Smoke-Free Policies in the World’s 50 Busiest Airports — August 2017

Exposure to secondhand smoke from burning tobacco products causes premature death and disease, including coronary heart disease, stroke, and lung cancer among nonsmoking adults and sudden infant death syndrome, acute respiratory infections, middle ear disease, exacerbated asthma, respiratory symptoms, and decreased lung function in children (1,2). The U.S. Surgeon General has concluded that there is no risk-free level of exposure to secondhand smoke (1). Previous CDC reports on airport smoke-free policies found that most large-hub airports in the United States prohibit smoking (3); however, the extent of smoke-free policies at airports globally has not been assessed. CDC assessed smoke-free policies at the world’s 50 busiest airports (airports with the highest number of passengers traveling through an airport in a year) as of August 2017; approximately 2.7 billion travelers pass through these 50 airports each year (4). Among these airports, 23 (46%) completely prohibit smoking indoors, including five of the 10 busiest airports. The remaining 27 airports continue to allow smoking in designated smoking areas. Designated or ventilated smoking areas can cause involuntary secondhand smoke exposure among nonsmoking travelers and airport employees. Smoke-free policies at the national, city, or airport authority levels can protect employees and travelers from secondhand smoke inside airports.

The 50 busiest airports were identified using data from the Airport International Council, which lists airports based on total passenger traffic for 2016 (4). The Airport International Council defines passenger traffic as the sum of enplaned passengers, deplaned passengers, and direct-transit passengers. To determine the extent of smoke-free policies at each of the 50 busiest airports worldwide, CDC reviewed and analyzed public information available on airport websites regarding availability of designated indoor smoking rooms at airports as of August 2017. Results were confirmed with information on smoke-free airports maintained by Americans for Nonsmokers’ Rights Foundation* and with other Internet resources, including information intended to assist smokers in finding places where smoking is permitted in airports. In a limited number of instances where airport websites contained unclear or ambiguous statements about policies, additional information was collected from other sources, including airport personnel and local public health personnel.

Airports were considered to have a smoke-free policy if they completely prohibit smoking in all indoor areas. Airports were considered to have no smoke-free policy if they allowed smoking in any indoor areas, including designated or ventilated indoor smoking areas. Designated smoking areas can include, but are not limited to, rooms designed for smoking tobacco; areas or rooms of restaurants or bars where smoking is allowed; and designated areas and rooms in airline clubs where smoking is allowed. Policy status was assessed overall and by global region.

Among the 50 busiest airports worldwide, 23 (46%) had a smoke-free policy (Table 1). Among the top 10 busiest airports, five had a smoke-free policy (Beijing Capital, Chicago’s O’Hare International, London’s Heathrow, Los Angeles International, and Shanghai Pudong International) and five allowed smoking in certain indoor areas (Atlanta Hartsfield Jackson International, Dubai International, Hong Kong International, Paris’s Charles de Gaulle, and Tokyo International).

Regional differences were observed in smoke-free policy status among the world’s 50 busiest airports (Table 2). Among those in North America, 14 of 18 had a smoke-free policy; in Europe, four of nine had a smoke-free policy, including airports in Madrid, Barcelona, and London (Heathrow and Gatwick airports); and in Asia, four of 22 had a smoke-free policy (all four are in China, including Beijing Capital International Airport, the world’s second busiest airport). The only airport among the 50 busiest in Oceania is Sydney International, which is smoke-free. None of the world’s 50 busiest airports is located in South America or Africa.

Acknowledgment

Xiao Lin, National Tobacco Control Office, China CDC.

Corresponding author: Michael A. Tynan, mtynan@cdc.gov, 404-498-1202.

¹Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, CDC.

References

1. US Department of Health and Human Services. The health consequences of involuntary exposure to tobacco smoke: a report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, CDC; 2006. https://www.surgeongeneral.gov/library/reports/secondhandsmoke/index.htmlexternal icon
2. US Department of Health and Human Services. The health consequences of smoking—50 years of progress: a report of the Surgeon General. Atlanta: US Department of Health and Human Services, CDC, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014. https://www.surgeongeneral.gov/library/reports/50-years-of-progress/index.htmlexternal icon
3. CDC. Smoking restrictions in large-hub airports—United States, 2002 and 2010. MMWR Morb Mortal Wkly Rep 2010;59:1484–7. PubMedexternal icon
4. Port Authority of New York and New Jersey. Airport traffic report. Passenger traffic: top 50 worldwide airport comparisons, 2016, table 2.1.2. New York, NY: Port Authority of New York and New Jersey; 2016. http://www.panynj.gov/airports/pdf-traffic/ATR2016.pdfpdf iconexternal icon
5. Pion M, Givel MS. Airport smoking rooms don’t work. Tob Control 2004;13(Suppl 1):i37–40. CrossRefexternal icon PubMedexternal icon
6. Lee K, Hahn EJ, Robertson HE, Whitten L, Jones LK, Zahn B. Air quality in and around airport enclosed smoking rooms. Nicotine Tob Res 2010;12:665–8. CrossRefexternal icon PubMedexternal icon
7. CDC. Indoor air quality at nine large-hub airports with and without designated smoking areas—United States, October–November 2012. MMWR Morb Mortal Wkly Rep 2012;61:948–51. PubMedexternal icon
8. Stillman FA, Soong A, Kleb C, Grant A, Navas-Acien A. A review of smoking policies in airports around the world. Tob Control 2015;24:528–31. CrossRefexternal icon PubMedexternal icon

TABLE 1. Indoor smoke-free policy status of 50 busiest airports — worldwide, August 2017

*Ranked by total 2016 passenger traffic, according to the Airports Council International.
^† Airports are considered to have a smoke-free policy if they completely prohibit smoking in all indoor areas. Airports were considered to have no smoke-free policy if they allowed smoking in any indoor areas, including designated or ventilated indoor smoking areas.

TABLE 2. Smoke-free airports among the 50 busiest airports, by region — worldwide, August 2017

*No airports among the world’s 50 busiest were in the Africa or South America regions.
^† Airports are considered to have a smoke-free policy if they completely prohibit smoking in all indoor areas. Airports were considered to have no smoke-free policy if they allowed smoking in any indoor areas, including designated or ventilated indoor smoking areas.