Air Quality, Child, and Adult Health in Homes where Hookahs are Smoked

项目摘要 吸烟和接触二手烟（SHS）是导致吸烟的主要可预防原因。 在美国和世界范围内的发病率和死亡率。没有安全的烟草烟雾暴露水平。短短 4年，从2009年到2012年（最新数据），18-24岁的美国人吸烟 (the最有可能吸食香烟或水烟的年龄组别）则减少8.4%至5，254，500人。形成鲜明 相比之下，水烟（例如水管）的使用在过去30天内增加了142%， 5,745,690.这突出表明，水烟使用的增长速度远远超过香烟使用的下降速度， 使得该年龄组中水烟使用者的数量现在大于香烟使用者的数量。 如果目前的趋势持续下去，美国整个年龄段的水烟吸烟者人数将增加。 大大增加。这导致了广泛的公共卫生问题，水烟的使用可能会消除大多数或 在过去60年里，烟草使用量大幅下降。 在拟议的研究中，我们关注水烟，因为它们是最广泛采用的替代品 烟草制品（ATP）。关于其对家庭环境空气质量的影响的数据非常缺乏， 暴露于主流的个人的健康，例如实际吸烟产生的烟雾，以及 这样的家。与此形成鲜明对比的是， 香烟我们和其他人已经证明了水烟吧的室内空气质量非常差， 颗粒物、黑碳和有机碳、一氧化碳、尼古丁和多种 关注的微量元素。一个相关的，但仍然是初步的研究文献正在出现，显示急性 以及主动和被动暴露于水烟烟雾的长期负面后果。疾控中心药监局 和美国肺脏协会都对水烟的使用表示严重关切， 卫生局局长指出，儿童最重要的环境烟草烟雾暴露 发生在家里。 拟议的研究将调查家庭环境空气质量的潜在有害变化 在吸水烟的地方，以及居住在那里的儿童和成人的健康的某些方面， 家庭，其中水烟发生，并比较结果的空气质量和健康的那些生活在 没有水烟的家庭。我们假设，环境空气质量是在家庭中的精神上改变 在吸水烟的地方，吸入这种水烟产生的SHS导致 对这些家庭的居民的肺和心血管产生不利影响。 这项研究的结果可能具有非常重要的研究，临床和政策意义 通过加强对这一极其重要但目前研究不足的领域的了解， 在美国应用最广泛、增长最快的ATP。

PROJECT SUMMARY Tobacco use and exposure to secondhand smoke (SHS) are the leading preventable causes of morbidity and mortality in the US and worldwide. There is no safe level of tobacco smoke exposure. In just 4 years, from 2009 to 2012 (the most recent data available), cigarette use among US individuals aged 18-24 (the age group most likely to use cigarettes or hookahs) decreased by 8.4% to 5,254,500. In marked contrast, hookah (e.g. waterpipe) use in the last 30 days increased 142% in the same time period, to 5,745,690. This highlights that hookah use is increasing at a far greater rate than cigarette use is declining, such that the number of hookah users in this age group is now greater than the number of cigarette users. Should current trends persist, the number of hookah smokers across the entire age spectrum in the US will increase greatly. This has led to widespread public health concern that hookah use may eradicate most or all of the profound decrease in tobacco use achieved over the past 60 years. In the proposed study, we focus on hookahs, as they have been the most widely adopted alternative tobacco product (ATP). There is a profound paucity of data on its effect on household ambient air quality and the health of individuals exposed to mainstream, e.g. smoke derived from actually smoking, and SHS in such homes. This contrasts markedly with the extensive knowledge base on related issues concerning cigarettes. We and others have demonstrated markedly poor indoor air quality in hookah bars, with significant elevations in particulate matter, black and organic carbon, carbon monoxide, nicotine and multiple trace elements of concern. A related but still rudimentary research literature is emerging showing both acute and long term negative consequences of active and passive exposure to hookah smoke. The CDC, FDA, and the American Lung Association each has expressed grave concerns about hookah use and The Surgeon General has noted that the most important environmental tobacco smoke exposure for children occurs in the home. The proposed study will investigate potential deleterious alterations in ambient air quality in homes where hookahs are smoked, and selected aspects of the health of both children and adults residing in homes where hookah smoking occurs, and compare results to the air quality and health for those living in homes without hookah smoking. We hypothesize that ambient air quality is detrimentally altered in homes where hookahs are smoked, and that inhalation of SHS generated by such hookah smoking results in adverse pulmonary and cardiovascular effects in residents of such homes. Findings from this study will likely have very significant research, clinical and policy implications by enhancing understanding of this profoundly important and currently understudied area concerning the most widely adopted and fastest growing ATP in the US.