20 March 2012 -- WHO urges governments to protect the public from exposure to second-hand smoke by implementing 100% smoke-free air policies in all enclosed public places. This was a key recommendation of a report released today that measured levels of “second-hand smoke” in countries of the WHO Eastern Mediterranean Region. In its call to action, WHO recommended that implementation of smoke-free laws in enclosed places be supported by monitoring compliance and providing guidelines for enforcement officials.

The WHO Regional Office for the Eastern Mediterranean collaborated with the Johns Hopkins Bloomberg School of Public Health’s Institute for Global Tobacco Control and the Roswell Park Cancer Institute (United States) to conduct a pilot study measuring second-hand smoke particles in selected public places in the capital cities of 11 countries of the Region: Bahrain, Djibouti, Egypt, Islamic Republic of Iran, Iraq, Jordan, Lebanon, Oman, Pakistan, Sudan and Yemen.

Using a portable aerosol monitor device that analyses the concentration of suspended fine particles in air, the study measured concentrations of 2.5 micron sized particles in enclosed places. This size fraction included most of the tobacco smoke particles suspended in air. The types of venue sampled included health facilities, educational facilities, public offices, recreational venues (including restaurants, bars and other entertainment venues) and public transport vehicles.

Out of 244 venues studied, active smoking was observed in 98 venues. Recreational venues had the highest percentage of observed smoking, followed by public transport. Smoking was also observed in nearly a fourth of educational and health venues across the participating countries. Particulate matter concentrations were 6.2 times higher in places that had evidence of smoking. About one-third of health care facilities, educational facilities and indoor offices, one-half of public transport venues, and two-thirds of recreational venues had evidence of second-hand smoke.

“There is no safe level of exposure to second-hand smoke,” says WHO Regional Director for the Eastern Mediterranean, Dr Ala Alwan. “Only strict enforcement of smoking bans in all enclosed public workplaces, including catering and drinking establishments, and all public buildings and transport can protect the health of employees and non-smokers”.

The report highlights the need for improved enforcement measures, backed by smoke-free legislation. “The results of the study are important for all countries of the Region that are looking forward to implementing 100% smoke-free laws” remarked Dr Fatimah El Awa, WHO Regional Adviser for the Tobacco-Free Initiative. “Legislation and enforcement need to be coupled together; half measures do not work”, she added.

In the report, WHO recommends that in order to overcome challenges of enforcement, countries should completely ban smoking indoors, use clear and non-debatable language in the legislation and implement regular monitoring and evaluation mechanisms as an integral part of the ban on smoking in public places.