Tobacco smoke exposure in public places and workplaces after smoke-free policy implementation: a longitudinal analysis of smoker cohorts in Mexico and Uruguay

Abstract

Objective: To determine the prevalence, correlates and changes in secondhand smoke (SHS) exposure over the period after comprehensive smoke-free policy implementation in two Latin American countries.Methods: Data were analysed from population-based representative samples of adult smokers and recent quitters from the 2008 and 2010 waves of the International Tobacco Control Policy Evaluation Survey in Mexico (n = 1766 and 1840, respectively) and Uruguay (n = 1379 and 1411, respectively). Prevalence of SHS exposure was estimated for regulated venues, and generalized estimating equations were used to determine correlates of SHS exposure.Results: Workplace SHS exposure in the last month was similar within and across countries (range: Mexico 20–25%; Uruguay 14–29%). At the most recent restaurant visit, SHS exposure was lower where comprehensive smoke-free policies were implemented (range: Uruguay 6–9%; Mexico City 5–7%) compared with Mexican cities with weaker policies, where exposure remained higher but decreased over time (32–17%). At the most recent bar visit, SHS exposure was common (range: Uruguay 8–36%; Mexico City 23–31%), although highest in jurisdictions with weaker policies (range in other Mexican cities: 74–86%). In Uruguay, males were more likely than females to be exposed to SHS across venues, as were younger compared with older smokers in Mexico.Conclusions: Comprehensive smoke-free policies are more effective than weaker policies, although compliance in Mexico and Uruguay is not as high as desired.

Neighbourhood deprivation and smoking and quit behaviour among smokers in Mexico: findings from the ITC Mexico Survey

“…For instance, Mexican smokers have a much lower intensity, and less frequent, consumption of cigarettes compared with smokers in HICs 46 47. In addition, prior to and during this study period, Mexico implemented several Framework Convention on Tobacco Control policies, including introduction of pictorial health warnings48 49; implementation of smoke-free laws at the local level12 50; increased taxes on tobacco products51–53 and prohibition of most tobacco advertising, promotion and sponsorship 54. The relatively simultaneous implementation of a comprehensive set of tobacco control policies, along with lower levels of addiction, may have provided the broader context for potentially inverting the commonly found relationship between neighbourhood deprivation and smoking outcomes.…”

“…At the initial wave of data collection for each city, two block groups within each census tract were selected, with selection proportional to the number of residents. Households were then visited in random order to enumerate household members and recruit eligible study participants 12. Quotas were set for smokers per block group; if that number was not reached, another block group was selected at random and eligible participants selected according to the same protocol.…”

A percepção do cumprimento das leis antifumo em bares e restaurantes em três cidades brasileiras: dados do ITC-Brasil

“…Saúde Pública 2017; 33 Sup 3:e00140315 period was not statistically different per city. Exposure to passive smoking in bars was also higher in other Mexican cities (86%-74%) compared to Mexico City (31%-23%), and the respective drops observed in 2008 and 2010 were of the same magnitude 24 .…”

“…Air monitoring data from enclosed spaces collected in 2010 indicate high enforcement of the legislation 25 . In Mexico City, the prevalence of passive smoking in restaurants remained stable between 2008 and 2010 (5%-7%), while in other Mexican cities with passive smoking prevalence higher than Mexico City's, a statistically significant reduction was observed in the same period (32%-17%) 24 . Mexico City was the first jurisdiction of the country to ban smoking in public and workspaces, in April 2008.…”

“…Regarding Uruguay and Mexico, countries where the ITC survey was also conducted, in the former, exposure to passive smoking did not change between 2008 and 2010 (in Montevideo, 6%-6%; in the other cities, 8%-9%) 24 . Since 2006 Uruguay has had national smoke-free environment legislation.…”