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Int. J. Environ. Res. Public Health 2016, 13(10), 952;

Children’s Exposure to Secondhand Smoke during Ramadan in Jakarta, Indonesia

Center for Indonesia’s Strategic Development Initiatives, Jakarta 10350, Indonesia
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
Center for Behavioral Epidemiology and Community Health, San Diego State University, San Diego, CA 92182, USA
Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, POB 39040, Ramat Aviv 69978, Israel
School of Public Health, Universitas Indonesia, Depok, West Java 16424, Indonesia
Center for Global Tobacco Control, Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
Author to whom correspondence should be addressed.
Academic Editors: Laura L. Jones and Amanda Farley
Received: 15 July 2016 / Revised: 19 September 2016 / Accepted: 20 September 2016 / Published: 26 September 2016
(This article belongs to the Special Issue Exposure and Health Effects of Secondhand Smoke)
Full-Text   |   PDF [444 KB, uploaded 26 September 2016]   |  


Secondhand smoke exposure (SHS) causes a disproportionate health burden for children, yet existing smoke-free laws are often poorly enforced. We monitored air quality while observing children and adult nonsmokers present in public venues during Ramadan, a period of Muslim religious observance marked by family and social gatherings, in Jakarta, Indonesia. A repeated-measures design was used to assess indoor air quality during and after Ramadan in 43 restaurants and in five smoke-free control venues. Fine particulate matter of 2.5 microns or less (PM2.5) was sampled. The average number of children and active smokers present in each venue was also observed. PM2.5 levels were significantly higher during Ramadan (mean 86.5 µg/m3) compared with post-Ramadan (mean 63.2 µg/m3) in smoking venues (p = 0.015). During Ramadan, there were more active smokers (p = 0.012) and children (p = 0.051) observed in venues where smoking occurred, compared with the same venues post-Ramadan. Poor enforcement of the smoke-free law in Jakarta has failed to protect children from SHS exposure in public venues during Ramadan. Collaboration between the government, NGOs (such as the Indonesian Cancer Foundation (YKI) and the Smoking Control Foundation (LM3)), religious leaders, and venue owners and managers must be developed to ensure that the comprehensive smoking bans apply to all venues, and that smoke-free laws are enforced. View Full-Text
Keywords: secondhand smoke; tobacco; children; policy; Indonesia; behavioral ecological model secondhand smoke; tobacco; children; policy; Indonesia; behavioral ecological model

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Luntungan, N.N.H.; Byron, M.J.; Hovell, M.F.; Rosen, L.J.; Anggraeni, A.; Rees, V.W. Children’s Exposure to Secondhand Smoke during Ramadan in Jakarta, Indonesia. Int. J. Environ. Res. Public Health 2016, 13, 952.

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