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

项目总结 烟草使用和接触二手烟(SHS)是可预防的主要原因 美国和世界各地的发病率和死亡率。烟草烟雾暴露的安全水平是不存在的。在短短的几分钟内 4年来，从2009年到2012年(可获得的最新数据)，18-24岁美国人的香烟使用情况 (最有可能使用香烟或水烟的年龄组)下降8.4%，至5254500人。在标记中 相比之下，过去30天使用水烟(如水烟)的人数在同一时期增加了142%，达到 5745690人。这突显了水烟使用的增长速度远远超过了香烟使用的下降速度， 使得这个年龄段的水烟使用者的数量现在超过了香烟使用者的数量。 如果目前的趋势持续下去，美国整个年龄段的水烟吸烟者数量将 大大增加了。这导致了公众广泛的健康担忧，即使用水烟可能会根除大多数或 所有这些都是过去60年来烟草使用量的大幅减少。 在这项拟议的研究中，我们将重点放在水烟上，因为它们是被最广泛采用的替代品 烟草制品(ATP)。关于它对家庭环境空气质量的影响的数据严重缺乏， 暴露在主流环境中的个人的健康，例如实际吸烟产生的烟雾，以及 这样的家。这与有关以下问题的广泛知识库形成了鲜明对比 香烟。我们和其他人已经证明，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 关注的痕量元素。一份相关但仍处于初级阶段的研究文献正在涌现，表明这两种疾病 以及主动和被动暴露在水烟中的长期负面后果。疾控中心，FDA， 美国肺脏协会都对水烟的使用和 卫生局局长指出，对儿童来说，最重要的环境烟草烟雾暴露 发生在家里。 这项拟议的研究将调查家庭环境空气质量的潜在有害变化。 在哪里抽水烟，以及居住在那里的儿童和成年人的健康状况 吸水烟的家庭，并将结果与居住在 没有水烟的家庭。我们假设家庭中的环境空气质量会受到有害的影响 吸食水烟的地方，吸入这种吸食水烟产生的SHS会导致 这类家庭的居民对肺部和心血管的不良影响。 这项研究的发现可能会有非常重要的研究、临床和政策意义 通过增进对这一极其重要且目前研究不足的领域的了解， 在美国被广泛采用和增长最快的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.