Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.
Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany.
Prev Med. 2022 Jan;154:106868. doi: 10.1016/j.ypmed.2021.106868. Epub 2021 Nov 3.
Exposure to second-hand smoke (SHS) is an important public health problem. We assessed SHS exposure in restaurants and bars across the European Union (EU) and studied associations with country-level smoke-free legislation. Data of Eurobarometer surveys 2014 and 2017 were used to estimate country-specific prevalence of observing smoking in restaurants and bars, which can be considered a marker of SHS exposure. Additionally, we used multilevel logistic regression models to study associations with comprehensiveness of national smoke-free regulations in restaurants and bars, which were derived from the Tobacco Control Scale. In total, 44,809 people from all 28 EU member states were included in the analysis. The results of the multilevel logistic analysis show that in countries with complete and extensive bans, respondents were less likely to have observed people smoking inside restaurants than in countries with partial bans, which represented the lowest level of smoke-free policy implementation (OR 0.24, 95%CI 0.10-0.57 for complete ban and OR 0.23, 95%CI 0.10-0.54 for incomplete but extensive ban). Also, the prevalence of seeing people smoking in a bar was lower in the countries with an extensive ban (OR 0.23 95%CI 0.11-0.45) and with a complete ban (OR 0.20 95%CI 0.10-0.40). Between 2014 and 2017, SHS exposure in restaurants and bars decreased significantly. Our results confirm that in countries with extensive or complete smoking bans, people were less exposed to SHS in restaurants and bars; and that partial bans are less effective in reducing SHS exposure.
二手烟（SHS）暴露是一个重要的公共卫生问题。我们评估了欧盟（EU）各地餐馆和酒吧的 SHS 暴露情况，并研究了与国家级无烟立法的关联。使用 2014 年和 2017 年的欧洲晴雨表调查数据来估计观察到餐馆和酒吧吸烟的国家特定患病率，这可以被视为 SHS 暴露的标志物。此外，我们使用多水平逻辑回归模型来研究与餐馆和酒吧国家无烟法规全面性的关联，这些关联源自烟草控制量表。总共分析了来自欧盟 28 个成员国的 44809 人。多水平逻辑分析的结果表明，在全面和广泛禁止吸烟的国家，受访者在餐馆内观察到有人吸烟的可能性低于部分禁止吸烟的国家，这代表了最低水平的无烟政策实施（完全禁止的 OR 为 0.24，95％CI 为 0.10-0.57，不完全但广泛禁止的 OR 为 0.23，95％CI 为 0.10-0.54）。此外，在广泛禁止和完全禁止的国家，酒吧内吸烟的人比例也较低（广泛禁止的 OR 为 0.23，95％CI 为 0.11-0.45，完全禁止的 OR 为 0.20，95％CI 为 0.10-0.40）。2014 年至 2017 年间，餐馆和酒吧的 SHS 暴露明显下降。我们的结果证实，在广泛或完全禁止吸烟的国家，人们在餐馆和酒吧中受到的 SHS 暴露较少；而部分禁令在减少 SHS 暴露方面效果较差。
