title: Protection from secondhand smoke in countries belonging to the WHO European Region: an assessment of legislation.
abstract: OBJECTIVE
  Comprehensive smokefree laws, as recommended by the WHO Framework Convention of Tobacco Control (WHO FCTC), are the most effective tool to protect the population from secondhand smoke (SHS) and to ensure healthy environments. Studies evaluating how laws govern SHS protection are scarce. This study assessed the level of protection from SHS of laws from countries belonging to the WHO European Region.
  
  
  METHODS
  A new methodology system was developed to evaluate the smokefree legislation according to the principles provided by the WHO guidelines for the correct implementation of Article 8 of the FCTC. For each law, six main sectors and 28 facilities were evaluated.
  
  
  RESULTS
  Overall 68 laws from 48 countries from the WHO European Region were reviewed. 'Education' and 'Public transport' were the most protected sectors from SHS. Many WHO European laws do not provide protection from SHS across all public sectors. For example, 48.5% of general health facilities and 71.2% of restaurants are unprotected from SHS. The level of protection provided in the 28 facilities studied was low; many WHO European laws still allow smoking under certain conditions, permitting smoking in designated and/or ventilated areas.
  
  
  CONCLUSIONS
  Nine years after the adoption of the WHO FCTC there are still legal formulas in which smoking is allowed in several facilities, through the inclusion of separated areas, ventilated areas and other conditions. Tobacco control efforts still face the challenge of eradicating the legal clauses that prevent 100% smokefree environments.
authors.affiliation: Tobacco Control Unit, Cancer Prevention and Control Department, Institut Català d'Oncologia-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain Medicine and Health Sciences School, Universitat Internacional de Catalunya, Barcelona, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Martínez
authors.affiliation: Tobacco Control Unit, Cancer Prevention and Control Department, Institut Català d'Oncologia-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Jose María
authors.initials: JM
authors.lastname: Martínez-Sánchez
authors.affiliation: City and Hackney Public Health Directorate, NHS North East London and the City, London, UK.
authors.forename: Gillian
authors.initials: G
authors.lastname: Robinson
authors.affiliation: Independent Lawyer, specialized in tobacco legislation, Berlin, Germany.
authors.forename: Christina
authors.initials: C
authors.lastname: Bethke
authors.affiliation: Tobacco Control Unit, Cancer Prevention and Control Department, Institut Català d'Oncologia-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain Department of Clinical Sciences, School of Medicine, Campus of Bellvitge, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Esteve
authors.initials: E
authors.lastname: Fernández
mesh_terms: D005060:Europe; D033161:Government Regulation; D006801:Humans; D012907:Smoking / Q000331:legislation & jurisprudence*; D000074606:Smoking Prevention; D014028:Tobacco Smoke Pollution / Q000331:legislation & jurisprudence*; D014944:World Health Organization
chemical_list: D014028:Tobacco Smoke Pollution
keywords: Environment; Public policy; Secondhand smoke