Secondhand tobacco smoke in bars and restaurants in Guatemala: Before and after indoor smoking ban evaluation

"Levels dropped, but we want to see levels go down to zero. There should be no smoking following a ban," said Joaquin Barnoya, M.D., M.P.H., research assistant professor of surgery at Washington University in St. Louis and director of research at the Cardiovascular Institute in Guatemala.

Guatemala implemented its smoking ban in February 2009. Barnoya's research group measured air nicotine levels six months later and compared those levels with those found two years prior.

In 2007, nicotine levels were 4.57 mg/m3 in bars and 0.58 mg/m3 in restaurants.

Six months after the ban went into effect, nearly all bars still had nicotine levels that were measurable. However, the median levels had dropped to 0.32 mg/m3 (an 87 percent reduction). In restaurants, 24 percent had no detectable levels of nicotine. The median level of those restaurants that still registered nicotine levels was 0.03 mg/m3 (a 94 percent reduction).

"This study helps us to see that smoking bans, rather than just a response to popular opinion, have evidence-based results," said Barnoya. "With more commitment and enforcement, we could see these nicotine levels brought down to zero."

Barnoya's study showed that 81 percent of restaurant employees supported a smoke-free workplace, compared with 32 percent before the law was implemented.

"It is clear that pressure could be placed on Guatemalan officials to step up enforcement," said Barnoya.

This research was recently presented at the American Association for Cancer Research 101st Annual Meeting 2010.