Skip to main navigation menu Skip to main content Skip to site footer

Original article

Vol. 141 No. 5152 (2011)

Improved health of hospitality workers after a Swiss cantonal smoking ban

  • AD Durham
  • S Bergier
  • X Morisod
  • I Locatelli
  • JP Zellweger
  • CK Huynh
DOI
https://doi.org/10.4414/smw.2011.13317
Cite this as:
Swiss Med Wkly. 2011;141:w13317
Published
19.12.2011

Summary

QUESTIONS UNDER STUDY: Hospitality workers are a population particularly at risk from the noxious effects of environmental tobacco smoke (ETS). The Canton of Vaud, Switzerland banned smoking in public places in September 2009. This prospective study addresses the impact of the ban on the health of hospitality workers.

METHODS: ETS exposure was evaluated using a passive sampling device that measures airborne nicotine; lung function was assessed by spirometry; health-related quality of life, ETS exposure symptoms and satisfaction were measured by questionnaire.

RESULTS: 105 participants (smokers and non-smokers) were recruited initially and 66 were followed up after one year. ETS exposure was significantly lower after the ban. Hospitality workers had lower pre-ban forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) values than expected. FEV1 remained stable after the ban, with a near-significant increase in the subgroup of asthmatics only. FVC increased at one year follow-up from 90.42% to 93.05% (p = 0.02) in the entire cohort; women, non-smokers and older participants gained the greatest benefit. The health survey showed an increase in physical wellbeing after the ban, the greatest benefit being observed in non-smokers. ETS exposure symptoms were less frequent after the ban, especially red and irritated eyes and sneezing. The new law was judged useful and satisfactory by the vast majority of employees, including smokers.

CONCLUSION: The recent cantonal ban on smoking in public places brought about an improvement in lung function, physical well-being and ETS symptoms of hospitality workers, including smokers.

References

  1. Leuenberger P, Schwartz J, Ackermann-Liebrich U, Blaser K, Bolognini G, Bongard JP, et al. Passive smoking exposure in adults and chronic respiratory symptoms (SAPALDIA Study). Swiss Study on Air Pollution and Lung Diseases in Adults, SAPALDIA Team. Am J Respir Crit Care Med. 1994;150(5 Pt 1):1222–8.
  2. Zemp E, Elsasser S, Schindler C, Kunzli N, Perruchoud AP, Domenighetti G, et al. Long-term ambient air pollution and respiratory symptoms in adults (SAPALDIA study). The SAPALDIA Team. Am J Respir Crit Care Med. 1999;159(4 Pt 1):1257–66.
  3. Brennan P, Buffler PA, Reynolds P, Wu AH, Wichmann HE, Agudo A, et al. Secondhand smoke exposure in adulthood and risk of lung cancer among never smokers: a pooled analysis of two large studies. Int J Cancer. 2004;109(1):125–31.
  4. Siegel M, Skeer M. Exposure to secondhand smoke and excess lung cancer mortality risk among workers in the “5 B’s”: bars, bowling alleys, billiard halls, betting establishments, and bingo parlours. Tob Control. 2003;12(3):333–8.
  5. Zhong L, Goldberg MS, Parent ME, Hanley JA. Exposure to environmental tobacco smoke and the risk of lung cancer: a meta-analysis. Lung Cancer. 2000;27(1):3–18.
  6. He J, Vupputuri S, Allen K, Prerost MR, Hughes J, Whelton PK. Passive smoking and the risk of coronary heart disease – a meta-analysis of epidemiologic studies. N Engl J Med. 1999;340(12):920–6.
  7. McElduff P, Dobson AJ, Jackson R, Beaglehole R, Heller RF, Lay-Yee R. Coronary events and exposure to environmental tobacco smoke: a case-control study from Australia and New Zealand. Tob Control. 1998;7(1):41–6.
  8. Pitsavos C, Panagiotakos DB, Chrysohoou C, Skoumas J, Tzioumis K, Stefanadis C, et al. Association between exposure to environmental tobacco smoke and the development of acute coronary syndromes: the CARDIO2000 case-control study. Tob Control. 2002;11(3):220–5.
  9. Rosenlund M, Berglind N, Gustavsson A, Reuterwall C, Hallqvist J, Nyberg F, et al. Environmental tobacco smoke and myocardial infarction among never-smokers in the Stockholm Heart Epidemiology Program (SHEEP). Epidemiology. 2001;12(5):558–64.
  10. Bonita R, Duncan J, Truelsen T, Jackson RT, Beaglehole R. Passive smoking as well as active smoking increases the risk of acute stroke. Tob Control. 1999;8(2):156–60.
  11. Iribarren C, Darbinian J, Klatsky AL, Friedman GD. Cohort study of exposure to environmental tobacco smoke and risk of first ischemic stroke and transient ischemic attack. Neuroepidemiology. 2004;23(1-2):38–44.
  12. IARC. Tobacco Smoke and Involuntary Smoking. 2004.
  13. Allwright S, Paul G, Greiner B, Mullally BJ, Pursell L, Kelly A, et al. Legislation for smoke-free workplaces and health of bar workers in Ireland: before and after study. BMJ. 2005;331(7525):1117.
  14. Eagan TM, Hetland J, Aaro LE. Decline in respiratory symptoms in service workers five months after a public smoking ban. Tob Control. 2006;15(3):242–6.
  15. Eisner MD, Smith AK, Blanc PD. Bartenders’ respiratory health after establishment of smoke-free bars and taverns. JAMA. 1998;280(22):1909–14.
  16. Farrelly MC, Nonnemaker JM, Chou R, Hyland A, Peterson KK, Bauer UE. Changes in hospitality workers' exposure to secondhand smoke following the implementation of New York's smoke-free law. Tob Control. 2005;14(4):236–41.
  17. Fernandez E, Fu M, Pascual JA, Lopez MJ, Perez-Rios M, Schiaffino A, et al. Impact of the Spanish smoking law on exposure to second-hand smoke and respiratory health in hospitality workers: a cohort study. PLoS One. 2009;4(1):e4244.
  18. Goodman P, Agnew M, McCaffrey M, Paul G, Clancy L. Effects of the Irish smoking ban on respiratory health of bar workers and air quality in Dublin pubs. Am J Respir Crit Care Med. 2007;175(8):840–5.
  19. Larsson M, Boethius G, Axelsson S, Montgomery SM. Exposure to environmental tobacco smoke and health effects among hospitality workers in Sweden – before and after the implementation of a smoke-free law. Scand J Work Environ Health. 2008;34(4):267–77.
  20. Menzies D, Nair A, Williamson PA, Schembri S, Al-Khairalla MZ, Barnes M, et al. Respiratory symptoms, pulmonary function, and markers of inflammation among bar workers before and after a legislative ban on smoking in public places. JAMA. 2006;296(14):1742–8.
  21. Schoj V, Alderete M, Ruiz E, Hasdeu S, Linetzky B, Ferrante D. The impact of a 100% smoke-free law on the health of hospitality workers from the city of Neuquen, Argentina. Tob Control. 2010;19(2):134–7.
  22. Barone-Adesi F, Vizzini L, Merletti F, Richiardi L. Short-term effects of Italian smoking regulation on rates of hospital admission for acute myocardial infarction. Eur Heart J. 2006;27(20):2468–72.
  23. Pell JP, Haw S, Cobbe S, Newby DE, Pell AC, Fischbacher C, et al. Smoke-free legislation and hospitalizations for acute coronary syndrome. N Engl J Med. 2008;359(5):482–91.
  24. Sargent RP, Shepard RM, Glantz SA. Reduced incidence of admissions for myocardial infarction associated with public smoking ban: before and after study. BMJ. 2004;328(7446):977–80.
  25. Trachsel LD, Kuhn MU, Reinhart WH, Schulzki T, Bonetti PO. Reduced incidence of acute myocardial infarction in the first year after implementation of a public smoking ban in Graubuenden, Switzerland. Swiss Med Wkly. 2010 Jan 12.
  26. Bonetti PO, Trachsel LD, Kuhn MU, Schulzki T, Erne P, Radovanovic D, et al. Incidence of acute myocardial infarction after implementation of a public smoking ban in Graubunden, Switzerland: Two year follow-up. Swiss Med Wkly. 2011;141:w13206.
  27. Hauri DD, Lieb CM, Rajkumar S, Kooijman C, Sommer HL, Roosli M. Direct health costs of environmental tobacco smoke exposure and indirect health benefits due to smoking ban introduction. Eur J Public Health. 2011;21(3):316–22.
  28. Huynh CK, Moix JB, Dubuis A. Development and application of the passive smoking monitor MoNIC. Rev Med Suisse. 2008;4(144):430–3.
  29. Hammond SK, Leaderer BP, Roche AC, Schenker M. Collection and analysis of Nicotine as a marker for environmental tobacco smoke. Atmospheric Environment (1967). 1987;21(2):457-62.
  30. Ogden MW, Maiolo KC. Comparative Evaluation of Diffusive and Active Sampling Systems for Determining Airborne Nicotine and 3-Ethenylpyridine. Environmental Science & Technology. 1992;26(6):1226–34.
  31. Barr RG, Stemple KJ, Mesia-Vela S, Basner RC, Derk SJ, Henneberger PK, et al. Reproducibility and validity of a handheld spirometer. Respir Care. 2008;53(4):433–41.
  32. Walters JA, Wood-Baker R, Walls J, Johns DP. Stability of the EasyOne ultrasonic spirometer for use in general practice. Respirology. 2006;11(3):306–10.
  33. Brandli O, Schindler C, Kunzli N, Keller R, Perruchoud AP. Lung function in healthy never smoking adults: reference values and lower limits of normal of a Swiss population. Thorax. 1996;51(3):277–83.
  34. Morris JF, Temple W. Spirometric “lung age” estimation for motivating smoking cessation. Preventive medicine. 1985;14(5):655–62.
  35. Ware JE, Jr. SF-36 health survey update. Spine (Phila Pa 1976). 2000;25(24):3130–9.
  36. Mallinckrodt CH, Clark WS, David SR. Accounting for dropout bias using mixed-effects models. J Biopharm Stat. 2001;11(1-2):9–21.
  37. Weiss RE. Modeling longitudinal data. New York; London: Springer; 2005.
  38. Firmann M, Mayor V, Vidal PM, Bochud M, Pecoud A, Hayoz D, et al. The CoLaus study: a population-based study to investigate the epidemiology and genetic determinants of cardiovascular risk factors and metabolic syndrome. BMC Cardiovasc Disord. 2008;8:6.
  39. Marques-Vidal P, Cerveira J, Paccaud F, Cornuz J. Smoking trends in Switzerland, 1992–2007: a time for optimism? J Epidemiol Community Health. 2011;65(3):281–6.
  40. Downs SH, Schindler C, Liu LJ, Keidel D, Bayer-Oglesby L, Brutsche MH, et al. Reduced exposure to PM10 and attenuated age-related decline in lung function. N Engl J Med. 2007;357(23):2338–47.
  41. Downs SH, Brandli O, Zellweger JP, Schindler C, Kunzli N, Gerbase MW, et al. Accelerated decline in lung function in smoking women with airway obstruction: SAPALDIA 2 cohort study. Respir Res. 2005;6:45.