| BackgroundTobacco use is one of the most serious and preventable public health issues in the world and in the China as well currently.There are approximately 1.1 billion smokers in the world among whom 5 million smokers died yearly attributable to tobacco use. However,those dead cases should be totally avoided.Now tobacco control actions have been spreaded globally.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.Then,FCTC went into effect in China on Jan 9th 2006.Chinese Government really respects campaigns of tobacco control and makes effort in pushing those campaigns.Tobacco use in China is still serious.Now more emphasis has been focused on the risk of secondhand smoke.Most of the scientific researches confirmed that there are no safe exposure levels for secondhand smoking,even if using filter or ventilation individually or combining both of them.Smoke-free environment is the only effective way to protect non-smokers'health.More and more researches from different fields of China have reached a common sense that implementing smoke free policy in public places is a necessary trend in China.As a mega-city,Shanghai has issued and enforced'Interim smoking restrictions in public places in Shanghai'since 1994.A few researches,however,have been conducted about exposure to Secondhand smoke in public places in Shanghai.Furthermore,air monitoring indoor smoke exposure level in public places is still in the research stage to explore in China.ObjectiveThe objective of this study is to evaluate the exposure to secondhand smoke in public places in Changning District.It is hoped that this study could provide strong evidence to advocate for a smoke-free legislation in Shanghai.In addition,the present study could make contribution to exploring effective inspection methods on exposure to secondhand smoke in Changning District.Method1.Exposure information of 24 smoke-free public places was collected through applying convenient sampling from star hotel,stock exchange and restaurant in east and west of Changning District.Monitoring exposure level of smoking particles and size of space of those public places were monitored with AM510 air monitoring. Meanwhile,Air flowing,size of hall,number of lients and staff were observed and recorded.In this means,the status of exposure to secondhand smoke could be evaluated in public places without legal smoking restrictions.2.Related information of 600 workers in hotels and restaurants was collected through self-completed questionnaires from twenty-one from hotels and restaurants in Changning District.The questions included the status of secondhand smoke,effect of exposure to secondhand smoke on health and attitude for smoke-free policy.3.Related information of 811 clients was collected through self-completed questionnaires from thirteen four-star and five-star hotels in Changning District with purposive sampling from mid Apr to late Apr in 2008.The contents of questionnaire included demography,smoking behavior,exposure to secondhand smoke indifferent public places in Shanghai,attitudes about establishing smoking-free legisltation.Results1.The average PM2.5concentration indoor in the 24 public places without smoking ban was 334.62μg/m3 and was 116.71%higher than the PM2.5concentration outdoors. Fine particle concentrations hotels,stock exchange and restaurants were 125.14μg/m3, 353.84μg/m3 and 518.38μg/m3.The PM2.5concentration in hotels and restaurants was significantly correlated with the density of the litten cigarettes.2.75.2%of the workers surveyed were found to be exposed to SHS while working, 69.8%of the hotels workers surveyed were found to be exposed to SHS,93.2%of the restaurants workers surveyed were found to be exposed to SHS.The average hours of exposure to secondhand smoke per day were 2.91±2.42, 2.43±2.22,3.94±2.53 hours correspondently.Respiratory and irritative symptoms were significantly related to smoking and SHS were found in most workers(76.8%). 3.62.1%of respondents considered the environmental smoke exposure in the public places in Shanghai as serious.Bars,railway stations and restaurants were the most frequently mentioned public places by the respondents where they were substantially exposed to secondhand smoke.There were 72.9%of respondents supporting smoking ban in the public places.Less than half of clients did not know the current tobacco control regulations in Shanghai.The result of logistic regress analysis indicated that the non-smokers and clients who came from nations(areas)with smoke-free policies in the public places showed more supportive attitude to smoking bans.The correspondent OR value were 4.42(95%CI:2.58-7.58)and 3.92(95%CI:2.03-7.56) respectively.The middle aged respondents(30-49 year)showed more supportive attitude to smoking ban in the public places in Shanghai.The correspondent OR were 1.81(95%CI:1.01-3.26).There were 75.8%of respondents agreeing that"smoke free public place can promote the image of the city".54.8%of respondents expressed that they were more likely to come to Shanghai if there was a total smoking ban in the public places.28%of respondents reported that such a measure would not have any impact on their willingness to visit Shanghai.Conclusions1.Exposure to environmental smoking in the public places was serious in Shanghai, especially in restaurants,hotels,and public transportation stations.It also caused harm for workers health.The current tobacco control polices in Shanghai could not protect public from secondhand smoke.There is urgent need to establish smoke-free policies in Shanghai.2.Public in Shanghai highly supported the smoking ban in the public places.A smoke-free policy is a feasible and practical measure for control secondhand smoking in Shanghai. |
