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      Night entertainment venues comply poorly with the smoke-free law in Chile Translated title: Los locales de entretenimiento nocturno cumplen mal la Ley de ambientes libres de humo en Chile

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          Abstract

          Abstract The initial high level of compliance with the Chilean comprehensive national smoke-free law in 2013 is fading, particularly in the hospitality sector. This paper draws attention to how using a simple and low-cost surveillance inquiry may help focus on the use of scarce inspection resources to improve compliance with the law in the hospitality sector. We conducted a cross-sectional assessment of second-hand smoke exposure in night entertainment venues in Santiago, Chile, by measuring particulate matter of less than 2.5 µm (PM2.5). Smoking where prohibited by law was observed in 36% of the venues visited. Venues where smoking was spotted at the time of the observation had a median PM2.5 concentration 13 times higher than background concentration on the street. The study shows that a targeted approach for inspection to find pockets of venues with suboptimal compliance is feasible and affordable.

          Translated abstract

          Resumen El alto nivel inicial de cumplimiento de la Ley integral chilena de ambientes libres de humo de 2013 se está desvaneciendo, particularmente en el sector de la restauración. Este documento muestra cómo una encuesta de vigilancia simple y económica puede ayudar a mejorar el uso de recursos de inspección escasos para mejorar el cumplimiento de la ley en dicho sector. Se realizó una evaluación transversal de la exposición al humo de tabaco ajeno en locales de entretenimiento nocturno en Santiago, Chile, midiendo el nivel de partículas menores de 2,5 µm (PM2.5). En el 36% de los locales visitados se fumaba donde lo prohíbe la ley. Los locales en los que se fumaba tenían una concentración mediana de PM2.5 13 veces mayor que la concentración en la calle. El estudio muestra que una vigilancia enfocada en la inspección de lugares con cumplimiento subóptimo es factible y asequible.

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          Most cited references10

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          Variability in the correlation between nicotine and PM2.5 as airborne markers of second-hand smoke exposure.

          The aim of this study was to assess the relationship between particulate matter of diameter≤2.5 µm (PM2.5) and airborne nicotine concentration as markers of second-hand smoke exposure with respect to the setting studied, the intensity of exposure, and the type of environment studied (indoors or outdoors). Data are derived from two independent studies that simultaneously measured PM2.5 and nicotine concentrations in the air as airborne markers of second-hand smoke exposure in public places and workplaces, including health care centres, bars, public administration offices, educational centres, and transportation. We obtained 213 simultaneous measures of airborne nicotine and PM2.5. Nicotine in the air was measured with active samplers containing a sodium bisulphate-treated filter that was analysed by gas chromatography/mass spectrometry. PM2.5 was measured with a SidePak AM510 Personal Aerosol Monitor. We calculated Spearman's rank correlation coefficient and its 95% confidence intervals (95% CI) between both measures for overall data and stratified by setting, type of environment (indoors/outdoors), and intensity of second-hand smoke exposure (low/high, according to the global median nicotine concentration). We also fitted generalized regression models to further explore these relationships. The median airborne nicotine concentration was 1.36 µg/m3, and the median PM2.5 concentration was 32.13 µg/m3. The overall correlation between both markers was high (Spearman's rank correlation coefficient=0.709; 95% CI: 0.635-0.770). Correlations were higher indoors (Spearman's rank correlation coefficient=0.739; 95% CI: 0.666-0.798) and in environments with high second-hand smoke exposure (Spearman's rank correlation coefficient=0.733; 95% CI: 0.631-0.810). The multivariate analysis adjusted for type of environment and intensity of second-hand smoke exposure confirmed a strong relationship (7.1% increase in geometric mean PM2.5 concentration per µg/m3 nicotine concentration), but only in indoor environments in a stratified analysis (6.7% increase; 95% CI: 4.3-9.1%). Although the overall correlation between airborne nicotine and PM2.5 is high, there is some variability regarding the type of environment and the intensity of second-hand smoke exposure. In the absence of other sources of combustion, air nicotine and PM2.5 measures can be used indoors, while PM2.5 should be used outdoors with caution.
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            Adoption and compliance in second-hand smoking bans: a global econometric analysis

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              Lower incidence of myocardial infarction after smoke-free legislation enforcement in Chile

              Abstract Objective To evaluate the impact of a complete smoking ban in enclosed spaces on the incidence of acute myocardial infarction in Chile. Methods The population-based study involved residents of urban areas, where 80% of the Chilean population live, aged 20 years or older who had a myocardial infarction. Monthly myocardial infarction incidence and mortality rates at health-care facilities between January 2011 and December 2014 were derived from admission and mortality databases. Regression discontinuity methods were used to estimate the near-immediate impact on disease incidence of enforcing smoke-free legislation in March 2013. The same analysis was performed for ischaemic stroke, degenerative disc disease and colon cancer. Data on the concentration of fine respirable particulates were included in an additional analysis of myocardial infarction incidence in the Santiago metropolitan area. Results The enforcement of smoke-free legislation was associated with an abrupt, near-immediate decline of 0.639 cases of myocardial infarction per 100 000 adults per month (95% confidence interval, CI: 0.242 to 1.036; relative decline: 7.8%). Similar declines were observed in men and women and in people aged over and under 70 years. However, enforcement of the legislation was not associated with a significant change in the rate of ischaemic stroke, degenerative disc disease or colon cancer. The abrupt decline in myocardial infarction incidence was also observed when data on fine respirable particulates were included in an analysis for Santiago. Conclusion The enforcement of extensive smoke-free legislation in Chile was associated with an abrupt, near-immediate decline in the incidence of myocardial infarction.
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                Author and article information

                Journal
                gs
                Gaceta Sanitaria
                Gac Sanit
                Sociedad Española de Salud Pública y Administración Sanitaria (SESPAS) (Barcelona, Barcelona, Spain )
                0213-9111
                August 2021
                : 35
                : 4
                : 402-404
                Affiliations
                [5] L'Hospitalet de Llobregat, Barcelona Cataluña orgnameUniversitat de Barcelona orgdiv1Campus de Bellvitge orgdiv2School of Medicine and Health Sciences Spain
                [1] Santiago Santiago de Chile orgnameUniversidad del Desarrollo orgdiv1Facultad de Medicina Clínica Alemana orgdiv2Center for Epidemiology and Health Policy Chile
                [3] L'Hospitalet de Llobregat, Barcelona orgnameInstitut Català d'Oncologia (ICO) orgdiv1WHO Collaborating Centre for Tobacco Control orgdiv2Tobacco Control Unit, Cancer Control and Prevention Program Spain
                [4] orgnameCIBER of Respiratory Diseases (CIBERES) Spain
                [2] L'Hospitalet de Llobregat, Barcelona orgnameBellvitge Biomedical Research Institute (IDIBELL) orgdiv1Tobacco Control Research Group Spain
                Article
                S0213-91112021000400018 S0213-9111(21)03500400018
                10.1016/j.gaceta.2020.04.016
                87d69d88-b28d-4371-bd0d-7c902545767d

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 16 March 2020
                : 06 April 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 10, Pages: 3
                Product

                SciELO Spain

                Categories
                Field Notes

                Fumador pasivo,Legislación de ambientes libres de humo,Sector restauración,Cumplimiento de la ley,Second-hand smoke,Tobacco smoke pollution,Passive smoking,Smoke-free legislation,Hospitality sector,Enforcement,Humo de tabaco ajeno,Contaminación por humo de tabaco

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