Secondhand tobacco smoke in public venues in three Indonesian cities
Background: The aim of this study was to measure secondhand tobacco (including kretek) smoke (SHS) concentrations in public places in Jakarta, Bogor, and Palembang before laws banning smoking in public spaces went into effect.
Methods: Particulate matter (PM2.5) was measured in 15 hospitals, 15 government offices, 30 restaurants, and 26 entertainment venues throughout the three cities. Also, in Jakarta, vapor-phase nicotine was measured in 5 schools, 5 hospitals, 5 government offices, 9 restaurants, and 10 entertainment venues. Data were analyzed descriptively. Differences by city and venue characteristics were analyzed by Studentâs t-test, ANOVA, and Bonferroni pairwise statistical tests.
Results: Geometric mean PM2.5 levels were highest in entertainment venues (96 µg/m3), followed by restaurants (78 µg/m3), government offices (57 µg/m3), and hospitals (46 µg/m3). Air nicotine levels in Jakarta were highest in designated smoking areas (4.71 µg/m3) and designated non-smoking areas (1.55 µg/m3) of entertainment venues. These were followed by government offices (0.30 µg/m3), designated smoking areas (0.24 µg/m3) and designated non-smoking areas (0.19 µg/m3) of restaurants, hospitals (0.01 µg/m3), and schools (0.01 µg/m3).
Conclusion: SHS was detected in all venues in the three cities in Indonesia. High levels of air nicotine were found in non-smoking areas of restaurants and entertainment venues, indicating that designated smoking areas are not an effective solution to eliminate SHS. There is no safe level of SHS exposure and thus SHS in these venues increases the risk of adverse health effects among children and adults. These findings support the need for 100% smoke-free laws covering all public venues in these and other Indonesian cities. (Med J Indones. 2013;22:232-7. doi: 10.13181/mji.v22i4.606)
US Department of Health and Human Services. The health consequences of involuntary exposure to tobacco smoke: A report of the Surgeon General. Atlanta, GA: US DHHS Centers for Disease Control and Prevention, Office on Smoking and Health; 2006.
WHO. Protection from exposure to second-hand tobacco smoke: Policy recommendations. Geneva: World Health Organization; 2007.
WHO. WHO Framework Convention on Tobacco Control. Geneva: World Health Organization; 2005 updated reprint.
WHO [Internet]. Parties to the WHO Framework Convention on Tobacco Control. 2013 [updated 2013 June 25; cited 2013 July 29]; Available from: http://www.who.int/fctc/signatories_parties/en/index.html.
Eriksen M, Mackay J, Ross H. The tobacco atlas. 4th ed. New York: World Lung Foundation; 2012.
WHO. Global Adult Tobacco Survey: Indonesia report 2011. Geneva: World Health Organization; 2012.
WHO. Global Youth Tobacco Survey: Indonesia 2009 factsheet (ages 13-15). Geneva: World Health Organization; 2009.
Brinson B. A good match. Tobacco Reporter. November 2008.
Euromonitor. Cigarettes - Indonesia. London: Euromonitor International; 2010.
Ministry of Health, Republic of Indonesia. Factsheet No.4. Indonesians strongly support establishment of 100% smoke-free environments. Ministry of Health, Republic of Indonesia, Directorate General of Disease Control and Environmental Health, Directorate of Non-Communicable Disease Control, 2011.
Wipfli HL, Fujimoto K, Valente TW. Global tobacco control diffusion: The case of the Framework Convention on Tobacco Control. Am J Public Health. 2010;100(7):1260-6. http://dx.doi.org/10.2105/AJPH.2009.167833
Hyland A, Travers MJ, Dresler C, Higbee C, Cummings KM. A 32-country comparison of tobacco smoke derived particle levels in indoor public places. Tob Control. 2008;17(3):159-65. http://dx.doi.org/10.1136/tc.2007.020479
Lee J, Lim S, Lee K, Guo X, Kamath R, Yamato H, et al. Secondhand smoke exposures in indoor public places in seven Asian countries. Int J Hyg Environ Health. 2010;213(5):348-51. http://dx.doi.org/10.1016/j.ijheh.2010.05.007
Kim S, Sohn J, Lee K. Exposure to particulate matters (PM2.5) and airborne nicotine in computer game rooms after implementation of smoke-free legislation in South Korea. Nicotine Tob Res. 2010;12(12):1246-53. http://dx.doi.org/10.1093/ntr/ntq189
Navas-Acien A, Peruga A, Breysse P, Zavaleta A, Blanco-Marquizo A, Pitarque R, et al. Secondhand tobacco smoke in public places in Latin America, 2002-2003. JAMA. 2004;291(22):2741-5. http://dx.doi.org/10.1001/jama.291.22.2741
Hammond SK, Leaderer BP. A diffusion monitor to measure exposure to passive smoking. Environ Sci Technol. 1987;21:494-7. http://dx.doi.org/10.1021/es00159a012
Avila-Tang E, Travers MJ, Navas-Acien A. Promoting smoke-free environments in Latin America: a comparison of methods to assess secondhand smoke exposure. Salud Publica Mex. 2010;52 Suppl 2:S138-48. http://dx.doi.org/10.1590/S0036-36342010000800009
Hornung R, Reed L. Estimation of average concentration in the presence of nondetectable values. Appl Occup Environ Hyg. 1990(5):46-51. http://dx.doi.org/10.1080/1047322X.1990.10389587
Stillman F, Navas-Acien A, Ma J, Ma S, Avila-Tang E, Breysse P, et al. Second-hand tobacco smoke in public places in urban and rural China. Tob Control. 2007;16(4):229-34. http://dx.doi.org/10.1136/tc.2006.018333
WHO. WHO air quality guidelines for particulate matter, ozone, nitrogen dioxide, and sulfur dioxide: Summary of risk assessment. Geneva: World Health Organization; 2006; Available from: whqlibdoc.who.int/hq/2006/WHO_SDE_PHE_OEH_06.02_eng.pdf.
Copyright (c) 2013 M. J. Byron, Dollaris R. Suhadi, Lisa M. Hepp, Erika Avila-Tang, Jingyan Yang, Gema Asiani, Rubaeah Rubaeah, Stephen A. Tamplin, Tara S. Bam, Joanna E. Cohen
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