Changes in Secondhand Smoke Exposure After Smoke-Free Legislation (Spain, 2006-2011)

Area of Science:

• Public Health
• Environmental Health
• Tobacco Control Policy

Background:

• Spain enacted comprehensive smoke-free legislation in 2011, extending previous bans to all indoor public spaces and some outdoor areas.
• This legislation aimed to reduce public exposure to secondhand smoke (SHS).

Purpose of the Study:

• To evaluate the change in self-reported exposure to secondhand smoke among the adult, nonsmoking population in Spain following the 2011 legislation.
• To assess the impact of comprehensive smoke-free laws on SHS exposure across various settings.

Main Methods:

• Two national cross-sectional surveys of adult (≥18 years) nonsmokers were conducted in Spain.
• Surveys were administered in 2006 (pre-legislation) and 2011 (post-legislation).
• Prevalence and adjusted prevalence ratios (PR) of self-reported SHS exposure in different settings were calculated.

Main Results:

• Overall self-reported SHS exposure decreased from 71.9% in 2006 to 45.2% in 2011 (PR=0.43).
• Significant reductions were observed in homes (29.2% to 12.7%, PR=0.36), work/education venues (35.0% to 13.0%, PR=0.40), leisure settings (56.2% to 32.2%, PR=0.44), and transportation (40.6% to 12.7%, PR=0.24).

Conclusions:

• Comprehensive smoke-free legislation in Spain led to a significant decrease in SHS exposure among nonsmokers.
• Exposure reductions occurred in areas covered by the new law (leisure) and those not explicitly regulated, such as homes and outdoor transport areas.
• Extending smoke-free policies to additional outdoor settings could further reduce SHS exposure.