title: Impact of a smoking ban in hospitality venues on second hand smoke exposure: a comparison of exposure assessment methods.
abstract: BACKGROUND
  In May 2010, Switzerland introduced a heterogeneous smoking ban in the hospitality sector. While the law leaves room for exceptions in some cantons, it is comprehensive in others. This longitudinal study uses different measurement methods to examine airborne nicotine levels in hospitality venues and the level of personal exposure of non-smoking hospitality workers before and after implementation of the law.
  
  
  METHODS
  Personal exposure to second hand smoke (SHS) was measured by three different methods. We compared a passive sampler called MoNIC (Monitor of NICotine) badge, to salivary cotinine and nicotine concentration as well as questionnaire data. Badges allowed the number of passively smoked cigarettes to be estimated. They were placed at the venues as well as distributed to the participants for personal measurements. To assess personal exposure at work, a time-weighted average of the workplace badge measurements was calculated.
  
  
  RESULTS
  Prior to the ban, smoke-exposed hospitality venues yielded a mean badge value of 4.48 (95%-CI: 3.7 to 5.25; n = 214) cigarette equivalents/day. At follow-up, measurements in venues that had implemented a smoking ban significantly declined to an average of 0.31 (0.17 to 0.45; n = 37) (p = 0.001). Personal badge measurements also significantly decreased from an average of 2.18 (1.31-3.05 n = 53) to 0.25 (0.13-0.36; n = 41) (p = 0.001). Spearman rank correlations between badge exposure measures and salivary measures were small to moderate (0.3 at maximum).
  
  
  CONCLUSIONS
  Nicotine levels significantly decreased in all types of hospitality venues after implementation of the smoking ban. In-depth analyses demonstrated that a time-weighted average of the workplace badge measurements represented typical personal SHS exposure at work more reliably than personal exposure measures such as salivary cotinine and nicotine.
authors.affiliation: Swiss Tropical and Public Health Institute, Basel, Switzerland.
authors.forename: Sarah
authors.initials: S
authors.lastname: Rajkumar
authors.forename: Cong Khanh
authors.initials: CK
authors.lastname: Huynh
authors.forename: Georg F
authors.initials: GF
authors.lastname: Bauer
authors.forename: Susanne
authors.initials: S
authors.lastname: Hoffmann
authors.forename: Martin
authors.initials: M
authors.lastname: Röösli
mesh_terms: D003430:Cross-Sectional Studies; D004781:Environmental Exposure; D004784:Environmental Monitoring / Q000379:methods*; D006801:Humans; D016273:Occupational Exposure / Q000009:adverse effects*; D018570:Risk Assessment; D016540:Smoking Cessation / Q000331:legislation & jurisprudence*; D011795:Surveys and Questionnaires; D013557:Switzerland; D014028:Tobacco Smoke Pollution / Q000009:adverse effects / Q000032:analysis*
chemical_list: D014028:Tobacco Smoke Pollution