Variability in the correlation between nicotine and PM2.5 as airborne markers of second-hand smoke exposure

Secondhand smoke exposure in public outdoor spaces in the Netherlands: The stronger the smell, the more exposure to nicotine

INTRODUCTION

While secondhand smoke exposure in outdoor spaces has been investigated before, no data on outdoor secondhand smoke exposure have been collected in the Netherlands. Such data could help policymakers gain support for smoke-free outdoor public spaces.

METHODS

Between May and November 2021, we visited 25 outdoor locations across the Netherlands. At each location, we conducted four measurements with smokers and one measurement without smokers. During each measurement, we counted the number of smokers present and we rated tobacco smell intensity on a five-point scale. Airborne nicotine and 3-ethenylpyridine (3-EP) data were collected through active sampling on thermal desorption tubes. The contents of these tubes were later analyzed using gas chromatography-mass spectrometry. Using linear mixed models, we investigated the association between levels of nicotine and the presence of smokers, the number of smokers, and the intensity of tobacco smell. We also investigated these association with levels of 3-EP.

RESULTS

Nicotine levels were higher when smokers were present (B=1.40; 95% CI: 0.69-2.11, p<0.001). For each additional smoker present, we measured higher levels of nicotine (B=0.23; 95% CI: 0.10-0.37, p=0.001). When the smell of tobacco smoke was noted to be stronger by the researchers, higher levels of nicotine were measured through sampling (B=0.85; 95% CI: 0.44-1.26, p<0.001). We found similar results for 3-EP levels.

CONCLUSIONS

This study showed that both nicotine and 3-EP are useful in quantifying levels of secondhand smoke in various outdoor locations. The level of nicotine exposure outdoors was positively associated with the number of smokers nearby. The intensity of the tobacco smell was also related to nicotine exposure: the stronger the smell of tobacco smoke, the more nicotine was measured in the air.

A new hybrid prediction model of air quality index based on secondary decomposition and improved kernel extreme learning machine

Air quality index (AQI) prediction is important to control air pollution. To improve its accuracy, a new hybrid prediction model of AQI based on complete ensemble empirical mode decomposition with adaptive noise (CEEMDAN), multivariate multiscale dispersion entropy (mvMDE), variational mode decomposition optimized by bald eagle search (BES) algorithm (BVMD) and kernel extreme learning machine optimized by rat swarm optimizer (RSO) algorithm (RSO-KELM), named CEEMDAN-mvMDE-BVMD-RSO-KELM, is proposed. Firstly, AQI series is decomposed by CEEMDAN to obtain multiple intrinsic mode function (IMF) components, and each IMF component's complexity is calculated by mvMDE. Secondly, VMD optimized by BES algorithm, named BVMD, is proposed to solve the problem of choosing the decomposition level K and penalty factor α of VMD, and BVMD is used to perform the secondary decomposition of high complexity components. Thirdly, the penalty coefficient and kernel parameter of KELM optimized by RSO algorithm, named RSO-KELM, is proposed, and all IMF components are predicted by RSO-KELM. Finally, the final prediction results are obtained by reconstructing the prediction results of all IMF components. The objective of this study is to propose a new hybrid prediction model of AQI based on secondary decomposition and improved KELM. Taking Shanghai, Beijing and Xi'an as examples, the results show that compared with the comparison models, the proposed model has the highest prediction accuracy.

Night entertainment venues comply poorly with the smoke-free law in Chile

The initial high level of compliance with the Chilean comprehensive national smoke-free law in 2013 is fading, particularly in the hospitality sector. This paper draws attention to how using a simple and low-cost surveillance inquiry may help focus on the use of scarce inspection resources to improve compliance with the law in the hospitality sector. We conducted a cross-sectional assessment of second-hand smoke exposure in night entertainment venues in Santiago, Chile, by measuring particulate matter of less than 2.5μm (PM_2.5). Smoking where prohibited by law was observed in 36% of the venues visited. Venues where smoking was spotted at the time of the observation had a median PM_2.5 concentration 13 times higher than background concentration on the street. The study shows that a targeted approach for inspection to find pockets of venues with suboptimal compliance is feasible and affordable.

Exposure to secondhand smoke in hospitality settings in Ghana: Evidence of changes since implementation of smoke-free legislation

INTRODUCTION

Ghana has a partial smoking ban with smoking allowed in designated smoking areas. Studies evaluating smoke-free laws are scarce in Sub-Saharan Africa. Evaluation of smoke-free laws is an effective means of measuring progress towards a smoke-free society. This study assessed the level of compliance to the provisions of the current smoke-free policy using air quality measurements for fine particulate matter (PM_2.5) in hospitality venues in Ghana.

METHODS

This was a cross-sectional observational study conducted in 2019 using a structured observational checklist complemented with air quality measurements using Dylos monitors across 152 randomly selected hospitality venues in three large cities in Ghana.

RESULTS

Smoking was observed in a third of the venues visited. The median indoor PM_2.5 concentration was 14.6 μg/m³ (range: 5.2-349). PM_2.5 concentrations were higher in venues where smoking was observed (28.3 μg/m³) compared to venues where smoking was not observed (12.3 μg/m³) (p<0.001). Hospitality locations in Accra, Ghana's capital city, had the lowest compliance levels (59.5%) and poorer air quality compared to the cities of Kumasi and Tamale.

CONCLUSIONS

The study shows that while smoking and SHS exposure continues in a substantial number of hospitality venues, there is a marked improvement in PM_2.5 concentrations compared to earlier studies in Ghana. There is still a considerable way to go to increase compliance with the law. Efforts are needed to develop an action plan to build upon recent progress in providing smoke-free public spaces in Ghana.

Cardiac Autonomic Effects of Secondhand Exposure to Nicotine from Electronic Cigarettes: An Exploratory Study

Background

The rapid increase in prevalence of e-cigarette (EC) use may lead to widespread exposure to secondhand emissions among nonsmokers, but evidence on the potential cardiovascular health risks is limited. We aimed to investigate effect of short-term secondhand exposure to nicotine from e-cigarette (EC) emissions on cardiac autonomic function using heart rate variability (HRV).

Methods

A randomized, repeated measures crossover study of healthy nonsmoking volunteers was conducted. Standard deviation of NN intervals (SDNN), average of the standard deviation of NN intervals (ASDNN), root mean square of successive differences (rMSSD), and heart rate-corrected QT interval (QTc) were calculated during one hour of EC exposure session.

Results

Nicotine from EC emissions was associated with a 7.8% decrease in SDNN (95% CI, -11.2% to -4.3%), 7.7% decrease in ASDNN (95% CI, -11.0% to -4.2%) and 3.8 msec decrease in QTc (95% CI, -5.8 to -1.9). Compared with a short exposure time period (<15min), greater nicotine associated with reductions in ASDNN (P _{for interaction} = 0.076) with longer exposure time periods. For QTc, greater nicotine associated with reductions were found during 15-30 min exposure time period (P _{for interaction} = 0.04).

Conclusion

We present the first evidence of cardiac autonomic effects of short-term secondhand exposure to nicotine from EC emissions among healthy nonsmokers. Further comprehensive research on EC exposure extending to more subjects and flavor compounds is warranted.

Second-hand smoke exposure in outdoor hospitality venues: Smoking visibility and assessment of airborne markers

INTRODUCTION

After the implementation of smoke-free policies in indoor hospitality venues (including bars, cafeterias, restaurants, and pubs), smokers may have been displaced to their outdoor areas. We aimed to study smoking visibility and second-hand smoke exposure in outdoor hospitality venues.

METHODS

We collected information on signs of tobacco consumption on entrances and terraces of hospitality venues in 2016 in the city of Madrid, Spain. We further measured airborne nicotine concentrations and particulate matter of less than 2.5 µm in diameter (PM2.5) in terraces with monitors by active sampling during 30 min. We calculated the medians and the interquartile ranges (IQR) of nicotine and PM2.5 concentrations, and fitted multivariate models to characterize their determinants.

RESULTS

We found 202 hospitality venues between May and September (summer), and 83 between October and December 2016 (fall) that were opened at the time of observation. We found signs of tobacco consumption on 78.2% of the outdoor main entrances and on 95.1% of outdoor terraces. We measured nicotine and PM2.5 concentrations in 92 outdoor terraces (out of the 123 terraces observed). Overall median nicotine concentration was 0.42 (IQR: 0.14-1.59) μg/m³, and overall PM2.5 concentration was 10.40 (IQR: 6.76-15.47) μg/m³ (statistically significantly higher than the background levels). Multivariable analyses showed that nicotine and PM2.5 concentrations increased when the terraces were completely closed, and when tobacco smell was noticed. Nicotine concentrations increased with the presence of cigarette butts, and when there were more than eight lit cigarettes at a time.

CONCLUSIONS

Outdoor hospitality venues are areas where non-smokers, both employees and patrons, continue to be exposed to second-hand smoke. These spaces should be further studied and considered in future tobacco control interventions.

Knowledge, opinions and compliance related to the 100% smoke-free law in hospitality venues in Kampala, Uganda: cross-sectional results from the KOMPLY Project

OBJECTIVE

This study evaluated knowledge, opinions and compliance related to Uganda's comprehensive smoke-free law among hospitality venues in Kampala Uganda.

DESIGN

This multi-method study presents cross-sectional findings of the extent of compliance in the early phase of Uganda's comprehensive smoke-free law (2 months postimplementation; pre-enforcement).

SETTING

Bars, pubs and restaurants in Kampala Uganda.

PROCEDURE AND PARTICIPANTS

A two-stage stratified cluster sampling procedure was used to select hospitality sites stratified by all five divisions in Kampala. A total of 222 establishments were selected for the study. One hospitality representative from each of the visited sites agreed to take part in a face-to-face administered questionnaire. A subsample of hospitality venues were randomly selected for tobacco air quality testing (n=108). Data were collected between June and August 2016.

OUTCOME MEASURES

Knowledge and opinions of the smoke-free law among hospitality venue staff and owners. The level of compliance with the smoke-free law in hospitality venues through: (1) systematic objective observations (eg, active smoking, the presence of designated smoking areas, 'no smoking' signage) and (2) air quality by measuring the levels of tobacco particulate matter (PM_2.5) in both indoor and outdoor venues.

RESULTS

Active smoking was observed in 18% of venues, 31% had visible 'no smoking' signage and 47% had visible cigarette remains. Among interviewed respondents, 57% agreed that they had not been adequately informed about the smoke-free law; however, 90% were supportive of the ban. Nearly all respondents (97%) agreed that the law will protect workers' health, but 32% believed that the law would cause financial losses at their establishment. Indoor PM_2.5 levels were hazardous (267.6 µg/m³) in venues that allowed smoking and moderate (29.6 µg/m³) in smoke-free establishments.

CONCLUSIONS

In the early phase of Uganda's smoke-free law, the level of compliance in hospitality venues settings in Kampala was suboptimal. Civil society and the media have strong potential to inform and educate the hospitality industry and smokers of the benefits and requirements of the smoke-free law.

Nicotine, aerosol particles, carbonyls and volatile organic compounds in tobacco- and menthol-flavored e-cigarettes

BACKGROUND

We aimed to assess the content of electronic cigarette (EC) emissions for five groups of potentially toxic compounds that are known to be present in tobacco smoke: nicotine, particles, carbonyls, volatile organic compounds (VOCs), and trace elements by flavor and puffing time.

METHODS

We used ECs containing a common nicotine strength (1.8%) and the most popular flavors, tobacco and menthol. An automatic multiple smoking machine was used to generate EC aerosols under controlled conditions. Using a dilution chamber, we targeted nicotine concentrations similar to that of exposure in a general indoor environment. The selected toxic compounds were extracted from EC aerosols into a solid or liquid phase and analyzed with chromatographic and spectroscopic methods.

RESULTS

We found that EC aerosols contained toxic compounds including nicotine, fine and nanoparticles, carbonyls, and some toxic VOCs such as benzene and toluene. Higher mass and number concentrations of aerosol particles were generated from tobacco-flavored ECs than from menthol-flavored ECs.

CONCLUSION

We found that diluted machine-generated EC aerosols contain some pollutants. These findings are limited by the small number of ECs tested and the conditions of testing. More comprehensive research on EC exposure extending to more brands and flavor compounds is warranted.

Second-hand smoke exposure in indoor and outdoor areas of cafés and restaurants: Need for extending smoking regulation outdoors?

Smoke-free legislation in indoor public places has concentrated smokers in the areas outside building entrances or other outdoor areas. This study assessed the drift of second-hand smoke between outdoor and indoor areas of cafés and restaurants in Barcelona, Spain, and characterized the exposure on outdoor terraces. Using a cross-sectional design, we monitored vapor-phase nicotine in indoor areas and outside entrances simultaneously (n=47), and on some outdoor terraces (n=51). We computed the median nicotine concentration and interquartile range (IQR) to describe the data and performed multivariate analysis to describe nicotine concentration and its determinants. The overall median nicotine concentration indoors was 0.65µg/m(3) (IQR: 0.29-1.17µg/m(3)), with significant differences based on the number of smokers at the entrance (p=0.039). At outside entrances, the overall median nicotine concentration was 0.41µg/m(3) (IQR: 0.21-1.17µg/m(3)). The nicotine concentrations indoors and at the corresponding outside entrances were not significantly different, and the multivariate analysis confirmed the relationship between these variables. On terraces, the overall median nicotine concentration was 0.54µg/m(3) (IQR: 0.25-1.14µg/m(3)), but it increased to 0.60µg/m(3) when a tobacco smell was perceived, 0.72µg/m(3) on closed terraces, 1.24µg/m(3) when there were >6 smokers, and 1.24µg/m(3) when someone smoked >20min. Multivariate analysis confirmed the outdoor terrace area, the season, the type of enclosure, and the number of smokers as the most relevant variables explaining nicotine concentration (R(2)=0.396). These findings show that second-hand smoke exposure exists in indoor areas due to smokers smoking at the outside entrances. In addition, exposure may occur on outdoor terraces when smokers are present and the terrace is enclosed to some extent. Thus, the current Spanish law does not fully protect non-smokers from second-hand smoke and supports extending regulation to some outdoor areas.

Exposure to secondhand smoke from neighbours and respiratory symptoms in never-smoking adolescents in Hong Kong: a cross-sectional study

OBJECTIVES

To investigate secondhand smoke (SHS) exposure at home from neighbours in Hong Kong adolescents and its association with respiratory symptoms in never-smokers.

DESIGN

A cross-sectional study.

SETTING

79 randomly selected secondary schools in Hong Kong.

PARTICIPANTS

61,810 secondary 1 (USA grade 7) to 7 students, in which 50,762 never-smokers were identified and included in the analysis of the association between SHS exposure at home from neighbours and respiratory symptoms.

MAIN OUTCOME MEASURES

Smoking status, family smoking status, SHS exposure at home from inside the home and from neighbours in the past 7 days, respiratory symptoms and sociodemographic characteristics were reported. Adjusted ORs (AORs) of respiratory symptoms for SHS exposure from the 2 sources in never-smokers were calculated using logistic regression.

RESULTS

In all students, 33.2% were exposed to SHS at home, including 16.2% from inside the home only, 10.0% from neighbours only and 7.0% from both. The prevalence of SHS exposure from neighbours was 17.1%, including 13.5% for 1-4 days/week and 3.6% for 5-7 days/week. In never-smokers (n=50,762), respiratory symptoms were significantly associated with SHS exposure from neighbours with AORs (95% CI) of 1.29 (1.20 to 1.39) for any exposure (p<0.001), 1.21 (1.12 to 1.31) for 1-4 days/week (p<0.001) and 1.63 (1.44 to 1.86) for 5-7 days/week (p<0.001) (P for trend <0.001). Compared with no SHS exposure at home from any source, the AORs were 1.16 (1.07 to 1.25) for SHS from inside the home only (p<0.001), 1.20 (1.11 to 1.31) from neighbours only (p<0.001), and 1.74 (1.56 to 1.94) from both (p<0.001).

CONCLUSIONS

SHS exposure at home from neighbours was prevalent in Hong Kong adolescents, and was associated with respiratory symptoms in never-smokers. SHS exposure at home may be underestimated by ignoring the neighbouring source. Smoke-free housing policy is needed to protect children and adolescents from harms of SHS.

Spatial and Temporal Distribution of PM2.5 Pollution in Xi'an City, China

The monitoring data of the 13 stations in Xi’an city for the whole years of 2013 and 2014 was counted and analyzed. Obtaining the spatial and temporal distribution characteristics of PM_2.5 was the goal. Cluster analysis and the wavelet transform were utilized to discuss the regional distribution characteristics of PM_2.5 concentration (ρ(PM_2.5)) and the main features of its yearly changes and sudden changes. Additionally, some relevant factors were taken into account to interpret the changes. The results show that ρ(PM_2.5) in Xi’an during 2013 was generally higher than in 2014, it is high in winter and low in summer, and the high PM_2.5 concentration centers are around the People’s Stadium and Caotan monitoring sites; For the regional PM_2.5 distribution, the 13 sites can be divided into three categories, in which Textile city is Cluster 1, and High-tech Western is Cluster 2, and Cluster 3 includes the remaining 11 monitoring sites; the coefficient of goodness of the cluster analysis is 0.6761, which indicates that the result is acceptable. As for the yearly change, apart from June and July, the average ρ(PM_2.5) concentration has been above the normal concentration criteria of Chinese National Standard (50 g/m³); cloudy weather and low winds are the major meteorological factors leading to the sudden changes of ρ(PM_2.5).

Assessing exposure to secondhand smoke in restaurants and bars 2 years after the smoking regulations in Beijing, China

Field observation of patron smoking behaviors and multiple sampling approaches were conducted in 79 restaurants and bars in Beijing, 2010, 2 years after implementing the governmental smoking regulations. Smoking was observed in 30 visits to 22 of the 37 nominal non-smoking venues during peak patronage times and six visits to four of the 14 nominal non-smoking sections. The median area secondhand smoke (SHS) concentrations during peak patronage time were 27, 15, 43, and 40 μg/m(3) in nominal non-smoking venues, non-smoking sections, smoking sections, and smoking venues, respectively, as indicated by the difference between indoor and outdoor PM2.5 levels; and 1.4, 0.6, 1.7, and 2.7 μg/m(3) , respectively, as indicated by airborne nicotine. In the 27 venues with sampling of different approaches and over different time periods, the median nicotine concentration was 1.8 μg/m(3) by one-hour peak patronage-time sampling, 1.1 μg/m(3) by 1-day active area sampling, 2.5 μg/m(3) by 1-day personal sampling, and 2.3 μg/m(3) by week-long passive sampling. No significant differences in nicotine levels were observed among venues/sections with different nominal smoking policies by all sampling approaches except during peak patronage time. This study showed that the 2008 Beijing governmental smoking restriction has been poorly implemented, and SHS exposures in Beijing restaurants and bars remain high.

PRACTICAL IMPLICATIONS

The 2008 Beijing governmental smoking restriction requires large restaurants to designate no less than 50% of their dining area as non-smoking, without defining ‘large’ or specifying how the designated smoking sections and non-smoking sections should be separated. Two years after its implementation, smoking is still commonly observed in nominally non-smoking restaurants and bars and in designated non-smoking sections, and both patrons and servers are exposed to high concentrations of secondhand smoke. These results indicate that the Beijing governmental regulation fails to protect the population from SHS exposure in restaurants and bars and that more efforts are needed to pass stronger smoking regulations and ensure better compliance in Beijing, China.