Tobacco Smoke Exposure in Indoor and Outdoor Locations in Airports Across Europe and the United States: A Cross-Sectional Study
Por:
Stillman, FA, Soong, A, Pang, YJ, Zheng, L, Garcia-Esquinas, E, Lopez, MJ, Navas-Acien, A
Publicada:
1 dic 2017
Resumen:
Objective: Conduct a systematic evaluation of indoor and outdoor areas of selected airports, assess compliance and identify areas of improvement with smoke-free policies in airports.
Methods: Cross-sectional observational study conducted at 21 airports in Europe (11) and the United States (10). Using a standardized protocol, we assessed compliance (smoking, cigarette butts, smoke smell), and the physical environment (signage, ashtrays, designated smoking rooms [DSRs], tobacco sales).
Results: Cigarette butts (45% vs. 0%), smoke smell (67% vs. 0%), ashtrays (18% vs. 10%), and DSRs (63% vs. 30%) were observed more commonly indoors in Europe than in the United States. Poor compliance indoors was related to the presence of DSRs (OR 4.8, 95% CI 0.69, 33.8) and to cigarettes sales in pre-security areas (OR 6.0, 95% CI 0.57, 64.7), although not significantly different. Smoking was common in outdoor areas of airports in Europe and the United States (mean (SD) number of smokers 27.7 (23.6) and 6.3 (7.7), respectively, p value < .001). Around half (55%) of airports in Europe and all airports in the United States had some/partial outdoor smoking restrictions.
Conclusions: Exposure to secondhand smoke (SHS) remains a public health problem in major airports across Europe and in some airports in the United States, specifically related to the presence of DSRs and SHS exposure in outdoor areas. Airports must remove DSRs. Research is needed in low-and middle-income countries and on the effectiveness of outdoor smoking-restricted areas around entryways. Eliminating smoking at airports will protect millions of people from SHS exposure and promote social norms that discourage smoking.
Implications: Airports are known to allow exceptions to smoke-free policy by providing DSRs. We found that smoking still occurs in indoor areas in airports, particularly in the context of DSRs. Smoking, moreover, is widespread in outdoor areas and compliance with smoking restrictions is limited. Advancing smoke-free policy requires improvements to the physical environment of airports, including removal of DSRs and implementation of stricter outdoor smoking restrictions.
Filiaciones:
Stillman, FA:
Johns Hopkins Bloomberg Sch Publ Hlth, Inst Global Tobacco Control, Dept Hlth Behav & Soc, Baltimore, MD USA
Soong, A:
Univ Maryland, Sch Publ Hlth, Ctr Young Adult Hlth & Dev, Dept Behav & Community Hlth, College Pk, MD 20742 USA
Johns Hopkins Bloomberg Sch Publ Hlth, Inst Global Tobacco Control, Dept Hlth Behav & Soc, Baltimore, MD USA
Pang, YJ:
Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA
Zheng, L:
Icahn Sch Med Mt Sinai, Dept Environm Med & Publ Hlth, New York, NY 10029 USA
Garcia-Esquinas, E:
CIBER Epidemiol & Publ Hlth CIBERESP, Madrid, Spain
Univ Autonoma Madrid, IdiPaz, Sch Med, Dept Prevent Med & Publ Hlth, Madrid, Spain
Lopez, MJ:
Publ Hlth Agcy Barcelona, Barcelona, Spain
St Pau Inst Biomed Res IIb St Pau, Barcelona, Spain
Spanish Consortium Res Epidemiol & Publ Hlth CIBE, Madrid, Spain
Navas-Acien, A:
Johns Hopkins Bloomberg Sch Publ Hlth, Dept Environm Hlth Sci, Baltimore, MD USA
Columbia Univ, Mailman Sch Publ Hlth, Dept Environm Hlth Sci, 722 W 168th St,Off 1105F, New York, NY 10032 USA
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