Key Points:

• Nonsmoking sections in social clubs provide at best only partial protection from environmental tobacco smoke. • Bar and restaurant revenues do not always decline following a ban on smoking.

RANDWICK, AUSTRALIA—Anyone who has sought solace from secondhand smoke in restaurants, bars, or other places has probably noticed that tobacco fumes often encroach on the nonsmoking section to such a degree that having such a section seems pointless. A recent study by Cains et al[1] suggests that this observation may be accurate.

In the study, ambient levels of nicotine, carbon dioxide, and particulate matter with a diameter of less than 10 microns (PM10) were measured in 17 social clubs and nightclubs during a time of maximal occupancy. Comparison of measurements taken in the smoking and nonsmoking sections indicated that the latter provides only partial protection from environmental tobacco smoke (ETS). Indeed, the authors of the study described the protection offered by nonsmoking areas as “trivial.”

“Given the prevailing opinion that the only acceptable level of exposure to a known carcinogen is the absolute minimum that can be achieved, then a 50% reduction in ETS exposure is simply unacceptable,” stated Bernard W. Stewart, PhD, one of the investigators. “One can imagine that people would regard such a reduction in exposure to asbestos or similar hazardous material as simply inadequate,” remarked Dr. Stewart, who heads the Cancer Control Program of the Southeastern Sydney Area Health Service in Australia.

In two cases, PM10 levels were actually higher in the nonsmoking section than in areas where smoking was permitted, he pointed out. Furthermore, being in a separate nonsmoking room was only marginally better at limiting ETS exposure than being in a conventional nonsmoking section that was contiguous to a smoking area.

Bar and restaurant owners may be anxious about such findings because they fear that their incomes will shrink if smoking is banned completely in their establishments. However, a recent analysis confirms that bar and restaurant revenues do not necessarily decline after a smoking ban takes effect.

SMOKING VERSUS NONSMOKING

To ensure fairness, the researchers measured carbon dioxide and PM10 levels in the air outside of the clubs, as well as in the smoking and nonsmoking sections. Their results showed that indoor air quality was markedly worse than outdoor air quality, regardless of where patrons sat. Almost all of the indoor carbon dioxide and PM10 measurements were higher than the corresponding outdoor concentrations.

Mean carbon dioxide measurements were similar in the smoking and nonsmoking areas—849 and 872 parts per million, respectively. In contrast, the mean outdoor carbon dioxide level was 600 parts per million.

Mean PM10 levels, which were 61 µg/m3 outdoors, were 460 µg/m3 in the smoking areas and 210 µg/m3 in the nonsmoking areas. However, in two clubs, the PM10 measurements were substantially higher in the nonsmoking sections than in the smoking sections.

In all of the clubs, mean nicotine concentrations were lower in the nonsmoking areas than in the smoking areas (41 vs 101 µg/m3). However, tremendous variations in nicotine levels were found in both sections of the clubs.

Twelve clubs provided separate nonsmoking rooms. In these rooms, the mean nicotine and PM10 levels (35.8 and 129 µg/m3, respectively) were lower than those measured in the rooms where smoking was permitted (83.2 and 421 µg/m3, respectively). The extent of the protection against nicotine offered by separate nonsmoking rooms (a 55% reduction in exposure) was no better than that provided by a conventional nonsmoking section (a 53% decrease). Separate nonsmoking rooms did offer better protection against PM10 levels (a 66% versus a 17% decline in exposure); however, the PM10 levels in the nonsmoking rooms were still more than twice that in the outdoor air.

THE ONLY VIABLE OPTION

Based on their findings, the investigators asserted that nonsmoking areas are not effective in protecting nonsmokers from ETS in establishments that permit smoking. The available evidence indicates that banning smoking on the premises is the only viable option, they concluded.

“This conclusion was not a priori in our minds when we began the study,” Dr. Stewart stressed. “Had we found that nonsmoking areas worked, we would have recommended them and advised that they be adequately signposted.”

Smoking Bans Don’t Hurt Bar Revenues

Atlanta—As of January 2004, laws prohibiting smoking in almost all workplaces, restaurants, and bars were on the books in five states—California, Connecticut, Delaware, Maine, and New York—and in 72 municipalities. To help assess the economic impact of such bans, the Texas Department of Health and the CDC analyzed bar and restaurant revenues in El Paso, Texas, before and after a ban against smoking in all public places and workplaces went into effect.[1] The smoking ban, which began on January 2, 2002, was the strongest smoke-free indoor air ordinance in Texas; it included fines of up to $500 for violations. The proprietors of many bars and restaurants had fought the ban, claiming that it would reduce revenues, particularly those from the sale of alcoholic beverages. To determine whether these claims were valid, the investigators analyzed sales and mixed-beverage tax reports from El Paso bars and restaurants during the 12 years preceding and one year after the smoking ban. These reports allowed the investigators to estimate the revenue generated by the sale of meals and drinks. A comparison of preban and postban data indicated that “no statistically significant changes in restaurant and bar revenues occurred after the smoking ban took effect,” reported the investigators; the results were no different when the analysis was adjusted for inflation and price changes. The investigators also noted that these results are consistent with those from studies of smoking bans in other US cities. Although the investigators were able to examine only the revenue data from the first year after the El Paso smoking ban took effect, they do not believe that a longer-term follow-up study will refute their findings. Indeed, no such reduction has been observed in cities that had the tax data needed to analyze restaurant and bar revenues for several years after a smoking ban was implemented. —Timothy Begany

Reference 1. Centers for Disease Control and Prevention. Impact of a smoking ban on restaurant and bar revenues—El Paso, Texas, 2002. MMWR Morb Mortal Wkly Rep. 2004;53:150-152.

—Timothy Begany

Reference
1. Cains T, Cannata S, Poulos R, et al. Designated “no smoking” areas provide from partial to no protection from environmental tobacco smoke. Tobacco Control. 2004;13:17-22.

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