Is a Review of the Current Smoke-Free Legislation and Guidance Required in the United Kingdom? Considering Smoking Shelters Design, Planning Requirements and Smoke-Free Legislation Enforcement

Perspectives in Public Health, July 2017 | Go to article overview

Is a Review of the Current Smoke-Free Legislation and Guidance Required in the United Kingdom? Considering Smoking Shelters Design, Planning Requirements and Smoke-Free Legislation Enforcement


Smoke-Free legislation came into practice in the United Kingdom in 2007; however, since then there has been a rise in the number of shisha premises. In this article, Gam Gurung, Janet Bradley and Juana Maria Delgado-Saborit of the University of Birmingham and Environmental Health, Birmingham City Council, consider the potential public health harms of shisha smoking in confined spaces.

In the United Kingdom, the Smoke-Free regulations described in the Health Act 2006[1] prohibit smoking activities in all enclosed and substantially enclosed work and public places. Shisha business premises, whose business model is to sell smoking activities to patrons, are covered by this legislation. To comply, shisha must be smoked outdoors in open air conditions, or within shelters which are 50% open to the air, at all times.

Since the Smoke-Free legislation came into effect on 1 July 2007 in England, shisha premises have risen in number by 360%, with at least 600 known shisha cafes registered in January 2016 in the United Kingdom,[2] representing an increase in popularity of smoking shisha.[3] In the United Kingdom, shisha smoking has become more prevalent in the major cities, both among non-smokers and regular (cigarette) smokers, men and women, and particularly among students of various cultural and ethnic groups.[4]

Due to observations of poor air quality within shisha premises, and therefore the potential harmful exposures and associated health consequences to owners, employees and shisha smoking and non-smoking customers, the local authority of Birmingham, that is, Birmingham City Council (BCC), in collaboration with the University of Birmingham, has assessed the public health situation by evaluating the extent of shisha environmental tobacco smoke exposure among those who work in and are customers of shisha businesses.

The results of this research, which have been published in the peer reviewed journal Science of the Total Environment,[5] shows that the customers and employees within shisha premises are exposed to consistently elevated concentrations of PM2.5 (i.e. very small particulate matter), and carbon monoxide (CO), a known toxic gas, independently of whether they are smoking shisha or not. The high concentrations measured inside shisha premises might pose a health risk for those working or socialising inside the shisha premises.[6]-[8] The number of active shisha pipes and charcoal burning procedures has been significantly associated with high concentrations of these pollutants inside the shisha premises.

Equally important, concentrations of PM2.5 in the vicinity of shisha premises have been directly linked with the concentrations measured inside the premises, highlighting shisha bars as a potential source of air pollution. …

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