Article Text

Assessment of risk for asthma initiation and cancer and heart disease deaths among patrons and servers due to secondhand smoke exposure in restaurants and bars
  1. Ruiling Liu1,
  2. David L Bohac2,
  3. Lara A Gundel3,
  4. Martha J Hewett2,
  5. Michael G Apte3,
  6. S Katharine Hammond1
  1. 1Department of Environmental Health Sciences, School of Public Health, University of California, Berkeley, California, USA
  2. 2Center for Energy and Environment, Minneapolis, Minnesota, USA
  3. 3Department of Indoor Environment, Lawrence Berkeley National Laboratory, Berkeley, California, USA
  1. Correspondence to Dr S Katharine Hammond, Department of Environmental Health Sciences, School of Public Health, University of California, 50 University Hall #7360, Berkeley, California 94720-7360, USA; hammondk{at}berkeley.edu

Abstract

Background Despite efforts to reduce exposure to secondhand smoke (SHS), only 5% of the world's population enjoy smoke-free restaurants and bars.

Methods Lifetime excess risk (LER) of cancer death, ischaemic heart disease (IHD) death and asthma initiation among non-smoking restaurant and bar servers and patrons in Minnesota and the US were estimated using weighted field measurements of SHS constituents in Minnesota, existing data on tobacco use and multiple dose-response models.

Results A continuous approach estimated a LER of lung cancer death (LCD) of 18×10−6(95% CI 13 to 23×10−6) for patrons visiting only designated non-smoking sections, 80×10−6(95% CI 66 to 95×10−6) for patrons visiting only smoking venues/sections and 802×10−6(95% CI 658 to 936×10−6) for servers in smoking-permitted venues. An attributable-risk (exposed/non-exposed) approach estimated a similar LER of LCD, a LER of IHD death about 10−2 for non-smokers with average SHS exposure from all sources and a LER of asthma initiation about 5% for servers with SHS exposure at work only. These risks correspond to 214 LCDs and 3001 IHD deaths among the general non-smoking population and 1420 new asthma cases among non-smoking servers in the US each year due to SHS exposure in restaurants and bars alone.

Conclusions Health risks for patrons and servers from SHS exposure in restaurants and bars alone are well above the acceptable level. Restaurants and bars should be a priority for governments’ effort to create smoke-free environments and should not be exempt from smoking bans.

  • Secondhand smoke
  • Smoking Caused Disease
  • Public policy
  • Priority/special populations
  • Environment

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/

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