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Low-Cost Air Quality Monitoring Methods to Assess Compliance With Smoke-Free Regulations: A Multi-Center Study in Six Low- and Middle-Income Countries.
Nicotine Tob Res. 2016 May; 18(5):1258-64.NT

Abstract

INTRODUCTION

Many low- and middle-income countries (LMICs) have enacted legislation banning smoking in public places, yet enforcement remains challenging. The aim of this study was to assess the feasibility of using a validated low-cost methodology (the Dylos DC1700) to provide objective evidence of smoke-free (SF) law compliance in hospitality venues in urban LMIC settings, where outdoor air pollution levels are generally high.

METHODS

Teams measured indoor fine particulate matter (PM2.5) concentrations and systematically observed smoking behavior and SF signage in a convenience sample of hospitality venues (bars, restaurants, cafes, and hotels) covered by existing SF legislation in Mexico, Pakistan, Indonesia, Chad, Bangladesh, and India. Outdoor air PM2.5 was also measured on each sampling day.

RESULTS

Data were collected from 626 venues. Smoking was observed during almost one-third of visits with substantial differences between countries-from 5% in India to 72% in Chad. After excluding venues where other combustion sources were observed, secondhand smoke (SHS) derived PM2.5 was calculated by subtracting outdoor ambient PM2.5 concentrations from indoor measurements and was, on average, 34 µg/m(3) in venues with observed smoking-compared to an average value of 0 µg/m(3) in venues where smoking was not observed (P < .001). In over one-quarter of venues where smoking was observed the difference between indoor and outdoor PM2.5 concentrations exceeded 64 µg/m(3).

CONCLUSIONS

This study suggests that low-cost air quality monitoring is a viable method for improving knowledge about environmental SHS and can provide indicative data on compliance with local and national SF legislation in hospitality venues in LMICs.

IMPLICATIONS

Air quality monitoring can provide objective scientific data on SHS and air quality levels in venues to assess the effectiveness of SF laws and identify required improvements. Equipment costs and high outdoor air pollution levels have hitherto limited application in LMICs. This study tested the feasibility of using a validated low-cost methodology in hospitality venues in six LMIC urban settings and suggests this is a viable method for improving knowledge about SHS exposure and can provide indicative data on compliance with SF legislation.

Authors+Show Affiliations

Department of Tobacco Control, The International Union Against Tuberculosis and Lung Disease, Edinburgh, Scotland; ajackson-morris@theunion.org.Department of Tobacco Control, The International Union Against Tuberculosis and Lung Disease, Edinburgh, Scotland;Scottish Centre for Indoor Air, Respiratory Group, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland;Department of Tobacco Control, The International Union Against Tuberculosis and Lung Disease, Edinburgh, Scotland;Department of Tobacco Control, The International Union Against Tuberculosis and Lung Disease, Edinburgh, Scotland;Department of Tobacco Control, The International Union Against Tuberculosis and Lung Disease, Edinburgh, Scotland;Department of Tobacco Control, The International Union Against Tuberculosis and Lung Disease, Edinburgh, Scotland;Department of Tobacco Control, The International Union Against Tuberculosis and Lung Disease, Edinburgh, Scotland;Department of Tobacco Control, The International Union Against Tuberculosis and Lung Disease, Edinburgh, Scotland;Department of Tobacco Control, The International Union Against Tuberculosis and Lung Disease, Edinburgh, Scotland;Scottish Centre for Indoor Air, Respiratory Group, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland; Center for Human Exposure Science, Institute of Occupational Medicine, Edinburgh, Scotland.

Pub Type(s)

Journal Article
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26814194

Citation

Jackson-Morris, Angela, et al. "Low-Cost Air Quality Monitoring Methods to Assess Compliance With Smoke-Free Regulations: a Multi-Center Study in Six Low- and Middle-Income Countries." Nicotine & Tobacco Research : Official Journal of the Society for Research On Nicotine and Tobacco, vol. 18, no. 5, 2016, pp. 1258-64.
Jackson-Morris A, Bleymann K, Lyall E, et al. Low-Cost Air Quality Monitoring Methods to Assess Compliance With Smoke-Free Regulations: A Multi-Center Study in Six Low- and Middle-Income Countries. Nicotine Tob Res. 2016;18(5):1258-64.
Jackson-Morris, A., Bleymann, K., Lyall, E., Aslam, F., Bam, T. S., Chowdhury, I., Daouda, E. A., Espinosa, M., Romo, J., Singh, R. J., & Semple, S. (2016). Low-Cost Air Quality Monitoring Methods to Assess Compliance With Smoke-Free Regulations: A Multi-Center Study in Six Low- and Middle-Income Countries. Nicotine & Tobacco Research : Official Journal of the Society for Research On Nicotine and Tobacco, 18(5), 1258-64. https://doi.org/10.1093/ntr/ntv290
Jackson-Morris A, et al. Low-Cost Air Quality Monitoring Methods to Assess Compliance With Smoke-Free Regulations: a Multi-Center Study in Six Low- and Middle-Income Countries. Nicotine Tob Res. 2016;18(5):1258-64. PubMed PMID: 26814194.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Low-Cost Air Quality Monitoring Methods to Assess Compliance With Smoke-Free Regulations: A Multi-Center Study in Six Low- and Middle-Income Countries. AU - Jackson-Morris,Angela, AU - Bleymann,Kayleigh, AU - Lyall,Elaine, AU - Aslam,Fouad, AU - Bam,Tara Singh, AU - Chowdhury,Ishrat, AU - Daouda,Elhadj Adam, AU - Espinosa,Mariana, AU - Romo,Jonathan, AU - Singh,Rana J, AU - Semple,Sean, Y1 - 2016/01/26/ PY - 2015/02/18/received PY - 2015/12/23/accepted PY - 2016/1/28/entrez PY - 2016/1/28/pubmed PY - 2016/12/15/medline SP - 1258 EP - 64 JF - Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco JO - Nicotine Tob Res VL - 18 IS - 5 N2 - INTRODUCTION: Many low- and middle-income countries (LMICs) have enacted legislation banning smoking in public places, yet enforcement remains challenging. The aim of this study was to assess the feasibility of using a validated low-cost methodology (the Dylos DC1700) to provide objective evidence of smoke-free (SF) law compliance in hospitality venues in urban LMIC settings, where outdoor air pollution levels are generally high. METHODS: Teams measured indoor fine particulate matter (PM2.5) concentrations and systematically observed smoking behavior and SF signage in a convenience sample of hospitality venues (bars, restaurants, cafes, and hotels) covered by existing SF legislation in Mexico, Pakistan, Indonesia, Chad, Bangladesh, and India. Outdoor air PM2.5 was also measured on each sampling day. RESULTS: Data were collected from 626 venues. Smoking was observed during almost one-third of visits with substantial differences between countries-from 5% in India to 72% in Chad. After excluding venues where other combustion sources were observed, secondhand smoke (SHS) derived PM2.5 was calculated by subtracting outdoor ambient PM2.5 concentrations from indoor measurements and was, on average, 34 µg/m(3) in venues with observed smoking-compared to an average value of 0 µg/m(3) in venues where smoking was not observed (P < .001). In over one-quarter of venues where smoking was observed the difference between indoor and outdoor PM2.5 concentrations exceeded 64 µg/m(3). CONCLUSIONS: This study suggests that low-cost air quality monitoring is a viable method for improving knowledge about environmental SHS and can provide indicative data on compliance with local and national SF legislation in hospitality venues in LMICs. IMPLICATIONS: Air quality monitoring can provide objective scientific data on SHS and air quality levels in venues to assess the effectiveness of SF laws and identify required improvements. Equipment costs and high outdoor air pollution levels have hitherto limited application in LMICs. This study tested the feasibility of using a validated low-cost methodology in hospitality venues in six LMIC urban settings and suggests this is a viable method for improving knowledge about SHS exposure and can provide indicative data on compliance with SF legislation. SN - 1469-994X UR - https://www.unboundmedicine.com/medline/citation/26814194/Low_Cost_Air_Quality_Monitoring_Methods_to_Assess_Compliance_With_Smoke_Free_Regulations:_A_Multi_Center_Study_in_Six_Low__and_Middle_Income_Countries_ L2 - https://academic.oup.com/ntr/article-lookup/doi/10.1093/ntr/ntv290 DB - PRIME DP - Unbound Medicine ER -