Indoor secondhand tobacco smoke emission levels in six Lebanese cities

Abstract

BackgroundTo date, Lebanon has failed to enact comprehensive clean indoor air laws despite ratification of the Framework Convention on Tobacco Control (FCTC), which calls for the protection of non-smokers from exposure to secondhand tobacco smoke (SHS). Complicating the problem of SHS exposure in Lebanon is the widespread use of the tobacco water-pipe. While most research on SHS has involved cigarette smoking as a source of emissions, other sources, including tobacco water-pipes, may be an important contributor.MethodsPM2.5 concentrations (μg/m3) were measured in a sample of 28 public venues located in six major Lebanese cities. Active smoker density (number of smokers/100 m3) was calculated for both water-pipe and cigarette smokers. Venues were then categorised as having higher density of water-pipe smokers or higher density of cigarette smokers, and resultant emission levels were compared between the two groups.ResultsCigarette and water-pipe smoking was observed in 14 venues, while cigarette smoking only and water-pipe smoking only were found in 12 venues and one venue, respectively. Among all smoking-permitted venues, the mean PM2.5 concentration was 342 μg/m3. Venues with a higher density of water-pipe smokers (n =14) showed a similar median PM2.5 concentration (349 μg/m3) compared with venues with a higher density of cigarette smokers (n =13; 241 μg/m3; p=0.159). The mean PM2.5 concentration in the single venue with a voluntary smoke-free policy was 6 μg/m3.ConclusionsDespite ratification of the FCTC in 2005, both cigarette and water-pipe smoking are commonly practised in enclosed public places throughout Lebanon, leading to unsafe levels of indoor particulate pollution. Smoke-free policies are needed in Lebanon to protect the public's health, and should apply to all forms of tobacco smoking.

Secondhand smoke emission levels in waterpipe cafes in Doha, Qatar

“…Moreover, Hammal et al 34 observed mean indoor PM 2.5 levels of 264 μg/m 3 arising from the use of tobacco-free ‘herbal’ WP products. The particulate matter levels detected among WP cafes in Qatar also compare closely with those observed in non-smoke-free public venues (predominantly containing cigarettes) reported elsewhere in the EMR, and throughout the world 21 28 35 36…”

Second-hand smoke and indoor air quality in public places in Gaza city

“…Therefore, these results may not be representative of all public venues in Gaza city. However, the levels measured are consistent with monitoring conducting in many other jurisdictions around the world which have not banned indoor smoking [13][14][15]. Finally, smoking may not have been the only source of indoor particulate pollution.…”

“…Furthermore, these data are consistent with measurements taken from indoor public venues in other EMR countries. For example, high PM 2.5 levels have been found in indoor public venues with observed smoking in Syria (372 µg/m 3 ), Tunisia (328 µg/m 3 ) and Lebanon (342 µg/m 3 ) [13][14][15].…”

“…Such research has helped to educate the public and policy-makers about the dangers of SHS and has been instrumental in informing smoke-free policies [12]. SHS air quality monitoring has previously been conducted within the EMR and has identified dangerous levels of particulate matter in smoking public venues in Lebanon, Pakistan, Syrian Arab Republic and Tunisia [13][14][15]. To date, no known research has been conducted on SHS emissions in the Palestinian Authority, where economic and political uncertainty and instability have created unique public health challenges, and where effective preventive health policies are needed.…”

Implementation of a indoor air ban and an advertising and sponsorship ban in Lebanon: a baseline cross-sectional study

“…Observations could be supplemented by the monitoring of air quality in indoor places that provides a more accurate indicator of compliance with the smoke free legislation. This is particularly useful as we have data from 2008 on air quality prior to the implementation of the tobacco control law that could be used for comparison 28 . In the 2009-2011 strategic plan, the National Tobacco Control Program has stated that such monitoring would indeed take place in indoor public places in 40 key areas to monitor compliance.…”