Introduction:
Aim: Exposure to second-hand smoke (SHS) has serious adverse health effects, causing more than 600,000 deaths among non-smokers each year worldwide. Following the recommendations of the World Health Organization, most European countries adopted -more or less comprehensive- smoke-free legislations. Our aim was to quantify SHS exposure among non-smokers in selected European countries.

Material and Methods:
Within the TackSHS project, we are conducting a face-to-face survey, including information on exposure to SHS in selected private and public indoor places, and outdoor places. The fieldwork has already been conducted in Italy in December 2016 on a representative sample of 1059 Italians aged ≥15 years, and will soon be conducted in other 11 European countries (i.e., Bulgaria, England, France, Germany, Greece, Ireland, Latvia, Poland, Portugal, Romania, and Spain).

Results:
In Italy, 81% of survey participants were non-smokers (n=859). Of these, 27% were daily exposed to SHS in indoor places for a median time of 2 hours/day.The proportion of non-smokers reporting to have seen people smoking in indoor public settings was 23% in restaurants, 20% in indoor train stations or subway stops and 17% in disco clubs, and was 20% in private vehicles without minors, and 14% in presence of minors. A high proportion of non-smokers reported to have seen people smoking in various outdoor settings, including beaches (79%), outdoor areas of hospitals (71%) or schools (58%), and parks (68%).

Conclusions:
More than one out of four Italian non-smokers is daily exposed to SHS. We recognize the dramatic fall in SHS exposure thanks to the comprehensive Italian smoke-free legislation adopted more than 10 years ago. This notwithstanding, it is still not rare to observe people smoking in violation of the current legislation in Italy. Data from other 11 European countries with different smoke-free policies will allow cross-country comparisons.

Funding:
This work is funded by the European Union’s Horizon 2020 Research and Innovation Programme (The TackSHS Project; grant agreement: 681040)