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Maria J. Lopez,^1,2,3 Manel Nebot,^1,3,4 Marco Albertini,⁵ Pierre Birkui,⁶ Francesc Centrich,⁷ Monika Chudzikova,⁸ Maria Georgouli,⁹ Giuseppe Gorini,¹⁰ Hanns Moshammer,¹¹ Maurice Mulcahy,¹² Maria Pilali,⁹ Eulalia Serrahima,⁷ Piotr Tutka,¹³ and Esteve Fernandez^14,15

¹Evaluation and Intervention Methods Unit, Public Health Agency of Barcelona, Barcelona, Spain; ²PhD Program in Public Health and Methodology of Biomedical Research, Universitat Autònoma de Barcelona, Barcelona, Spain; ³CIBER Epidemiología y Salud Pública, Spain; ⁴ Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain; ⁵Centro Regionale di Riferimento per la Prevenzione, Florence, Italy; ⁶Office Français de Prevention du Tabagisme, Paris, France; ⁷Laboratory, Agency of Public Health, Barcelona, Spain; ⁸Stop Smoking NGO, Bratislava, Slovak Republic; ⁹Hellenic Cancer Society, Athens, Greece; ¹⁰Environmental and Occupational Epidemiology Unit, Centre for Study and Prevention of Cancer–Tuscan Cancer Institute, Florence, Italy; ¹¹Institute of Environmental Health, Medical University of Vienna, Vienna, Austria; ¹²Health Service Executive, Western Area, Galway, Ireland; ¹³Department of Experimental and Clinical Pharmacology, Medical University of Lublin, Lublin, Poland; ¹⁴Tobacco Control Research Unit, Institut Català d'Oncologia-IDIBELL, Barcelona, Spain; ¹⁵Department of Clinical Sciences, Campus of Bellvitge, Universitat de Barcelona, Barcelona, Spain

Abstract
Background: Although in the last few years some European countries have implemented smoking bans in hospitality venues, the levels of secondhand smoke (SHS) in this occupational sector could still be extremely high in most countries.

Objective: The aim of this study was to assess exposure to SHS in hospitality venues in 10 European cities.

Methods: We included 167 hospitality venues (58 discotheques and pubs, 82 restaurants and cafeterias, and 27 fast-food restaurants) in this cross-sectional study. We carried out fieldwork in 10 European cities: Vienna (Austria) , Paris (France) , Athens (Greece) , Florence and Belluno (Italy) , Galway (Ireland) , Barcelona (Spain) , Warsaw and Lublin (Poland) , and Bratislava (Slovak Republic) . We measured vapor-phase nicotine as an SHS marker.

Results: We analyzed 504 samples and found nicotine in most samples (97.4%) . We found the highest median concentrations in discos/pubs [32.99 µg/m³ ; interquartile range (IQR) , 8.06–66.84 µg/m³] and lower median concentrations in restaurants/cafeterias (2.09 µg/m³ ; IQR, 0.49–6.73 µg/m³) and fast-food restaurants (0.31 µg/m³ ; IQR, 0.11–1.30 µg/m³) (p < 0.05) . We found differences of exposure between countries that may be related to their smoking regulations. Where we sampled smoking and nonsmoking areas, nicotine concentrations were significantly lower in nonsmoking areas.

Conclusions: Hospitality venues from European cities without smoking regulations have very high levels of SHS exposure. Monitoring of SHS on a regular basis as well as a total smoking ban in hospitality sector would be needed.

Key words: Europe, hospitality sector, passive smoking, secondhand smoke, vapor-phase nicotine. Environ Health Perspect 116:1469–1472 (2008) .  doi:10.1289/ehp.11374 available via http://dx.doi.org/ [Online 18 July 2008]

Address correspondence to M.J. Lopez, Servei d'Avaluació i Mètodes d'Intervenció, Agència de Salut Pública de Barcelona, Lesseps, 1 Barcelona 08023, Spain. Telephone: 00-34-93-202-77-48. Fax: 0-34-93-292-14-43. E-mail: mjlopez@aspb.es

We are very grateful to A. Navas-Acien for her helpful comments, valuable suggestions, and detailed revision of the manuscript. We are also grateful to F. Sanchez-Martinez for the revision of the final version of the manuscript.

This study received financial support from the European Commission in the framework of the "Europe Against Cancer" program as part of the European Network for Smoking Prevention framework project (application 2003307) . E.F. was funded partly by the Thematic Network of Cooperative Research on Cancer  (RD06/0020/0089) , and the Ministry of Universities and Research, Government of Catalonia (SGR200500646) .

The authors declare they have no competing financial interests.

Received 15 February 2008 ; accepted 18 July 2008.