Passive Smoking In Public Places Of Shanghai

BackgroundTobacco use has been one of leading causes of death and dieases, as well as one of the most serious and preventable public health issues. WHO Framework Convention on Tobacco Control (FCTC) was implemented on Feb 27th 2005 in the world as the first worldwide legal convention regarding public health, which greatly promotes tobacco control actions spreaded globally. After China sighed FCTC on Nov 10th 2003, FCTC went into effect in China on Jan 9th 2006. FCTC brings in many opportunities and challenges for Chinese campaigns of tobacco control.As a mega-city, Shanghai has issued and enforced 'Interim smoking restrictions in public places in Shanghai'since 1994. Few researches, however, have been conducted about passive smoking in public places in Shanghai. Furthermore, the goverment of Shanghai has been tried hard to create a smoke-free environment for expo 2010 in Shanghai.ObjectiveThe objective of the present study was to overally evaluate the passive smoking in public places in Shanghai by investigation and monitoring. In addition, potential of creating a smoke-free environment in public places in Shanghai would be explored.Method1. A cross-sectional survey was employed through multistage stratified cluster sample among 4388 employees from 7 kinds of workplaces in public places in Shanghai. The questions included the status of passive smoking, effect of passive smoking on health and attitude for smoke-free policy.2. Five thickly populated districts were selected among the 19 districts in Shanghai. In each district, a certain number of public places where citizens heavily traveled were selected through applying purposive sampling from restaurants, star hotels, places of entertainment, shopping malls and hospitals. Altogether,110 public places were involved in the study. Exposure level of smoking particles of those public places was monitored with AM510 Personal Aerosol Monitor. Meanwhile, no smoking signs, air flowing, size of hall, number of clients and staff were observed and recorded. Through these means, the status of passive smoking could be evaluated in public places. 3. Five thickly populated districts were selected among the 19 districts in Shanghai. In each district, a certain number of managers of public places where citizens heavily traveled were selected as interviewees through applying purposive sampling from restaurants, star hotels, places of entertainment and shopping malls.30 managers' anttitude and willingness to smoke-free policy in public place came to find out through in-depth interview.Results1.55.1% of the employees surveyed were found to be exposed to passive smoking while working. Employees who worked in public places without any legal regulation on smoking exposed to passive smoking seriously, for example, the proportion of exposing to passive smoking of entertainment and resturant employees were 81.9% and 77.7% respectively.The average hours of exposure to passive smoking while working per day were 1.51±2.39,2.02±2.30,2.98±3.09 hours correspondently. The supporting rate of total smoking ban among the employees who are non-smokers and the employees who are smokers were 81.8% and 45.3% respectively. Exposure to passive smoking was a risk factor for 6 kinds of symptoms of disease (P<0.05).2. The average PM2.5 concentration indoors in the 110 public places was 61.05μg/m3 and was 68.6% higher than the PM2.5 concentration outdoors. The average PM2.5 concentration indoors in places of entertainment and resturants were 83.16μg/m3 and 94.68μg/m3 respectively, both higher than the PM2.5 concentration indoors of other 3 kinds of public places (P<0.05).Public places with 3 different kinds of smoking ban had different PM2.5 concentration indoors (P<0.05). The average PM2.5 concentration indoors in the public places with total smoking ban, a partial smoking ban and none smoking ban respectively were 27.86μg/m,52.73μg/m and 103.07μg/m respectively. The PM2.5 concentration indoors in public places was significantly correlated with the density of the litten cigarettes as well as the PM2.5 concentration outdoors.3. Among 30 managers in public places who were interviewed,73.3% supported the smoke-free policy in public places, with 8 out of 11 smokers supported the smoke-free policy in public places.63.3% managers expressed that the implementation of smoke-free policy wouldn't impact the operating revenue of public places. All managers considered that implementing the smoke-free policy in public places was feasible in the long run. Conclusions1. Exposure to passive smoking in the public places was serious in Shanghai, especially in restraurants, and places of entertainmen. It also caused harm for employees' health.2. Employees and managers in public places in Shanghai highly supported the total smoking ban in the public places. A smoke-free policy is a feasible and practical measure for control secondhand smoking in Shanghai.