Introduction:
After the implementation of smoke-free policies in indoor hospitality venues, smokers may have displaced to their outdoor areas. Authors aimed to describe smoking visibility and second-hand smoke exposure in outdoor hospitality venues.

Methods:
An observational study was conducted in Madrid city, Spain, in 2016. We collected information on signs of tobacco consumption on entrances and terraces of hospitality venues. We also measured vapor-phase nicotine and particulate matter 2.5 (PM2.5) in terraces with monitors by active sampling during 30 minutes. We calculated the medians and the interquartile ranges (IQR) of nicotine and PM2.5 concentrations, and computed multivariate analysis to characterize their determinants.

Results:
We characterized 174 outdoor main entrances of hospitality venues between May and September 2016. We found signs of tobacco consumption on 80.5% of the entrances. We repeated measures in 57 entrances between November and December 2016 with no differences in signs of tobacco consumption observed between seasons (p=1.00). We measured nicotine and PM2.5 concentrations in 92 outdoor terraces with an overall median of 0.42 μg/m3 (IQR: 0.14-1.59 μg/m3), and 10.40 μg/m3 (IQR: 6.76-15.47 μg/m3), respectively. The multivariate analysis showed that both nicotine and PM2.5 concentrations increased when the terraces were completely closed, and when there were tobacco smell. Nicotine concentrations also increased with the presence of cigarettes butts, and when there were more than eight lit cigarettes.

Conclusions:
Outdoor hospitality venues are areas where non-smoking population continues to be exposed to second-hand smoke. These spaces should be considered in future tobacco control interventions.

Funding:
This work was supported by the Instituto de Salud Carlos III, Subdirección General de Evaluación y Fomento de la Investigación, Government of Spain (PI15/02146). The Heart Healthy Hoods project was funded by the European Research Council under the European Union’s Seventh Framework Programme (FP7/2007– 2013/ERC Starting Grant HeartHealthyHoods Agreement no. 623 336893). The funding sources have not any involvement in the study design; in the collection, analysis, or interpretation of data; in the writing of this work; or in the decision to submit the manuscript for publication.