title: Evaluating the efficacy of different smoking policies in restaurants and bars in Beijing, China: a four-year follow-up study.
abstract: BACKGROUND
  In 2006, the World Health Organization Framework Convention on Tobacco Control became effective in mainland China. In 2007, advocacy on voluntary smoking bans in restaurants was initiated in Beijing, and in 2008 the Beijing government implemented a smoking regulation, requiring big restaurants to prohibit or restrict smoking.
  
  
  OBJECTIVE
  To evaluate the efficacy of different smoking policies adopted by Beijing restaurants and bars from 2006 to 2010.
  
  
  METHODS
  The study conducted field observations of patron smoking behavior and monitored fine particulate matter from secondhand smoke (SHS PM) from 91, 85, 94 and 79 Beijing restaurants and bars in 2006, 2007, 2008 and 2010, respectively, during peak-patronage times, with overlaps of venues during each two years. Area nicotine sampling during peak patronage times and servers' personal nicotine sampling during their working shifts were also conducted in 2010.
  
  
  RESULTS
  Smoking was nominally prohibited or restricted in 18% of restaurants and bars monitored in 2006, in 11% of venues in 2007, in 83% of venues in 2008, and in 69% of venues in 2010. However, smoking was observed in more than 40% of the nominal nonsmoking venues/sections in 2008 and 2010. The median of observed patron active smoker density (ASD) was 0.24, 0.27, 0.00 and 0.10 active smokers per 100 m3 in 2006, 2007, 2008 and 2010, respectively. The median of SHS PM concentrations was 53, 83, 18 and 27 μg/m3, respectively. In 2010, both the median SHS PM and air nicotine concentrations in designated nonsmoking sections were about 40% of those in designated smoking sections, according to simultaneous sampling in both sections. Servers' personal exposure to air nicotine was quite similar in venues with different nominal smoking policies. In the 15 venues followed from 2006 to 2010, SHS PM concentrations changed randomly from 2006 to 2007, decreased in most venues in 2008, and then increased to some extent in 2010.
  
  
  CONCLUSIONS
  Voluntary smoking policy is rarely adopted and cannot protect people from SHS exposure in restaurants and bars. The 2008 Beijing governmental smoking regulation failed to significantly reduce SHS exposure shortly or two years after its implementation. Restricting smoking to designated sections cannot eliminate SHS exposure.
authors.affiliation: School of Public Health, University of California Berkeley, 50 University Hall #7360, Berkeley, CA 94720, USA.
authors.forename: Ruiling
authors.initials: R
authors.lastname: Liu
authors.forename: Yuan
authors.initials: Y
authors.lastname: Jiang
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Travers
authors.forename: Qiang
authors.initials: Q
authors.lastname: Li
authors.forename: S Katharine
authors.initials: SK
authors.lastname: Hammond
mesh_terms: D016902:Air Pollution, Indoor / Q000032:analysis / Q000331:legislation & jurisprudence* / Q000517:prevention & control; D002681:China; D033161:Government Regulation; D009111:Local Government; D009538:Nicotine / Q000032:analysis; D052638:Particulate Matter / Q000032:analysis; D012147:Restaurants / Q000331:legislation & jurisprudence*; D012907:Smoking / Q000331:legislation & jurisprudence*; D014028:Tobacco Smoke Pollution / Q000032:analysis / Q000331:legislation & jurisprudence*
chemical_list: D052638:Particulate Matter; D014028:Tobacco Smoke Pollution; D009538:Nicotine
keywords: Follow-up study; Policy evaluation; Restaurants and bars; Secondhand smoke; Smoking restriction