Air quality at venues of mixed smoking policies in Kazakhstan
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National Coalition ‘Smoke-free Kazakhstan’, Nur-Sultan, Kazakhstan
Public Health Program, Nazarbayev University School of Medicine, Nur- Sultan, Kazakhstan
Jamilya Sadykova#   

National Coalition ‘Smoke-free Kazakhstan’, 25 Kenesary Street, Nur-Sultan, Kazakhstan
Ardak Baizhaxynova#   

National Coalition ‘Smoke-free Kazakhstan’, 25 Kenesary Street, Nur-Sultan, Kazakhstan
Publication date: 2020-09-15
Tob. Induc. Dis. 2020;18(September):79
#Co-correspondence authors
Enclosed designated smoking areas (DSAs) and smoking zones are allowed in food-serving venues in Kazakhstan. Air quality in smoke-free foodserving venues, in venues with smoking throughout, in those with DSAs and those with smoking zones, is not fully understood.

A cross-sectional study with aim to evaluate PM2.5 concentrations in the venues with mixed smoking was conducted from September to October 2017 in Almaty, the largest city of Kazakhstan. A total of 44 rooms within the selected 29 venues were evaluated: 100% smoke-free (5), non-smoking zones (7), smoking zones (7), non-smoking venues with DSAs (8), venues that allow smoking throughout (9), and DSAs (8). Real-time PM2.5 measurement was conducted by TSI SidePak AM510 Personal Aerosol Monitor and used to rank health-risk assessment using the Air Quality Index developed by the U.S. Environmental Protection Agency.

Smoke-free food-serving venues had moderate levels of air quality with mean PM2.5 of 26.2 μg/m3 while non-smoking zones inside venues that also permitted smoking had a mean of 56.5 μg/m3, corresponding to unhealthy air quality. Venues restricting smoking only to DSAs also had unhealthy air quality in non-smoking areas (mean PM2.5 = 87.6 μg/m3) while DSAs had hazardous levels of air quality (mean PM2.5 = 647.9 μg/m3). Smoking zones inside the venues and venues allowing smoking throughout had a mean PM2.5 of 180.3 and 182.0 μg/m3, respectively, ranking as very unhealthy. On average 3.5 persons were observed in DSAs with mean volume of 38.9 m3. Cigarette and/or hookah were the major source of PM2.5. The higher the smoker density the poorer the air quality in the venue.

Hazardous level of PM2.5 due to tobacco products inside DSAs demonstrated the low efficiency of a smoking ban with exemptions. A complete smoking ban in food-serving venues should be in place to fully protect people from hazardous air quality conditions.

The research team highly appreciates the input of the principal observer, Skatova Alexandra, the technical support from faculty members of Nazarbayev University, and the Smoke-free Kazakhstan coalition.
The authors have each completed and submitted an ICMJE form for disclosure of potential conflicts of interest. The authors declare that they have no competing interests, financial or otherwise, related to the current work. J. Sadykova and A. Baizhaxynova report a non-financial support from the American non-profit membership organization Campaign for Tobacco-Free Kids, during the conduct of the study.
This work was supported by Kazakhstan Smoke-free coalition and the Campaign for Tobacco-Free Kids, which provided the trainer and TSI SidePak AM510.
All authors contributed in composing, editing and critical analyzing the content of the manuscript. The manuscript was read and approved by all authors. JS justified the need of air monitoring research and obtained funding from TFK, designed and planned the study, participated as team observer, analyzed and interpreted the data, drafted and jointly edited the manuscript. AB analyzed and interpreted the data with statistical methods, drafted the first manuscript with further joint editing until the final version of the manuscript. BC edited and critically analyzed the manuscript, proofread and made ongoing and final editing.
Not commissioned; externally peer reviewed.
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