The document summarizes evidence from scientific studies that showed the partial smoking ban implemented in Spain in 2006 was ineffective at reducing secondhand smoke exposure. Three studies were highlighted: 1) A study found nicotine levels remained high in bars where smoking was allowed and in non-smoking areas of bars with separate rooms. 2) A study of hospitality workers found high cotinine levels and respiratory symptoms even after the law. 3) A study found PM2.5 levels far exceeded air quality standards in bars where smoking was allowed. The evidence supported a conclusion that a complete smoking ban was needed to protect workers and patrons from secondhand smoke exposure.

1. “Evidence-based failure of the partial
smoking ban: contributions of scientists”
Maria J. López
Public Health Agency of Barcelona
ICO-WHO Symposia on Tobacco Control
July 2012

2. Scientists...

3. The Spanish smoking law (January, 2006)
- Tobacco sales
- Tobacco advertisement
- Tobacco consumption:
-Smoking ban in workplaces
- Partial restrictions in
hospitality venues

4. Impact of
the law...

6. Smoking workgroup of the Spanish Society of Epidemiology
Impact evaluation of the
Spanish smoking law
implemented in 2006
http://seepidemiologia.es/documents/dummy/Monografia-Grupo%20Trabajo%20sobre%20tabaquismo.pdf
Manel Nebot y Esteve Fernández (coords.), Carles Ariza, Marcela Fu, Iñaki Galán, María José López, Jose M. Martínez, Albert
Moncada, Agustín Montes, Mónica Pérez-Ríos, Esteve Saltó, Anna Schiaffino, María Jesús Soriano

7. Half full? Half empty?
Evidence of
what was NOT
working...
- Decrease on SHS exposure in
workplaces
-No differences (or even decrease) on
SHS exposure prevalence at home
-Increase in support to the law
-No decrease on hospitality volume of
sales

8. 3 studies focused on the partial ban in
hospitality sector...

9. Study 1: Impact on SHS levels in workplaces
and hospitality venues
Nebot M, Lopez MJ, Ariza C et al. Lopez MJ, Nebot M, Schiaffino A et al.
Environmental Health Perspectives, 2009. Tobacco Control, 2012.

10. Study design: Before-after evaluation study
Spanish smoking law
(January 2006)
Pre-law 6 months 12 months 24 months
(October-December)

11. Study population
50 measurements / region:
hospitality venues and other
workplaces
SHS marker:
Vapour-phase nicotine
Passive sampler

12. Nicotine concentration (µg/m3) in bars/ restaurants where
smoking was banned after the law
Concentración de nicotina (µg/m3)
- 97%
p< 0.001
2.71 [RI 1.39 – 3.77]
0.09 [RI 0.01 – 0.26]
Baseline 12 months follow-up
* Logarithmic scale n=22

13. Nicotine concentration (µg/m3) in bars/ restaurants where
smoking was allowed after the law
Concentración de nicotina (µg/m3)
7,07 [RI 1,86 – 11,78] 5,70 [RI 2,77 – 11,73]
p= 0.191
Baseline 12 months follow-up
* Logarithmic scale n=33

14. Nicotine concentration (µg/m3) in bars/ restaurants
separated areas after the law
Smoking area Non-smoking area
p= 0.075 - 89%
Concentración de nicotina (µg/m3)
p< 0.001
Concentración de nicotina (µg/m3)
8.89 [RI 5.28 – 15.61]
5.58 [RI 2.42 – 12.42] 5.58 [RI 2.42 – 12.42]
0.62 [RI 0.34 – 1.40]
Baseline 12 months follow-up Baseline 12 months follow-up
n=18 n=18
* Logarithmic scale

15. Study 2: Impact on SHS in hospitality workers and
respiratory symptoms
Fernandez E, Fu M, Pascual JA et al.
Plos One, 2009.

16. SHS in Hospitality Workers Study
Before-after study with
comparison group
117 non-smokers
hospitality workers
20 hospitality workers in
Andorra & Portugal
Saliva cotinine samples
and questionnaires

17. Cotinine concentrations (ng/ml) in hospitality workers
Control
(Andorra & Portugal)
–63.7% p=0.937
Cotinine (ng/ml), log scale
(p<0.01) p=0.406 p=0.126
Smoking Areas Smoking allowed Smoking allowed
banned
n=32 n=22 n=63 n=20
Baseline
12 months follow-up

18. Proportion (%) of respiratory symptoms in hospitality workers
Control
(Andorra & Portugal)
-50.1%
(p<0.01) p=0.140 p=0.640 p=0.757
Smoking Areas Smoking allowed Smoking allowed
banned
n=32 n=22 n=63 n=20

19. Study 3: PM2.5 levels in hospitality venues
after the law
Villarroel N, López MJ, Sánchez-Martínez F et al.
Gaceta Sanitaria, 2011.

20. Study design: Cross-sectional study
Fieldwork: October- December 2007
Sampling: 40 hospitality venues in Barcelona
SHS marker: Particles smaller than 2.5 micrometers (PM2.5)
Side Pack AM 510 Personal Aerosol Monitor

21. PM2.5 concentration (µg/m3) in hospitality venues
according to the smoking regulation after the law
n Average (SD) p
Smoking banned 17 34.4 (14.2)
<0.001
Smoking allowed 16 182.2 (180.0)
Air quality standards
35 µg/m3 (24-hour standard) according to the EPA
25 µg/m3 (anual average) according to the European Comission

22. Conclusions
 Different scientific studies showed, consistently, that most
hospitality workers (and costumers) were still exposed to
SHS after the law.
 The evidence supported a complete ban on smoking in
hospitality sector.
 The work of the scientific community has been essential
in providing evidence and objective data that contributed
to the modification of the 2006 law.

23. “Tobacco Control engine”
Public
Adm Science
Citizens

24. Thank you!