ABSTRACT
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 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. RESULTS: 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. CONCLUSIONS: 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.