Second-hand smoke in indoor hospitality venues in Pakistan

BACKGROUND: Second-hand smoke (SHS) constitutes a significant public health threat in countries with a high smoking prevalence. However, data assessing the quality of indoor air at public venues in Pakistan are limited. OBJECTIVES: To measure mean concentrations of PM_2.5 (particulate matter ≤2.5 microns in diameter), a sensitive indicator of SHS, in hospitality venues in Pakistan. SETTING AND DESIGN: Data were collected discreetly from 39 indoor venues such as cafes, restaurants and shisha (water-pipe) bars from three major cities in Pakistan. Data were recorded using a portable air quality monitoring device. RESULTS: The overall mean PM_2.5 value for the visited venues was 846 μg/m³ (95%CI 484-1205). The mean PM_2.5 value was 101 μg/m³ (95%CI 69-135 μg/m³) for non-smoking venues, 689 μg/m³ (95%CI 241-1138) for cigarette smoking venues and 1745 μg/m³ (95%CI 925-2565) for shisha smoking venues. CONCLUSION: The significant levels of SHS recorded in this study, in particular from shisha smoking venues, could represent a major public health burden in Pakistan. Appropriate legislation needs to be enforced to protect the health of those exposed to the hazards of second-hand tobacco smoke.