Objectives The purpose of this study was to determine whether workplace smoking policy was associated with respiratory health effects among food and beverage servers.

Methods Data were obtained from a postal survey of hospitality workers. The participation rate for the questionnaire was 73.9% of those contacted. Current smokers were excluded from the analysis. Adjustment for differences between groups in age, gender, ex-smoker versus never smoker status, home exposure environmental tobacco smoke, childhood asthma, mail versus telephone questionnaire, and hours worked per week was done using logistic regression. A subset of 88 nonsmokers underwent laboratory evaluation, including spirometry and hair nicotine analysis.

Results The prevalence of irritant and respiratory symptoms among 383 nonsmokers was consistently higher among the participants from premises where smoking was permitted without restrictions on the workplace. In comparison with those from facilities where smoking was prohibited, the highest adjusted odds ratios (OR) were for chronic phlegm for those working where smoking was permitted (OR 8.5 95% confidence interval (95% CI) 2.4–30.0] or where there were partial smoking restrictions (OR 5.7 95% CI 1.7–19.4). Lung function was not reduced apart from the ratio between forced expiratory volume in 1 second and forced vital capacity, which was lower for workers from facilities where smoking was permitted. Hair nicotine levels were lowest for workers from facilities where smoking was prohibited.

Conclusions The results suggest that occupational exposure to environmental tobacco smoke, determined through smoking policies, can adversely affect the respiratory health of nonsmokers who work in the food and beverage service industry.

Key terms beverage server; environmental tobacco smoke; food server; hair nicotine; hospitality industry; lung function; respiratory health; respiratory symptom; smoking; smoking policy