Background:
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 (SHS) exposure in outdoor hospitality venues.

Methods:
An observational study was conducted in Madrid city. We collected information, through direct observation, on signs of tobacco consumption on entrances and terraces of hospitality venues. We also measured airborne nicotine in terraces with a monitor by active sampling during 30 minutes. We calculated the medians and the interquartile ranges (IQR) of nicotine concentrations. We computed an analysis stratified by the possible explanatory variables and compared the nicotine concentration using the Kruskal-Wallis test for independent samples.

Results:
We characterized 256 entrances of hospitality venues, 174 measured between May and September 2016 (hot season) and 82 between October and December 2016 (mild season). 204 entrances showed signs of tobacco consumption: 97 had ashtrays; 166 had cigarettes butts; in 66, tobacco smell was perceived; and, in 67 entrances, smokers were observed. There were no differences in signs of tobacco consumption observed between seasons (p=0.155). We measured nicotine concentration in 92 terraces with an overall median of 0.42 μg/m³ (IQR: 0.14-1.59 μg/m³). Nicotine concentration in terraces increased with number of cigarettes smoked from 0.03 μg/m³ (IQR: 0.03-0.91 μg/m³) when no cigarette was litten to 3.83 μg/m³ (0.97-4.70 μg/m³) when more than eight cigarettes were lighted (p = 0.001). We observed differences in nicotine concentration according to the number of covers from 0.37 μg/m³ (IQR: 0.15-1.59 μg/m³) in terraces with no cover to 2.40 μg/m³ (IQR: 0.64-13.36 μg/m³) on closed terraces (p=0.006).

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