key: cord-0934420-bhbrrwa3
authors: Teixeira da Silva, Jaime A.
title: Rethinking spitting in public spaces in the light of COVID-19 transmission through saliva
date: 2021-06-19
journal: Public Health
DOI: 10.1016/j.puhe.2021.06.008
sha: 6dbf24cf1fa6f97981f3b2cdec7f47b9d6a59991
doc_id: 934420
cord_uid: bhbrrwa3

nan

In this day and age, it is likely incorrect to assign a habit, such as spitting, to a specific culture, country 4 or population. At the end of the 19 th and early 20 th centuries, anti-spitting legislation was passed in several parts of the US to protect the public against the spread of tuberculosis, even though the 6 effectiveness of anti-spitting laws on reducing tuberculosis transmission was unknown or unproved, 7 and was most likely introduced as a measure to increase social civility. 1 Thus, there is a precedent of 8 associating spitting with the transmission of disease, even if the link is unclear.

Although spitting has been viewed as both an acceptable and an unacceptable habit from the 10 perspective of Eastern versus Western societies sensu lato, 2 in this letter, spitting habit and culture 11 will not be associated. Even in cultures or societies where spitting might be perceived as 'acceptable',

there are likely to be individuals who do not agree with, or repudiate, this habit, and even in cultures or 13 societies where spitting might be perceived as 'unacceptable', there are likely to be individuals who 14 agree with, or do not repudiate, this habit. Therefore, spitting will be considered as a personal choice 15 in this letter to simplify the complexities of attempting to assign influence by culture or society on this 16 habit. Furthermore, spitting in private spaces (e.g. in homes) is not considered and the discussion is 17 limited to public spaces. 

Spitting has been associated with hostility, disrespect, disdain, and even compensatory behaviour or 39 pleasure, but pathological spitting is difficult to control, so the use of fines for spitting in public might 40 not be a sufficiently strong deterrent. A greater understanding of the psychology of spitting, and wider 41 public health awareness and research is needed, especially given the risk of transmission of the SARS-

Spitting is dangerous, indecent, and against the law!" legislating health behavior 2020

Saliva: potential diagnostic value and transmission of 2019-nCoV

Saliva -friend and foe in the COVID-19 outbreak

Persistence of coronaviruses on inanimate surfaces 68 and their inactivation with biocidal agents

Temporal profiles of viral load in posterior oropharyngeal saliva samples and serum 71 antibody responses during infection by SARS-CoV-2: an observational cohort study

Clinical evaluation of self-collected saliva by quantitative reverse 74 transcription-PCR (RT-qPCR), direct RT-qPCR, reverse transcription-loop-mediated isothermal 75 amplification, and a rapid antigen test to diagnose COVID-19