Secondhand smoke exposure in European countries with different smoke-free legislation. Findings from the EUREST-PLUS ITC Europe Surveys.

Abstract

BACKGROUND\nExposure to secondhand smoke (SHS) poses serious and extensive health and economic-related consequences to European society and worldwide. Smoking bans are a key measure to reducing SHS exposure but have been implemented with varying levels of success. We assessed changes in the prevalence of self-reported SHS exposure and smoking behaviour in public places among smokers in six European countries and the influence of the country s type of smoking ban (partial or total ban) on such exposure and smoking behaviour.\n\n\nMETHODS\nThe EUREST-PLUS ITC Europe Surveys were conducted among adult smokers in Germany, Greece, Hungary, Poland, Romania, and Spain in 2016 (Wave 1, n=6,011) and 2018 (Wave 2, n=6,027). We used generalised estimating equations models to assess changes between Waves 1 and 2 and to test the interaction between the type of smoking ban and 1) self-reported SHS exposure, 2) self-reported smoking in public places.\n\n\nRESULTS\nA significant decrease in self-reported SHS exposure was observed in workplaces, from 19.1% in 2016 to 14.0% in 2018 (-5.1%; 95% CI: -8.0%;-2.2%). Self-reported smoking did not change significantly inside bars (22.7% in W2), restaurants (13.2% in W2) and discos/nightclubs (34.0% in W2). SHS exposure in public places was significantly less likely (OR=0.35; 95% CI: 0.26-0.47) in the countries with total bans as compared to those countries with partial bans.\n\n\nCONCLUSION\nThe inverse association between smoking in public places and smoking bans indicates an opportunity for strengthening smoke-free legislation and protecting bystanders from exposure to SHS in public places.