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

Nicotine Tob Res. 2017 Nov 1;19(11):1390-1394. doi: 10.1093/ntr/ntx040.


Introduction: In 2011, the Spanish partial smoke-free legislation was extended to affect all enclosed settings, including hospitality venues and selected outdoor areas. This study evaluated the change in self-reported exposure to secondhand smoke among the adult, nonsmoking population.

Methods: Two cross-sectional surveys were conducted on nationally representative samples of the adult (≥18 years) nonsmoking Spanish population. One was conducted in 2006 (6 months after the first ban) and the other in 2011, 6 months after the new ban was implemented. We assessed the prevalence and 95% confidence interval (CI) of self-reported exposure to secondhand smoke in various settings, and the corresponding adjusted prevalence ratios (PR) and 95% CIs.

Results: Overall, the self-reported exposure to secondhand smoke fell from 71.9% (95% CI: 70.1%-73.7%) in 2006 to 45.2% (95% CI: 43.1%-47.3%) in 2011 (PR = 0.43; 95% CI: 0.39-0.47). Specifically, self-reported exposure significantly decreased from 29.2% to 12.7% (PR = 0.36; 95% CI: 0.31-0.42) in the home, from 35.0% to 13.0% (PR = 0.40; 95% CI: 0.33-0.49) at work/education venues, from 56.2% to 32.2% (PR = 0.44; 95% CI: 0.39-0.48) during leisure time (mainly hospitality venues, but also venues other than work/education venues and home), and from 40.6% to 12.7% (PR = 0.24; 95% CI: 0.21-0.29) in transportation vehicles/stations.

Conclusions: The prevalence of secondhand smoke exposure among nonsmokers decreased after implementation of a comprehensive smoke-free legislation in Spain. In addition to the expected reduction in exposure during leisure time, we observed reductions in settings that were not subject to the new legislation, such as homes, outdoor bus stops, and train stations.

Implications: Exposure to secondhand smoke in selected outdoor settings may be further reduced by extending smoke-free legislation.

MeSH terms

  • Adolescent
  • Adult
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Self Report
  • Smoke-Free Policy
  • Smoking / legislation & jurisprudence*
  • Spain / epidemiology
  • Tobacco Smoke Pollution / prevention & control
  • Tobacco Smoke Pollution / statistics & numerical data*
  • Young Adult


  • Tobacco Smoke Pollution