Air quality at venues of mixed smoking policies in Kazakhstan

INTRODUCTION: Enclosed designated smoking areas (DSAs) and smoking zones are allowed in food-serving venues in Kazakhstan. Air quality in smoke-free food-serving venues, in venues with smoking throughout, in those with DSAs and those with smoking zones, is not fully understood. METHODS: A cross-sectional study with aim to evaluate PM(2.5) 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 PM(2.5) 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. RESULTS: Smoke-free food-serving venues had moderate levels of air quality with mean PM(2.5) of 26.2 μg/m(3) while non-smoking zones inside venues that also permitted smoking had a mean of 56.5 μg/m(3), corresponding to unhealthy air quality. Venues restricting smoking only to DSAs also had unhealthy air quality in non-smoking areas (mean PM(2.5) = 87.6 μg/m(3)) while DSAs had hazardous levels of air quality (mean PM(2.5) = 647.9 μg/m(3)). Smoking zones inside the venues and venues allowing smoking throughout had a mean PM(2.5) of 180.3 and 182.0 μg/m(3), respectively, ranking as very unhealthy. On average 3.5 persons were observed in DSAs with mean volume of 38.9 m(3). Cigarette and/or hookah were the major source of PM(2.5). The higher the smoker density the poorer the air quality in the venue. CONCLUSIONS: Hazardous level of PM(2.5) 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.