During a pilot study of indoor air quality in restaurants, a survey was performed in 34 medium-priced restaurants in six countries in Asia, Europe, and North America using a uniform protocol. The concentration of selected constituents of environmental tobacco smoke (ETS) present in occupied areas was determined during lunch and dinner periods by measuring the levels of four particulate-phase markers and two gas-phase markers. The particulate-phase markers determined were respirable suspended particles, ultraviolet particulate matter, fluorescing particulate matter, and solanesol particulate matter. The gas-phase markers were nicotine and 3-ethenylpyridine (3-EP). Correlation between the markers was investigated to explore an improved monitoring approach. It was concluded that at least one marker in each phase was necessary to describe adequately the ETS load. An assessment was made of the ventilation system in each restaurant, and effective ventilation rates were determined based on CO2 measurements. Smoking activity was also monitored. These data were used to model nicotine and 3-EP concentrations that resulted in a satisfactory prediction of their levels, especially at the higher concentrations. A total number of 1370 questionnaires were returned by the restaurant patrons in five countries. In some countries, dissatisfaction rates above 20% were observed for draft, freshness of air, and noise. The dissatisfaction rates related to tobacco smoke were less than 20%, which is lower than would be predicted based on measured ETS levels. Based on the results of this international pilot study, recommendations are given for future studies of this type.