1. SMOKE-FREE ENVIRONMENT: PROTECTION FROM EXPOSURE TO SECOND-HAND SMOKE SMOKE-FREE ENVIRONMENT: PROTECTION FROM EXPOSURE TO SECOND-HAND SMOKE

3. Source: Ott, W., Total human exposure. Environ Sci Technol, 1985. 19(10): p. 880-886 AND Ott W. Exposure Analysis: A Receptor-Oriented Science. In: Ott WR, Steinemann AC, Wallace LA, editors. Exposure Analysis. Boca Raton: Taylor & Francis; 2007. p. 3- 32. Movement of the Particle Source ExposureDoseEffects

4. 3 groups: (1)Smokers (who may also be passive smokers at the same time) (2)Passive smokers are non-smokers themselves but are exposed to tobacco smoke at home or in the workplace. (3) Non-smokers are not exposed to tobacco smoke either at home or at workplace. 3 groups: (1)Smokers (who may also be passive smokers at the same time) (2)Passive smokers are non-smokers themselves but are exposed to tobacco smoke at home or in the workplace. (3) Non-smokers are not exposed to tobacco smoke either at home or at workplace.

6. According to a study from Basel, Switzerland : 34% to 46% contribution to passive smokingWorkplaces where smoking is permitted make 34% to 46% contribution to passive smoking; smoke 18 cigarette equivalents/yearHeavily TS-exposed housewives potentially smoke 18 cigarette equivalents/year; smoke 61 cigarette equivalents/yearWorkers who are heavily exposed to TS in the workplace and at home potentially smoke 61 cigarette equivalents/year;

7. HUMAN HAIR 2.5µm particle CIGARETTE SMOKE PARTICLE

8. INDOOR AIR QUALITY IN 32 COUNTRIES AROUND THE WORLD INDOOR AIR QUALITY IN 32 COUNTRIES AROUND THE WORLD Levels of indoor air pollution in 2,531 locations in 32 countries. Global Air Monitoring Study TSI SidePak AM510 Personal Aerosol Monitor was used to measure PM2.5 On average, smoke-free laws result in an 8-fold reduction in the levels of indoor air pollution

9. Outdoors on busy Bangkok streets Restaurant with smoking

10. * Implemented comprehensive smokefree laws.

11. US EPA Air Quality Index Air Quality Air Quality Index PM 2.5 (  g/m 3 ) Health Advisory Good0-50≤15None. Moderate51-10016-40 Unusually sensitive people should consider reducing prolonged or heavy exertion. Unhealthy for Sensitive Groups 101-15041-65 People with heart or lung disease, older adults, and children should reduce prolonged or heavy exertion. Unhealthy151-20066-150 People with heart or lung disease, older adults, and children should avoid prolonged or heavy exertion. Everyone else should reduce prolonged or heavy exertion. Very Unhealthy 201-300151-250 People with heart or lung disease, older adults, and children should avoid all physical activity outdoors. Everyone else should avoid prolonged or heavy exertion. Hazardous≥301≥251 People with heart or lung disease, older adults, and children should remain indoors and keep activity levels low. Everyone else should avoid all physical activity outdoors.

12. Geometrix mean PM2.5 Types of venues2006 (µg/m 3 )2009 (µg/m 3 ) Discotheque270504 Pub & Bar225320 Air-conditioned restaurant 74105

13. Quickly reduce air pollution In bars and restaurant in Ireland after the smoking ban: Reduce by 83% level of fine particulates Reduce by 83% nicotine contents Reduce CO by 45%

14. Smoking section does not protect non-smokers ???

15. NEITHER DOES THIS?

16. ANALOGY

17. ASHRAE Statement, 2005 “At present, the only means of effectively eliminating the health risk associated with indoor exposure is to ban smoking activity.” “Because of AHSRAE’s mission to act for the benefit of the public, it encourages elimination of smoking in the indoor environment as the optimal way to minimize ETS exposure.” - American Society of Heating, Refrigerating, and Air Conditioning Engineers, from its 2005 position document on environmental tobacco smoke (SHS)

18. There is NO SAFE LEVEL of exposure to tobacco smoke and scientists have concluded that elimination of the source of the smoke is the ONLY scientifically-proven way to protect the health of nonsmokers. This means 100% smoke-free environments indoors.

19. Ireland: reduce 16.7% respiratory symptoms after one year California: reduce 59% respiratory symptoms after three months In Colorado USA and Piedmont Italy: reduce 20% hospitals admission due to heart attacks after smoking ban Improve health of workers and public

20. Reduce consumption and increase quit rate World Bank: SFE reduce consumption by 4-10% Summary of studies conducted in Australia, USA, Canada, Germany: –Reduce 3.1 cigarettes/day –Increase quitting by 3.8%.

21. SFE reduce up-take by children On average implementation of SFE help: –Reduce taking up by 17% –Reduce youth tobacco consumption by 50% Motivate implementation of smoke-free homes: –Help reduce youth taking up by 1/4

22. Other benefits of SFE 1.Increase productivity, 2.Reduce medical costs 3.Reduce insurance costs, 4.Reduce building maintenance costs 5.Improve image of the workplaces

23. Support for comprehensive smoking bans in bars and restaurants after implementation

25. Dr. Gro Harlem Brundtland, Director-General, World Health Organisation 1998-2003 "If we do not act decisively, a hundred years from now our grandchildren and their children will look back and seriously question how people claiming to be committed to public health and social justice allowed the tobacco epidemic to unfold unchecked."

26.  4 out of every 5 non-smokers support smoke free laws in work place and restorans  3 out of 5 smokers also support such law From Malaysia’s ITC Study  4 out of every 5 non-smokers support smoke free laws in work place and restorans  3 out of 5 smokers also support such law From Malaysia’s ITC Study

28. JAYA JUSCO SETIAWANGSA

29. Smoke-free in other countries

30. Davao City (Mindanao), Philipines Luang Prabang, Laos PDR Smoke-free in Southeast Asia Smoke-free in Southeast Asia

31. This effort is showing the Penang State Government’s obligation to protect the health of its people, both smokers and non-smokers. THANK YOU FOR NOT SMOKING!!