No ifs no butts – smoking research to reform apartment laws

Jan 14 2014

By Associate Professor Billie Bonevski

As a medical researcher it’s a great feeling to see the NSW Government responding to our study of second-hand smoke (SHS) exposure in multi-unit dwellings, with bans on smoking in building common areas set to be enacted this year.

SHS has been classified by international agencies as a known carcinogen and our data gives good, solid evidence that there is a significant problem in apartment blocks.

Currently there are more than 72,000 strata schemes in NSW, and within 20 years it’s predicted that half of the State’s population will be living or working in a strata or community scheme.

I’d love to take credit for conceiving the study (Smoky homes: Gender, socioeconomic and housing disparities in second hand tobacco smoke (SHS) exposure in a large population-based Australian cohort) but it resulted from an approach by Anne Jones OAM, former CEO of the ASH Australia health group, who was lobbying the Government to reform Strata laws.

Anecdotal evidence showed high levels of exposure but in Australia there was no reliable data. We turned to the NSW 45 and Up Study, a large cohort study with 266,848 adults, of which 160,824 participants aged 45 to 65 years were used.

Associations between socio-demographic characteristics, smoking status, housing-type and exposure to SHS were explored.

We found that more than 12,000 participants, including over 8,000 non-smokers, were routinely exposed to smoke in their homes for eight hours or more per week. Around 7,000 were exposed for at least eight hours per day.

Women reported high rates of exposure at home whereas men reported higher exposure at other places, mostly workplaces. Women generally do spend more time at home and that combined with social disadvantage puts them at increased risk.

For men, they tend to be in workplaces that perhaps don’t adhere to smoking policies as well as they should. We’ve found in some workplace-based studies that ‘smokos’ are still scheduled into the day’s program.

We tend to think of Australia as a mostly non-smoking society with a lot of existing restrictions on smoking in public places, so I was somewhat surprised by the number of people reporting exposure to SHS.

General trends however show that smoking rates are higher among those with lower education attainment, lower income and living in postcode areas classified as lower socio-economic status. In some cases it is as high as 90 per cent.

With a lot of Government-subsidised buildings being occupied by those from lower socio-economic groups, the non-smoking residents are really at high risk of being exposed to a toxic, carcinogenic nicotine drift.

About 10,000 participants reported having children still living in the house with them, and it’s known that kids who grow up in households with smokers, or the presence of smoke, have higher risks of respiratory diseases as well as cancer and heart disease.

Smoking take-up rates are increased and it also makes it harder for people to quit. Smoking is seen as the norm.

This is really important because international research shows how nicotine travels through buildings via elevator shafts, stairwells, air ducts and air-conditioning systems. They have found high concentrations of nicotine in units even where there are no smokers residing.

Improved monitoring of SHS exposure in high risk environments is required. Tailoring SHS messages to environments may also be needed, for example to women living in units, apartments and mobile homes and males in lower income workplaces.

The US Surgeon General has concluded that “there is no safe level of exposure to SHS, and even brief exposure can affect both children and adults” so for our study results to be taken up by NSW policy makers is the reason we do what we do.

I’d love to see this new legislation extended to other jurisdictions across Australia as well.

* Associate Professor Billie Bonevski from the University of Newcastle is a member of HMRI’s Public Health and Brain and Mental Health research programs. HMRI is a partnership between the University of Newcastle, Hunter New England Health and the community.