Changes in Secondhand Smoke Exposure After Smoke-Free Legislation (Spain, 2006-2011).
BACKGROUND
In 2011, the Spanish partial smoke-free legislation was extended to affect all enclosed settings, including hospitality venues and selected outdoor areas. This study evaluated the change in self-reported exposure to secondhand smoke among the adult, nonsmoking population.


METHODS
Two cross-sectional surveys were conducted on nationally representative samples of the adult (≥18 years) nonsmoking Spanish population. One was conducted in 2006 (6 months after the first ban) and the other in 2011, 6 months after the new ban was implemented. We assessed the prevalence and 95% confidence interval (CI) of self-reported exposure to secondhand smoke in various settings, and the corresponding adjusted prevalence ratios (PR) and 95% CIs.


RESULTS
Overall, the self-reported exposure to secondhand smoke fell from 71.9% (95% CI: 70.1%-73.7%) in 2006 to 45.2% (95% CI: 43.1%-47.3%) in 2011 (PR = 0.43; 95% CI: 0.39-0.47). Specifically, self-reported exposure significantly decreased from 29.2% to 12.7% (PR = 0.36; 95% CI: 0.31-0.42) in the home, from 35.0% to 13.0% (PR = 0.40; 95% CI: 0.33-0.49) at work/education venues, from 56.2% to 32.2% (PR = 0.44; 95% CI: 0.39-0.48) during leisure time (mainly hospitality venues, but also venues other than work/education venues and home), and from 40.6% to 12.7% (PR = 0.24; 95% CI: 0.21-0.29) in transportation vehicles/stations.


CONCLUSIONS
The prevalence of secondhand smoke exposure among nonsmokers decreased after implementation of a comprehensive smoke-free legislation in Spain. In addition to the expected reduction in exposure during leisure time, we observed reductions in settings that were not subject to the new legislation, such as homes, outdoor bus stops, and train stations.


CONCLUSIONS
Exposure to secondhand smoke in selected outdoor settings may be further reduced by extending smoke-free legislation.
Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d'Oncologia, WHO Collaborating Center for Tobacco Control, L'Hospitalet de Llobregat, Barcelona, Spain.|Cancer Prevention and Control Group, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.|Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain.
Esteve
E
Fernández
Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d'Oncologia, WHO Collaborating Center for Tobacco Control, L'Hospitalet de Llobregat, Barcelona, Spain.|Cancer Prevention and Control Group, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.|Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain.
Marcela
M
Fu
Epidemiology Unit, Galician Directorate for Public Health, Galician Health Authority, Xunta de Galicia, Santiago de Compostela, Spain.|Department of Preventive Medicine and Public Health, School of Medicine, Universidade de Santiago de Compostela, Santiago de Compostela, Spain.|Biomedical Research Centre Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain.
Mónica
M
Pérez-Ríos
Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d'Oncologia, WHO Collaborating Center for Tobacco Control, L'Hospitalet de Llobregat, Barcelona, Spain.|Cancer Prevention and Control Group, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
Anna
A
Schiaffino
Cancer Prevention and Control Group, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.|Social and Cardiovascular Epidemiology Research Group, School of Medicine, Universidad de Alcalá, Alcalá de Henares, Spain.
Xisca
X
Sureda
Biomedical Research Centre Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain.|Agència de Salut Pública de Barcelona, Barcelona, Spain.|Institute of Biomedical Research (IIB Sant Pau), Barcelona, Spain.
María J
MJ
López
D000293:Adolescent; D000328:Adult; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D057566:Self Report; D061845:Smoke-Free Policy; D012907:Smoking / Q000331:legislation & jurisprudence*; D013030:Spain / Q000453:epidemiology; D014028:Tobacco Smoke Pollution / Q000517:prevention & control / Q000706:statistics & numerical data*; D055815:Young Adult
D014028:Tobacco Smoke Pollution