Relationship of secondhand smoke exposure with sociodemographic factors and smoke-free legislation in the European Union.
BACKGROUND
To explore whether exposure to secondhand smoke (SHS) among non-smokers in the European Union (EU) showed any association with sociodemographic factors and/or the extent of national tobacco control policies.


METHODS
A secondary analysis was performed on data from 26 751 individuals ≥15 years old from 27 EU member states (EU MS), collected during the 2012 Special Eurobarometer survey (wave 77.1). Respondents were asked whether they had been exposed to SHS in eating or drinking establishments during the past 6 months, and/or in their workplace. Data on smoke-free policies were extracted from the European Tobacco Control Status Report and the European Tobacco Control Scale (TCS) in 2013.


RESULTS
In total, 29.0% of non-smoking participants reported being exposed to SHS in indoor areas. Males (vs. females) as well as individuals with difficulties to pay bills (vs. those with no difficulties), had significantly greater odds of being exposed to SHS in bars, restaurants and workplaces. For every unit increase of a country's score on the Smoke-free Component of the TCS (indicating greater adherence to smoke-free legislations) the odds ratio of reporting exposure to SHS was 0.82 in bars, 0.85 in restaurants and 0.94 in workplaces.


CONCLUSIONS
Differences in exposure to SHS clearly exist between and within EU MS, despite the fact that they all have signed the Framework Convention on Tobacco Control, with the burden found to disproportionally affect younger people and individuals with financial difficulties. Moreover, enforcement of smoke-free legislation was inversely associated with SHS exposure, highlighting the importance of enforcing comprehensive smoking bans.
1 Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK f.filippidis@imperial.ac.uk.
Filippos T
FT
Filippidis
2 Center for Global Tobacco Control, Harvard School of Public Health, Boston, MA, USA.
Israel T
IT
Agaku
3 Clinic of Social and Family Medicine, University of Crete, Heraklion, Greece.
Charis
C
Girvalaki
4 Tobacco Control Committee, European Respiratory Society, Brussels, Belgium 5 Unidad Especializada en Tabaquismo, Madrid, Spain.
Carlos
C
Jiménez-Ruiz
6 Department of European Affairs, European Respiratory Society, Brussels, Belgium.
Brian
B
Ward
7 Smoking Cessation Clinic, Pulmonary and Critical Care Department, Medical School, University of Athens, Athens, Greece.
Christina
C
Gratziou
2 Center for Global Tobacco Control, Harvard School of Public Health, Boston, MA, USA 3 Clinic of Social and Family Medicine, University of Crete, Heraklion, Greece.
Constantine I
CI
Vardavas
D000293:Adolescent; D000328:Adult; D004781:Environmental Exposure / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D005062:European Union; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012147:Restaurants / Q000331:legislation & jurisprudence; D012737:Sex Factors; D061845:Smoke-Free Policy / Q000331:legislation & jurisprudence*; D012907:Smoking / Q000331:legislation & jurisprudence*; D012959:Socioeconomic Factors; D014028:Tobacco Smoke Pollution / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data*; D017132:Workplace / Q000331:legislation & jurisprudence; D055815:Young Adult
D014028:Tobacco Smoke Pollution