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Smokefree Policies Reduce Secondhand Smoke Exposure

Overview

Exposure to secondhand smoke from burning tobacco products causes disease and premature death among nonsmokers.1 There is no risk-free level of secondhand smoke, and even brief exposure can cause immediate harm.1 Smokefree laws that prohibit smoking in all indoor areas of a venue fully protect nonsmokers from involuntary exposure to secondhand smoke indoors.1

National and international studies have found substantial declines in cotinine, a marker of secondhand smoke, among both hospitality workers and the general public following the implementation of smokefree laws.2-10 Cotinine is a byproduct the body creates when it breaks down nicotine, a major ingredient of tobacco smoke. Cotinine can be measured by testing saliva, urine, or blood.11

Selected Studies: Domestic

Studies in:Found that:
New York StateIn 2003, a statewide comprehensive smokefree law prohibiting smoking in all indoor areas of workplaces, restaurants, and bars was implemented in New York.
  • A study found that salivary cotinine levels among nonsmoking adults decreased by 47.4% within 1 year after the law took effect.2
  • Another study found that salivary cotinine levels among nonsmoking adult workers in the state decreased by 85% within 1 year after the law took effect.3
MinnesotaIn 2007, a statewide comprehensive smokefree law prohibiting smoking in all indoor areas of workplaces, restaurants, and bars was implemented in Minnesota.
  • A study found that urine cotinine levels among nonsmoking bar and restaurant employees decreased by 80% within 1 to 2 months after the law took effect.4
MichiganIn 2010, a statewide comprehensive smokefree law prohibiting smoking in all indoor areas of workplaces, restaurants, and bars was implemented in Michigan.
  • A study found that urine cotinine levels among nonsmoking bar employees decreased from 35.9 ng/ml to a level so low that it could not be measured within 2 months after the law took effect.5

Selected Studies: International

Studies in:Found that:
IrelandIn 2004, a nationwide comprehensive smokefree law prohibiting smoking in all indoor areas of workplaces, restaurants, and bars was implemented in Ireland.
  • A study found that salivary cotinine levels among nonsmoking adult bar workers decreased by 80% within 1 year after the law took effect.6
  • Another study found that salivary cotinine levels among nonsmoking adult hotel workers decreased by 69% within 4 to 6 weeks after the law took effect.7
ScotlandIn 2006, a nationwide comprehensive smokefree law prohibiting smoking in all indoor areas of workplaces, restaurants, and bars was implemented in Scotland.
  • A study found that salivary cotinine levels among nonsmoking adults decreased by 39% within 1 year after the law took effect.8
  • Another study found that salivary cotinine levels among nonsmoking primary school children decreased by 39% within 10 months after the law took effect.9
EnglandIn 2007, a nationwide comprehensive smokefree law prohibiting smoking in all indoor areas of workplaces, restaurants, and bars was implemented in England.

A study found that salivary cotinine levels among nonsmoking adults decreased by 80% within 1 year after the law took effect.10

References

  1. U.S. Department of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2006 [accessed 2014 May 1].
  2. Centers for Disease Control and Prevention. Reduced Secondhand Smoke Exposure After Implementation of a Comprehensive Statewide Smoking Ban–New York, June 26, 2003–June 30, 2004. Morbidity and Mortality Weekly Report 2007;56(28):705–8 [accessed 2014 May 1].
  3. Farrelly MC, Nonnemaker JM, Chou R, Hyland A, Peterson KK, Bauer UE. Changes in Hospitality Workers' Exposure to Secondhand Smoke Following the Implementation of New York's Smoke-Free Law. Tobacco Control 2005;14(4):236–41 [cited 2014 May 1].
  4. Jensen JA, Schillo BA, Moilanen MM, Lindgren BR, Murphy S, Carmella S, Hecht SS, Hatsukami DK. Tobacco Smoke Exposure in Nonsmoking Hospitality Workers Before and After a State Smoking Ban. Cancer Epidemiology, Biomarkers & Prevention 2010;19(4):1016–21 [cited 2014 May 1].
  5. Wilson T, Shamo F, Boynton K, Kiley J. The Impact of Michigan’s Dr. Ron Davis Smoke-Free Air Law on Levels of Cotinine, Tobacco-Specific Lung Carcinogen and Severity of Self-Reported Respiratory Symptoms Among Non-Smoking Bar Employees. Tobacco Control 2012;21:593–5 [cited 2014 May 1].
  6. Allwright S, Paul G, Greiner B, Mullally BJ, Pursell L, Kelly A, Bonner B, D’Eath M, McConnell B, McLaughlin JP, O’Conovan D, O’Kane E, Perry IJ. Legislation for Smoke-Free Workplaces and Health of Bar Workers in Ireland: Before and After Study. British Medical Journal 2005;331(7525):1117 [cited 2014 May 1].
  7. Mulcahy M, Evans DS, Hammond SK, Repace JL, Byrne M. . Secondhand Smoke Exposure and Risk Following the Irish Smoking Ban: An Assessment of Salivary Cotinine Concentrations in Hotel Workers and Air Nicotine Levels in Bars. Tobacco Control 2005;14:384–8 [cited 2014 May 1].
  8. Haw SJ, Gruer L. Changes in Exposure of Adult Non-Smokers to Secondhand Smoke After Implementation of Smoke-Free Legislation in Scotland: National Cross Sectional Survey. British Medical Journal 2007;335(7619):549–53 [cited 2014 May 1].
  9. Akhtar PC, Currie DB, Currie CE, Haw SJ. Changes in Child Exposure to Environmental Tobacco Smoke (CHETS) Study After Implementation of Smoke-Free Legislation in Scotland: National Cross Sectional Survey. British Medical Journal 2007;335(7619):545–9 [cited 2014 May 1].
  10. Sims M, Mindell JS, Jarvis MJ, Feyerabend C, Wardle H, Gilmore A. Did Smokefree Legislation in England Reduce Exposure to Secondhand Smoke among Nonsmoking Adults? Cotinine Analysis from the Health Survey for England. Environmental Health Perspectives 2012;120(3):425–30 [cited 2014 May 1].
  11. Avila-Tang E, Al-Delaimy WK, Ashley DL, Benowitz N, Bernert JT, Kim S, Samet JM, Hecht SS. Assessing Secondhand Smoke Using Biological Markers. Tobacco Control 2013;22(3):164–71 [cited 2014 May 1].

For Further Information

Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion
Office on Smoking and Health
E-mail: tobaccoinfo@cdc.gov
Phone: 1-800-CDC-INFO

Media Inquiries: Contact CDC's Office on Smoking and Health press line at 770-488-5493.

 
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