Does the implementation of smoke-free laws and smoking culture affect exposure to tobacco smoking? Results from 3 hospitality settings in South Korea
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Pai Chai University, Daejeon, Republic of Korea (Department of Gerontology Health and Welfare)
Yonsei University Wonju College of Medicine, Wonju, Republic of Korea (Department of Family Medicine)
National Cancer Center, Goyang, Republic of Korea (Department of Laboratory Medicine)
Online publication date: 2020-12-11
Corresponding author
Do Hoon Lee   

National Cancer Center, Department of Laboratory Medicine, 323 Ilsan-ro, Ilsandong-gu, Goyang-si Gyeonggi-do, 10408, Goyang, Republic of Korea
Int J Occup Med Environ Health. 2021;34(1):53-67
Objectives: It is especially difficult for hospitality workers to avoid secondhand smoke (SHS), meaning that they are likely particularly vulnerable to the effects of SHS. The authors aimed to determine the degree to which smoke-free laws protect hospitality workers from SHS exposure, by examining biochemical markers of such exposure. Material and Methods: This was a cross-sectional study examining SHS exposure in non-smoking employees working in hospitality settings where smoking is prohibited or permitted. The following biomarkers were selected: cotinine and tobaccospecific nitrosamines, which are known to measure SHS exposure, and 2 representative carcinogens: 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK). The authors compared these biomarkers between 3 hospitality settings. A descriptive analysis was performed. In addition, they conducted 1-way and 2-way analysis of covariance (ANCOVA) to compare the biochemical markers. Results: Smoking substances were identified by smoking ban levels. In the case of hair nicotine and urine cotinine, their concentrations were lower in areas with a complete smoking ban than in both areas with a separate smoking room and no smoking ban; however, there was no statistically significant difference between these. In the case of dust NNK, its level was the lowest in areas with a complete smoking ban. To confirm the smoking ban effect by hospitality settings, the authors checked the results of the 2-way ANCOVA. In karaoke and billiard halls, the dust NNK concentrations were significantly higher in areas with no smoking ban than in areas with a separate smoking room. Conclusions: Exposure to SHS is more prevalent in places that are more lenient when it comes to smoking (e.g., Internet cafés) than in places that are not (e.g., restaurants and cafés), even when smoking is similarly prohibited in both types of places. Int J Occup Med Environ Health. 2021;34(1):53–67
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