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Effects of a Smoke-Free Law on Hair Nicotine and Respiratory Symptoms of Restaurant and Bar Workers

Hahn, Ellen J. DNS, RN; Rayens, Mary Kay PhD; York, Nancy MSN, RN, PhD Candidate; Okoli, Chizimuzo T.C. PhD, MPH; Zhang, Mei BSN, MPH, RN; Dignan, Mark PhD; Al-Delaimy, Wael K. MD, PhD

Journal of Occupational and Environmental Medicine: September 2006 - Volume 48 - Issue 9 - p 906-913
doi: 10.1097/01.jom.0000215709.09305.01
Original Articles

Objective: Bar and restaurant workers’ exposure to secondhand smoke (SHS) was compared before and 3 and 6 months after implementation of a smoke-free ordinance.

Methods: Hair nicotine, self-reported exposure to SHS, and respiratory symptoms were assessed on 105 smoking and nonsmoking workers from randomly selected establishments in Lexington, Kentucky. Thirty-eight percent were current smokers with more than half smoking 10 or fewer cigarettes per day. Workers provided a hair sample at baseline and at the 3-month interview.

Results: There was a significant decline in hair nicotine 3 months postlaw when controlling for cigarettes smoked per day. Bar workers showed a significantly larger decline in hair nicotine compared with restaurant workers. The only significant decline in SHS exposure was in the workplace and other public places. Regardless of smoking status, respiratory symptoms declined significantly postlaw.

Conclusions: Hospitality workers demonstrated significant declines in hair nicotine and respiratory symptoms after the law. Comprehensive smoke-free laws can provide the greatest protection to bar workers who are the most vulnerable to SHS exposure at work.

From the University of Kentucky College of Nursing (Dr Hahn, Ms York, Dr Rayens, Ms Zhang) and the College of Public Health (Dr Hahn, Dr Rayens) Lexington, Kentucky; the University of British Columbia (Dr Okoli), British Columbia, Canada; the University of Kentucky Prevention Research Center and College of Medicine (Dr Dignan), Lexington, Kentucky; and the University of California San Diego (Dr Al-Delaimy), San Diego, California.

CME Available for this Article at

This study was funded by the University of Kentucky Prevention Research Center.

Ellen J. Hahn has no commercial interest related to this article.

Address correspondence to: Ellen J. Hahn, DNS, RN, Professor, University of Kentucky College of Nursing and College of Public Health, 760 Rose St., Lexington, KY 40536-0232; E-mail:

©2006The American College of Occupational and Environmental Medicine