Journal Article

Second-hand smoke in mental healthcare settings: time to implement total smoke-free bans?

Montse Ballbè, Xisca Sureda, Jose M Martínez-Sánchez, Esteve Saltó, Antoni Gual and Esteve Fernández

in International Journal of Epidemiology

Published on behalf of International Epidemiological Association

Volume 42, issue 3, pages 886-893
Published in print June 2013 | ISSN: 0300-5771
Published online March 2013 | e-ISSN: 1464-3685 | DOI:
Second-hand smoke in mental healthcare settings: time to implement total smoke-free bans?

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Background Second-hand smoke is associated with adverse health effects. Many countries have extended smoke-free policies to public buildings and workplaces such as hospitals, but mental health units have usually been exempted from complete smoke-free bans. The objective of this study was to evaluate second-hand smoke levels in mental health units with different types of smoking bans.

Method We conducted a cross-sectional study to evaluate second-hand smoke in 64 mental health inpatient units (95.5% of the all such units) in Catalonia, Spain. We measured air concentrations of particulate matter <2.5 μm (PM2.5) as a marker of second-hand smoke in different locations at each unit.

Results The geometric mean (95% confidence interval) of the PM2.5 concentration was 8.81 μg/m3 (8.06–9.56) in units with indoor and outdoor smoking bans, 13.80 μg/m3 (13.23–14.36) in units with indoor smoking bans that allowed smoking in outdoor areas, 24.29 μg/m3 (23.50–25.03) in units with indoor smoking rooms and 51.00 μg/m3 (49.83–52.04) in units that allowed smoking in common indoor areas (P < 0.05). The regression model adjusted for confounding variables showed a linear increase of PM2.5. The PM2.5 concentration in smoking rooms was 286.50 μg/m3 (283.95–288.89).

Conclusions Only units with indoor and outdoor smoking bans had PM2.5 levels below the standard recommended WHO levels of 10 μg/m3. Units with more permissive smoking policies had PM2.5 levels from second-hand smoke that have harmful health effects.

Keywords: Tobacco smoke pollution; smoking; hospitals; mental health services; policy

Journal Article.  3989 words. 

Subjects: Public Health and Epidemiology

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