual.

“No one has made a conventional cigarette product safer,” Samet said. “A cigarette typically contains 7,000 dangerous chemicals and it is hard to say taking out one or two chemicals will make any difference.”

“And how do you know any cigarette is low risk without watching people use it for 20 years?” he said.

Funding for tobacco control ‘inadequate’

Updated: 2011-12-19 07:48 http://www.chinadaily.com.cn/cndy/2011-12/19/content_14284297.htm

By Shan Juan (China Daily)

Print Mail Large Medium Small 0

BEIJING – Annual government funding for tobacco control is just several hundred thousand yuan for each province on the Chinese mainland, far below what’s needed and much less than the amounts provided in other countries, anti-smoking experts said.

In the United States, hundreds of millions of dollars are allocated annually for tobacco control research and projects, said Jonathan Samet, chairman of the Tobacco Products Scientific Advisory Committee of the US Food and Drug Administration (FDA).

“Although we’ve seen the prevalence of both the smoking epidemic and lung cancer decline in the US, tobacco control is still an urgent and important issue, given that nicotine is highly addictive and we don’t want our children to take up smoking,” he told China Daily in an interview on Sunday.

In 2011, the US had about 221,000 new cases of lung cancer, while about 157,000 people died from the disease, according to estimates from the US National Cancer Institute.

“Unfortunately, less-educated people today suffer the most from smoking in the US,” said Samet. He said that the smoking rate among the college-educated was less than 10 percent, but it was 40 percent among those who hadn’t finished high school.

Samet said that the prevalence of smoking peaked around 1961 in the US, when half of the men and 35 percent of the women smoked.

Now, less than 20 percent of the US population smokes. The rates are about equal for men and women but vary widely across the country, he said.

Tobacco control campaigns in the US started in the 1960s, following the first report linking smoking and lung cancer. Most offices and public places have become smoke-free in the past 15 years.

“Increasing public awareness and changing social norms helped achieve the change,” said Samet, himself brought up by parents who smoked.

The change has improved the US public health situation. Lung cancer rates among men began to drop some 20 years ago, while in women they are just beginning to decrease, he added.

However, in China, the lung cancer rate has kept increasing in the past decade, said Shi Yuankai, vice-president of the Chinese Academy of Medical Sciences Cancer Hospital. “It’s about an annual increase of 5 percent.”

“That rising trend won’t be reversed within 20 to 30 years, due to both smoking and air pollution,” he said.

Usually, smoking goes way up and about 20 to 30 years later, there is an evident rise in lung cancer, Samet said.

In China, smoking rates began to increase after the late 1970s and then dropped slightly in the 1990s, said Yang Gonghuan, head of the China Tobacco Control Office under the Chinese Center for Disease Control and Prevention.

But in the early 2000s, the smoking rate “began to climb a little bit again”, she said.

Health experts attributed that change to Chinese tobacco companies’ low-tar promotion strategy, which was undertaken in response to rising pressure for tobacco control, particularly after China ratified the World Health Organization’s Framework Convention on Tobacco Control in 2005.

Between 2000 and 2010, China experienced a 41.15 percent rise in cigarette sales, official statistics show.

Samet said that reducing the amount of tar and nicotine in cigarettes didn’t change the risk to human health.

Asked to comment on China’s new “tobacco academician”, Xie Jianping, who was inducted into the Chinese Academy of Engineering, said: “That’s quite unusual and couldn’t happen in the US, where tobacco researchers are hired secretly by tobacco companies.”

Yang said the government’s monopoly on tobacco was the root cause of such a situation.

Unlike in the US, where the tobacco industry is regulated by health departments, specifically the FDA, China’s tobacco industry is regulated by the State Tobacco Monopoly Bureau, which also represents the China National Tobacco Corp.

Taking into account the huge costs of smoking, in terms of treating smoking- related diseases and the loss of lives, “the Chinese government should try to get out of the tobacco business,” Samet said.

China Daily

Tobacco firm donates school items to regions worth 20m/-

IPPmedia – 2 hours ago

By The guardian reporter The Alliance One Tobacco Tanzania Limited (AOTTL) has donated items worth 20m/- to schools in five regions in the occasion of 

Secondhand smoke exposure (PM2.5) in outdoor dining areas and its correlates.

Source

Cancer Council Victoria, Carlton, Australia.

Abstract

BACKGROUND:

This study assessed the magnitude of secondhand smoke (SHS) exposure when people smoke in outdoor dining areas and explored conditions influencing exposure levels.

METHODS:

Data were gathered from 69 outdoor dining areas in Melbourne, Australia, during April/May 2007. Sitting at tables within 1 metre of an active smoker, the authors measured the concentration of particulate pollution (PM(2.5)) using TSI SidePak Personal Aerosol Monitors. PM(2.5) data were recorded by the monitor at 30-second intervals, and data were collected over an average of 25.8 minutes per venue. Information was collected about the presence of overhead coverings and the number of patrons and lit cigarettes.

RESULTS:

The average background level of PM(2.5) was 8.4 microg/m(3) (geometric mean (GM)=6.1 microg/m(3)), increasing to an average of 17.6 microg/m(3) (GM=12.7 microg/m(3)) over the observational period and 27.3 microg/m(3) (GM=17.6 microg/m(3)) during the time that cigarettes were actively smoked near the monitor. There was substantial variation in exposure levels, with a maximum peak concentration of 483.9 microg/m(3) when there were lit cigarettes close to the monitor. Average exposure levels increased by around 30% for every additional active smoker within 1 metre of the monitor. Being situated under an overhead cover increased average exposure by around 50%.

CONCLUSIONS:

When individuals sit in outdoor dining venues where smokers are present it is possible that they will be exposed to substantial SHS levels. Significant increases in exposure were observed when monitors were located under overhead covers, and as the number of nearby smokers increased. The role of outdoor smoking restrictions in minimising exposure to SHS must be considered.

PMID:

19850553

[PubMed – indexed for MEDLINE]

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http://www.ncbi.nlm.nih.gov/pubmed/20701558

Health Promot J Austr. 2010 Aug;21(2):99-105.

Second hand smoke in alfresco areas.

Stafford JDaube MFranklin P.

Source

WA Tobacco Document Searching Program, Curtin University of Technology, Western Australia. j.stafford@curtin.edu.au

Abstract

ISSUE ADDRESSED:

There are moves to ban smoking in outdoor areas of pubs, restaurants and cafes. Some argue that this is unnecessary as exposure to second hand smoke (SHS) is minimal. The aim of this study was to determine potential exposure of patrons to SHS in outdoor areas of eating and drinking venues.

METHODS:

Concentrations of fine particulate matter (PM2.5) were measured in the alfresco areas of 28 cafes and pubs. Data were collected on the number of smokers present during sampling and factors that could influence PM2.5 concentrations. PM2.5concentrations for periods with and without smokers were compared using paired and independent sample tests.

RESULTS:

PM2.5 concentrations were significantly increased when there was at least one smoker compared to periods with no smoking (14.25microg/m3 and 3.98 g/m3, respectively). There was evidence of a dose response increase with mean concentrations for none, one and two or more smokers of 3.98, 10.59and 17.00microg/m3, respectively. The differences remained significant after controlling for other factors. When two or more people were smoking, average PM2.5reached levels the US Environmental Protection Agency warns may put particularly sensitive people at risk of respiratory symptoms.

CONCLUSIONS:

Smoking increases PM2.5concentrations in outdoor areas to levels that are potentially hazardous to health.

PMID:

20701558

[PubMed – indexed for MEDLINE]