Environmental tobacco smoke.

B ans on smoking in public places and workplaces, including bars and restaurants, have recently been introduced in California and New York City and have been announced in Ireland. In addition, the UK Chief Medical Officer and the EU Health Commissioner have recently called for a ban on smoking in public places. Despite clear evidence that environmental tobacco smoke (ETS) adversely affects health and is an important occupational health hazard, the current UK policy response and regulatory framework for occupational ETS exposure remains inadequate with no discernable scientific rationale. ETS is a complex mixture of over 3800 gaseous and particulate components, including more than 50 known or suspected human carcinogens and 100 toxic chemicals. Exposure to ETS through passive smoking has been associated with many diseases including lung cancer, and cardiovascular and respiratory diseases. 3 The impact on cardiovascular disease is particularly important from an occupational and public health perspective. Steenland et al recently estimated that in the USA there are 2000–3000 deaths annually among non-smokers from cardiovascular related disease due to occupational exposure to ETS. Occupational exposure to ETS is widespread, with an estimated 7.5 million workers in the EU and 1.3 million workers in the UK exposed to ETS for at least 75% of their working time. Many are employed in the hospitality industry on a casual basis in bars, pubs, restaurants, hotels, and nightclubs. Studies have shown high ETS marker concentrations levels in a range of hospitality settings. 7