TY - JOUR
T1 - Ashtrays and Signage as Determinants of a Smoke-Free Legislation's Success
AU - Vardavas, Constantine I.
AU - Agaku, Israel
AU - Patelarou, Evridiki
AU - Anagnostopoulos, Nektarios
AU - Nakou, Chrysanthi
AU - Dramba, Vassiliki
AU - Giourgouli, Gianna
AU - Argyropoulou, Paraskevi
AU - Antoniadis, Antonis
AU - Gourgoulianis, Konstantinos
AU - Ourda, Despoina
AU - Lazuras, Lambros
AU - Bertic, Monique
AU - Lionis, Christos
AU - Connolly, Gregory
AU - Behrakis, Panagiotis
PY - 2013/9/4
Y1 - 2013/9/4
N2 - Introduction:Successful smoke-free legislation is dependent on political will, enforcement and societal support. We report the success and pitfalls of a non-enforced nationwide smoke-free legislation in Greece, as well as ways in which compliance and enforcement-related factors, including ashtrays and signage, may impact indoor secondhand smoke (SHS) concentrations.Methods:A follow-up study of venues (n = 150, at baseline, n = 75 at 2-year follow-up) in Greece assessed indoor particulate matter with a diameter less than 2.5 micrometers (PM2.5) concentrations attributable to SHS smoke every six months for two years (n = 455 venue/measurements).Results:Following the implementation of the 2010 smoke-free legislation, mean PM2.5 concentrations attributable to SHS fell from 175.3 μg/m3 pre-ban to 84.52 μg/m3 immediately post-ban, increasing over subsequent waves (103.8 μg/m3 and 158.2 μg/m3 respectively). Controlling for potential influential factors such as ventilation, time of day, day of week, city and venue type, all post-ban measurements were still lower than during the pre-ban period (Wave 2 beta: -118.7, Wave 3 beta: -87.6, and Wave 4 beta: -69.9). Outdoor or indoor signage banning smoking was not found to affect SHS concentrations (beta: -10.9, p = 0.667 and beta: -18.1, p = 0.464 respectively). However, ashtray or ashtray equivalents were strong determinants of the existence of indoor SHS (beta: +67 μg/m3, p = 0.017).Conclusions:While the public may be supportive of smoke-free legislation, adherence may decline rapidly if enforcement is limited or nonexistent. Moreover, enforcement agencies should also focus on the comprehensive removal of ashtray equivalents that could act as cues for smoking within a venue.
AB - Introduction:Successful smoke-free legislation is dependent on political will, enforcement and societal support. We report the success and pitfalls of a non-enforced nationwide smoke-free legislation in Greece, as well as ways in which compliance and enforcement-related factors, including ashtrays and signage, may impact indoor secondhand smoke (SHS) concentrations.Methods:A follow-up study of venues (n = 150, at baseline, n = 75 at 2-year follow-up) in Greece assessed indoor particulate matter with a diameter less than 2.5 micrometers (PM2.5) concentrations attributable to SHS smoke every six months for two years (n = 455 venue/measurements).Results:Following the implementation of the 2010 smoke-free legislation, mean PM2.5 concentrations attributable to SHS fell from 175.3 μg/m3 pre-ban to 84.52 μg/m3 immediately post-ban, increasing over subsequent waves (103.8 μg/m3 and 158.2 μg/m3 respectively). Controlling for potential influential factors such as ventilation, time of day, day of week, city and venue type, all post-ban measurements were still lower than during the pre-ban period (Wave 2 beta: -118.7, Wave 3 beta: -87.6, and Wave 4 beta: -69.9). Outdoor or indoor signage banning smoking was not found to affect SHS concentrations (beta: -10.9, p = 0.667 and beta: -18.1, p = 0.464 respectively). However, ashtray or ashtray equivalents were strong determinants of the existence of indoor SHS (beta: +67 μg/m3, p = 0.017).Conclusions:While the public may be supportive of smoke-free legislation, adherence may decline rapidly if enforcement is limited or nonexistent. Moreover, enforcement agencies should also focus on the comprehensive removal of ashtray equivalents that could act as cues for smoking within a venue.
UR - http://www.scopus.com/inward/record.url?scp=84883353781&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0072945
DO - 10.1371/journal.pone.0072945
M3 - Article
C2 - 24023795
AN - SCOPUS:84883353781
SN - 1932-6203
VL - 8
JO - PLoS ONE
JF - PLoS ONE
IS - 9
M1 - e72945
ER -