Policy effects of secondhand smoke exposure in public places in the republic of korea: Evidence from pm_2.5 levels and air nicotine concentrations

Objective: The purpose of this study was to evaluate secondhand smoke (SHS) exposure inside selected public places to provide basic data for the development and promotion of smoke-free policies. Methods: Between March and May 2009, an SHS exposure survey was conducted. PM_2.5 levels and air nicotine concentrations were measured in hospitals (n=5), government buildings (4), restaurants (10) and entertainment venues (10) in Seoul, Republic of Korea, using a common protocol. Field researchers completed an observational questionnaire to document evidence of active smoking (the smell of cigarette smoke, presence of cigarette butts and witnessing people smoking) and administered a questionnaire regarding building characteristics and smoking policy. Results: Indoor PM_2.5 levels and air nicotine concentrations were relatively higher in monitoring sites where smoking is not prohibited by law. Entertainment venues had the highest values of PM_2.5(μg/m³) and air nicotine concentration(μg/m³), which were 7.6 and 67.9 fold higher than those of hospitals, respectively, where the values were the lowest. When evidence of active smoking was present, the mean PM_2.5 level was 104.9 μg/m³, i.e., more than 4-fold the level determined by the World Health Organization for 24-hr exposure (25 μg/m³). Mean indoor air nicotine concentration at monitoring sites with evidence of active smoking was 59-fold higher than at sites without this evidence (2.94 μg/m³ vs. 0.05 μg/m³). The results were similar at all specific monitoring sites except restaurants, where mean indoor PM_2.5 levels did not differ at sites with and without active smoking evidence and indoor air nicotine concentrations were higher in sites without evidence of smoking. Conclusion: Nicotine was detected in most of our monitoring sites, including those where smoking is prohibited by law, such as hospitals, demonstrating that enforcement and compliance with current smoke-free policies in Korea is not adequate to protect against SHS exposure.