1. Introduction
chronic respiratory diseases, death, breast cancer, cardiovascular diseases, stroke, neoplasms, diabetes mellitus, lung cancer, asthma, deaths, COPD
ISCHEMIC HEART DISEASE, BREAST CANCER, CARDIOVASCULAR DISEASES, STROKE, DISEASE, DIABETES MELLITUS, NEOPLASMS, CHRONIC RESPIRATORY DISEASE, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, COPD, CHRONIC RESPIRATORY DISEASE, LOWER RESPIRATORY INFECTION, ASTHMA, LUNG CANCER, LUNG CANCERS, SECOND-HAND SMOKE
Smokefree laws are intended to protect against second-hand smoke (SHS) in outdoor areas. We examined if exposure to PM2.5 particles in outdoor smoking areas changed breathing rates in 60 patients with asthma (Smokefree legislation and policies have increased globally [They have been successful in reducing exposure to SHS, with short- and long-term benefits, improving health, reducing illness, increasing smoking cessation, and denormalising smoking [Despite decreasing smoking prevalence in the last thirty years, the increased population growth in the same period has led to a significant increase in the total number of smokers. In 2019, more than 1 billion people smoked tobacco regularly, with almost 8 million deaths attributable to smoking [While smokefree legislation and policies have led to a decline in smoking prevalence, as the global population grows and with an estimated 77% of the world’s population still vulnerable to SHS [A systematic exploration of the global burden of disease attributable to SHS across 204 countries and territories from 1990 to 2019 found that SHS exposure increased the risk of tracheal, bronchus and lung cancers, breast cancer, ischemic heart disease, chronic obstructive pulmonary disease (COPD), stroke, lower respiratory infections and diabetes mellitus [Regarding outdoor areas, the subject of this study, the details of the smokefree laws vary, and result in variable exposures. At entertainment venues, such as pubs, bars and clubs, an allowance is usually made within laws to permit an area (or terraces) outside the main premises where smoking is allowed, provided that these areas are separate and are not complete buildings to allow for increased ventilation, and that that there is no commercial activity [However, it has become obvious in many instances that these smoking areas allow for the accumulation of SHS and cannot be considered safe [Chronic respiratory diseases cause an important worldwide health burden. It was estimated that, in 2017, they were the third leading cause of death, behind cardiovascular diseases and neoplasms. Globally, there were 3,914,196 deaths due to chronic respiratory diseases in 2017, an increase of 18.0% since 1990 [While scientific evidence has accumulated linking SHS exposure to longer-term adverse health outcomes, including respiratory outcomes in children and adults, acute cardiovascular effects and lung cancer [The negative effects of SHS on respiratory function are thus well established. Moreover, it is well documented that SHS from combustible tobacco smoke outdoors results in poorer outdoor air quality [Three countries with statutory comprehensive smokefree laws, which have been in place for varying lengths of time—Czechia, Ireland and Spain—were selected. Ireland introduced its comprehensive smokefree laws in 2004 and was the first country in the world to do so; Spain introduced its smokefree laws initially in 2008 and strengthened them in 2012; and Czechia introduced its comprehensive laws in 2016 [