Second-hand smoke exposure in outdoor hospitality venues: Smoking visibility and assessment of airborne markers

Xisca Sureda, Usama Bilal, Esteve Fernandez, Roberto Valiente, Francisco Escobar, Ana Navas-Acien, Manuel Franco

Research output: Contribution to journalArticlepeer-review


After the implementation of smoke-free policies in indoor hospitality venues (including bars, cafeterias, restaurants, and pubs), smokers may have been displaced to their outdoor areas. We aimed to study smoking visibility and second-hand smoke exposure in outdoor hospitality venues.

We collected information on signs of tobacco consumption on entrances and terraces of hospitality venues in 2016 in the city of Madrid, Spain. We further measured airborne nicotine concentrations and particulate matter of less than 2.5 µm in diameter (PM2.5) in terraces with monitors by active sampling during 30 min. We calculated the medians and the interquartile ranges (IQR) of nicotine and PM2.5 concentrations, and fitted multivariate models to characterize their determinants.

We found 202 hospitality venues between May and September (summer), and 83 between October and December 2016 (fall) that were opened at the time of observation. We found signs of tobacco consumption on 78.2% of the outdoor main entrances and on 95.1% of outdoor terraces. We measured nicotine and PM2.5 concentrations in 92 outdoor terraces (out of the 123 terraces observed). Overall median nicotine concentration was 0.42 (IQR: 0.14–1.59) μg/m3, and overall PM2.5 concentration was 10.40 (IQR: 6.76–15.47) μg/m3 (statistically significantly higher than the background levels). Multivariable analyses showed that nicotine and PM2.5 concentrations increased when the terraces were completely closed, and when tobacco smell was noticed. Nicotine concentrations increased with the presence of cigarette butts, and when there were more than eight lit cigarettes at a time.

Outdoor hospitality venues are areas where non-smokers, both employees and patrons, continue to be exposed to second-hand smoke. These spaces should be further studied and considered in future tobacco control interventions.
Original languageEnglish
Pages (from-to)220-227
Number of pages7
JournalEnvironmental Research
Early online date1 May 2018
Publication statusPublished - 1 Aug 2018
Externally publishedYes


  • Second-hand smoke
  • PM2.5
  • Airborne nicotine
  • Smoke-free policies
  • Hospitality venues


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