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Research paper
Indoor secondhand tobacco smoke emission levels in six Lebanese cities
  1. Georges Saade1,
  2. Andrew B Seidenberg2,
  3. Vaughan W Rees2,
  4. Zaher Otrock3,
  5. Gregory N Connolly2
  1. 1Faculty of Public Health, Lebanese University, Beirut, Lebanon
  2. 2Harvard School of Public Health, Division of Public Health Practice, Boston, Massachusetts, USA
  3. 3Department of Pathology, American University of Beirut, Beirut, Lebanon
  1. Correspondence to Dr Vaughan Rees, Harvard School of Public Health, Division of Public Health Practice, Landmark Building, Level 3 East, 677 Huntington Ave, Boston, MA 02115, USA; vrees{at}hsph.harvard.edu

Abstract

Background To date, Lebanon has failed to enact comprehensive clean indoor air laws despite ratification of the Framework Convention on Tobacco Control (FCTC), which calls for the protection of non-smokers from exposure to secondhand tobacco smoke (SHS). Complicating the problem of SHS exposure in Lebanon is the widespread use of the tobacco water-pipe. While most research on SHS has involved cigarette smoking as a source of emissions, other sources, including tobacco water-pipes, may be an important contributor.

Methods PM2.5 concentrations (μg/m3) were measured in a sample of 28 public venues located in six major Lebanese cities. Active smoker density (number of smokers/100 m3) was calculated for both water-pipe and cigarette smokers. Venues were then categorised as having higher density of water-pipe smokers or higher density of cigarette smokers, and resultant emission levels were compared between the two groups.

Results Cigarette and water-pipe smoking was observed in 14 venues, while cigarette smoking only and water-pipe smoking only were found in 12 venues and one venue, respectively. Among all smoking-permitted venues, the mean PM2.5 concentration was 342 μg/m3. Venues with a higher density of water-pipe smokers (n =14) showed a similar median PM2.5 concentration (349 μg/m3) compared with venues with a higher density of cigarette smokers (n =13; 241 μg/m3; p=0.159). The mean PM2.5 concentration in the single venue with a voluntary smoke-free policy was 6 μg/m3.

Conclusions Despite ratification of the FCTC in 2005, both cigarette and water-pipe smoking are commonly practised in enclosed public places throughout Lebanon, leading to unsafe levels of indoor particulate pollution. Smoke-free policies are needed in Lebanon to protect the public's health, and should apply to all forms of tobacco smoking.

  • Environmental tobacco smoke

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.

https://doi.org/10.1136/tc.2009.030460

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    Footnotes

    • Funding This work was funded by grants from WHO, Beirut, Lebanonoffice to GS and the Flight Attendant Medical Research Institute to GNC. Additional funding and support provided by Framework Convention Alliance and Action on Smoking and Health International to GNC.

    • Competing interests None.

    • Provenance and peer review Not commissioned; externally peer reviewed.