New research bolsters evidence for stricter smoke-free laws
Authorities across Europe are being compelled to do more to protect children and non-smokers from tobacco smoke and e-cigarette emissions following landmark EU-funded research that has uncovered worrying levels of exposure to airborne nicotine in private and public spaces, including schools and playgrounds.
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Updated on 12 february 2020
Despite increasingly strict smoke-free laws in many countries, the EU-funded TackSHS project found that daily exposure to second-hand smoke is still prevalent in most of Europe, ranging from 24 % in Ireland to 68 % in Greece. Across the EU, three out of five smokers allow smoking in their homes, potentially exposing children and other non-smokers to very high levels of airborne nicotine, exceeded only by the extremely elevated concentrations found in smokers cars.
Even more alarming is the finding that second-hand smoke is present in most childrens playgrounds and primary school entrances, especially in deprived neighbourhoods and in countries with less-strict smoking regulations.
Acknowledging the problem is the first step toward making changes, says project coordinator Esteve Fernández of the Institut Català dOncologia in Barcelona, Spain. The evidence produced in the TackSHS project will contribute to efforts to enact new and stricter regulations to protect non-smokers from the health risks of exposure to second-hand tobacco smoke.
The researchers found that, in 2017, among children under the age of 14, exposure to second-hand smoke at home was associated with 344 deaths and the loss of 37 000 disability-adjusted life years across the EU. Second-hand smoke was also linked to 30 000 deaths and the loss of 712 000 disability-adjusted life years among non-smoking adults.
The project studies also analysed exposure to second-hand aerosols emitted by electronic cigarettes, which have become increasingly popular in recent years. Although more research is needed on the mid- to long-term effects of acute and chronic exposure to e-cigarette emissions, the research found that e-cigarette use impairs air quality with particulate matter, nicotine, volatile organic compounds and heavy metals among other substances.
Experimental and observational studies showed that people passively exposed to e-cigarette aerosols experienced immediate alterations to their lung function as well as symptoms of eye, nose and throat irritation.
As a precaution, the project consortium is calling for new policies to be introduced to restrict e-cigarette use, particularly in enclosed public spaces. Other recommendations include better implementing the existing smoke-free laws, extending smoking bans to some additional outdoor areas, strengthening enforcement of indoor smoking restrictions, and promoting smoke-free homes and cars through evidence-based interventions.
We are confident that the TackSHS results and recommendations will have an impact on policy agendas at both the EU and national levels, Fernández says. Europeans are supportive of the introduction of more restrictive smoke-free regulations, especially in public places. Some countries are already moving ahead with new measures such as banning smoking in cars when minors or pregnant women are aboard.
TackSHS results will be presented at several international scientific conferences this year, with more than 20 scientific papers also expected to be published. The project partners are now considering follow-up initiatives to expand their research to new and emerging smoking and vaping products as well as to more EU Member States and other countries.