Thirdhand Smoke: State of the Science and a Call for Policy Expansion

Northrup, Thomas F.; Jacob, Peyton; Benowitz, Neal L.; Hoh, Eunha; Quintana, Penelope J.E.; Hovell, Melbourne F.; Matt, Georg E.; Stotts, Angela L.

doi:10.1177/003335491613100206

Cited by 50 publications

(40 citation statements)

References 61 publications

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“…It may be important to implement hospital policies and interventions to reduce THS exposure, even ahead of collection of causal data, given the potential risks for NICU patients. Extending smoke-free policy definitions to include THS could have the added benefit to hasten the elimination of SHS in other environments 31 47What this paper adds

Thirdhand smoke (THS) contamination is unexplored in non-smoking, protected medical environments visited by smokers.

THS is estimated to take weeks to months to degrade in controlled environments.

Infants cared for during extended stays in neonatal intensive care units (NICUs) are protected from secondhand smoke, but exposure to THS is unknown.

This study demonstrated that THS is deposited in rooms of NICU infants visited by smokers.

Data showed that NICU infants are exposed to nicotine and nicotine-derived, tobacco-specific carcinogens, raising the possibility of exposure due to THS re-emission in the NICU.

These data justify more formal research documenting acute and cumulative THS exposure, sources of exposure, means of prevention and associations with morbidity/mortality for NICU infants.

…”

Section: Resultsmentioning

confidence: 97%

Thirdhand smoke contamination in hospital settings: assessing exposure risk for vulnerable paediatric patients: Table 1

et al. 2015

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Background Tobacco has regained the status of the world’s number two killer behind heart/vascular disease. Thirdhand smoke (THS) residue and particles from secondhand smoke (SHS) are a suspected health hazard (e.g., DNA damage) that likely contributes to morbidity and mortality, especially in vulnerable children. THS is easily transported and deposited indoors where it persists and exposes individuals for months, creating potential health consequences in seemingly nicotine-free environments, particularly for vulnerable patients. We collected THS data to estimate infant exposure in the neonatal ICU (NICU) after visits from household smokers. Infant exposure to nicotine, potentially from THS, was assessed via assays of infant urine. Methods Participants were mothers who smoked and had an infant in the NICU (N=5). Participants provided surface nicotine samples of their fingers, infants’ crib/incubator, and hospital-provided furniture. Infant urine was analyzed for cotinine, cotinine’s major metabolite: trans-3′-hydroxycotinine (3HC), and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), a metabolite of the nicotine-derived and tobacco-specific carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK). Results Incubators/cribs and other furniture had detectable surface nicotine. Detectable levels of cotinine, 3HC, and NNAL were found in the infants’ urine. Discussion THS appears to be ubiquitous, even in closely guarded healthcare settings. Future research will address potential health consequences and THS-reduction policies. Ultimately hospital policies and interventions to reduce THS transport and exposure may prove necessary, especially for immunocompromised children.

show abstract

Thirdhand smoke (THS) contamination is unexplored in non-smoking, protected medical environments visited by smokers.

THS is estimated to take weeks to months to degrade in controlled environments.

Infants cared for during extended stays in neonatal intensive care units (NICUs) are protected from secondhand smoke, but exposure to THS is unknown.

This study demonstrated that THS is deposited in rooms of NICU infants visited by smokers.

Data showed that NICU infants are exposed to nicotine and nicotine-derived, tobacco-specific carcinogens, raising the possibility of exposure due to THS re-emission in the NICU.

These data justify more formal research documenting acute and cumulative THS exposure, sources of exposure, means of prevention and associations with morbidity/mortality for NICU infants.

…”

Section: Resultsmentioning

confidence: 97%

Thirdhand smoke contamination in hospital settings: assessing exposure risk for vulnerable paediatric patients: Table 1

et al. 2015

Self Cite

View full text Add to dashboard Cite

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Section: Discussionmentioning

confidence: 99%

“…8 Although unexamined, there is concern that THS may be more toxic than SHS, given that THS includes novel pollutants not found in SHS, has multiple exposure routes and has a much longer duration of exposure. [9][10][11][12] The positive partial association between nicotine and cotinine indicates that, independent of age, hand nicotine can serve as a marker of OTS. The exposure may be through SHS or THS that accumulated in dust, on objects and on surfaces of the children's environments.…”

Section: Discussionmentioning

confidence: 99%

Preliminary evidence that high levels of nicotine on children’s hands may contribute to overall tobacco smoke exposure

2017

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Background Dust and surfaces are important sources of lead and pesticide exposure in young children. The purpose of this pilot study was to investigate if third-hand smoke (THS) pollutants accumulate on the hands of children who live in environments where tobacco is used and if hand nicotine levels are associated with second-hand smoke (SHS), as measured by salivary cotinine. Methods Participants were parents and children (n=25; age mean (SD)=5.4 (5.3) years) presenting to the emergency department with a potentially SHS-related illness. A convenience sample of participants were recruited at baseline from an ongoing two-group, randomised controlled trial of a SHS reduction and tobacco cessation intervention. Parents were current smokers; thus, all children were at risk of SHS and THS exposure to varying extents. Primary outcome measures, which were assessed in child participants only, were hand nicotine and salivary cotinine. Parents reported sociodemographics and smoking patterns; children’s medical records were abstracted for chief complaint, medical history and discharge diagnosis. Results All children had detectable hand nicotine (range=18.3–690.9 ng/wipe). All but one had detectable cotinine (range=1.2–28.8 ng/mL). Multiple linear regression results showed a significant positive association between hand nicotine and cotinine (p=0.009; semipartial r2=0.24), independent of child age. Discussion The higher-than-expected nicotine levels and significant association with cotinine indicate that THS may play a role in the overall exposure of young children to tobacco smoke toxicants and that hand wipes could be a useful marker of overall tobacco smoke pollution and a proxy for exposure.

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“…Smoking cessation programs and anti-smoking campaigns should emphasize that recent evidence on the health hazards of first-, second-and third-hand tobacco smoking. [36][37][38][39][40][41] The findings showed that former smokers less agreed than never smokers to ban smoking in restaurants. The dependency on nicotine that was experienced by former smokers may have contributed to that lenient attitude toward enforcing smoking banning.…”

Section: Discussionmentioning

confidence: 96%

Tobacco smoking among nursing students in Saudi Arabia: A descriptive correlational study

Raddaha

Al-Sabeely

Mohamed

et al. 2017

JNEP

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Background and objectives: Tobacco smoking is a global epidemic and health threat that continues to increase. Nursing students primarily develop their professional roles toward smoking cessation during their academic nursing education. We assessed prevalence and behavioral patterns of tobacco smoking among nursing students. Along with nature of education received on tobacco smoking cessation, we sought to explore their knowledge, attitudes and beliefs toward tobacco smoking. Methods: Using convenience sampling, a descriptive correlational research design was used. Subjects were undergraduate students from a public university located in Alriyadh, the capital of Saudi Arabia. A standardized self-administered questionnaire, the Global Health Professional Student Survey, was utilized. Results: Eighty-four percent reported not smoking tobacco throughout their lifetime (i.e., never smokers), while the remaining were former smokers. Although 11.7% indicated that they had received formal training on tobacco-smoking cessation, more former smokers reported receiving such formal training than never smokers (25% vs. 9.3%, χ 2 = 4.04, df = 1, p = .04). Students who were in third year of program, who thought that a smoker who quits smoking tobacco products would avoid/decrease serious health problems, and who stated that tobacco smoking never been allowed inside their living homes while children were present were more likely be never smokers. Conclusions: Adding training modules on smoking cessation to undergraduate nursing program curricula is highly suggested. Considering our unique findings on the effect of smoking status on the attitudes and beliefs toward smoking among nursing students when planning and implementing training modules seems beneficial. Future research is recommended to explore the lived experiences and consequences of smoking behavior among former smokers group.

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Thirdhand Smoke: State of the Science and a Call for Policy Expansion

Cited by 50 publications

References 61 publications

Thirdhand smoke contamination in hospital settings: assessing exposure risk for vulnerable paediatric patients: Table 1

Thirdhand smoke contamination in hospital settings: assessing exposure risk for vulnerable paediatric patients: Table 1

Preliminary evidence that high levels of nicotine on children’s hands may contribute to overall tobacco smoke exposure

Tobacco smoking among nursing students in Saudi Arabia: A descriptive correlational study

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