Secondhand Smoke Research
SHELT (Secondhand Smoke Exposure and Legislation in Turkey)
Turkey extended its smoke-free tobacco legislation to hospitality venues in July 2009. To comprehensively evaluate compliance with the legislation, we are using a mixed-method approach in 12 cities, including observations, exposure assessment based on particulate matter (PM2.5), and surveys with key informants. We aim to characterize and understand challenges in the implementation of the smoke-free laws. We work in partnership with Turkish investigators and are actively engaged in dissemination activities with the ultimate goal of protecting all people from exposure to secondhand smoke in public places.
Tobacco research and control efforts have generally focused on cigarettes. Waterpipe cafes and waterpipe tobacco smoking (also called hookah, nargile, shisha) have been growing in popularity in the United States and worldwide, particularly with young adults.
Informed by our preliminary findings in Baltimore, Maryland, we conducted cross-sectional surveys of water pipe venues and their employees in Istanbul, Turkey, Moscow, Russia, and Cairo, Egypt. We comprehensively assess secondhand smoke exposure in these venues by measuring ambient concentrations of nicotine, nicotine-derived nitrosamine ketone (NNK), carbon monoxide, PM2.5, and polycyclic aromatic hydrocarbons (PAHs). Hair, saliva, urine, and exhaled breath specimens were collected from employees to measure nicotine, cotinine, nicotine-derived nitrosamine alcohol (NNAL), carbon monoxide, and 1-hydroxpyrene (1-OHPG).
Our study will inform on waterpipe-related toxicant concentrations in real world settings and support policy interventions aiming to protect workers and customers from exposure to secondhand smoke.
Designated smoking rooms, lounges and other indoor smoking areas still exist in major airports around the world. Moreover, smoking in outdoor areas near entrances represents a major source of exposure for travelers and workers, including flight attendants. Funded by the Flight Attendant Medical Research Institute, we have conducted interviews with flight attendants, reviews of airport smoke-free policies around the world, and observations and nicotine-based exposure assessment across major airports in Europe and the United States. In our ongoing research we are conducting key informant interviews with flight attendants and planning a biomarker based exposure assessment to characterize ongoing exposure to secondhand smoke among flight attendants who regularly service international flights.
E-cigarettes are becoming increasingly popular in the US and other countries. Our objectives are to characterize opportunities for exposure, e.g. in air transit, and identify the major toxicants of concern in secondhand vapor.