BACKGROUND: In December 2024, the Council of the European Union (EU) adopted a recommendation to expand regulations on the use of nicotine-containing products both in indoor and specific outdoor settings. This policy reflects growing concerns about the health implications of secondhand exposure to smoke and aerosols. This study aimed to examine sociodemographic factors associated with exposure to secondhand smoke and aerosols across the EU and support for relevant regulations.
METHODS: We performed a secondary analysis of cross-sectional data from the Special Eurobarometer 99.3 (n=26.358, May-June 2023) across 27 EU Member States (MS). We estimated the weighted prevalence of secondhand exposure to smoke and aerosols as well as support for bans on smoking, e-cigarettes, and heated tobacco products in public settings. We employed multi-level Poisson regression models to examine associations between sociodemographic characteristics and outcomes related to exposure and regulatory support.
RESULTS: Exposure to secondhand smoke and aerosols varied across EU MS. Younger individuals, those with higher education, living with children, and current and former tobacco and nicotine users were more likely to report exposure to both secondhand smoke and aerosols. Support for regulatory bans was consistent across two policies: restrictions on smoking in outdoor areas with limited social distancing and bans on emerging nicotine products where smoking is prohibited. Women, those living with children, and those with higher education were more likely to support the bans, while support was lower among socioeconomically disadvantaged groups and current or former tobacco and nicotine users.
CONCLUSIONS: These findings revealed significant disparities in exposure to secondhand smoke and aerosol, as well as support for tobacco-related regulations, both across EU MS and within population subgroups. By identifying key demographic patterns, our findings would support EU MS in implementing targeted interventions to increase population support for and implement the recent EU Council recommendations.