Friday, May 17, 2013

New Study Warns of Dangers of Thirdhand Smoke in Nonsmoking Hotel Rooms Located in Hotels that Allow Smoking in Some Rooms

A study published online ahead of print in Tobacco Control warns of the dangers of thirdhand smoke (THS) exposure in nonsmoking hotel rooms in hotels with partial smoking bans (meaning that both smoking and nonsmoking rooms are available).

(See: Matt GE, et al. Thirdhand smoke and exposure in California hotels: non-smoking rooms fail to protect non-smoking hotel guests from tobacco smoke exposure.)

The methods are described as follows: "A stratified random sample of hotels with (n=10) and without (n=30) complete smoking bans was examined. Surfaces and air were analysed for tobacco smoke pollutants (ie, nicotine and 3-ethynylpyridine, 3EP)."

The results were as follows: "Compared with hotels with complete smoking bans, surface nicotine and air 3EP were elevated in non-smoking and smoking rooms of hotels that allowed smoking. Air nicotine levels in smoking rooms were significantly higher than those in non-smoking rooms of hotels with and without complete smoking bans. Hallway surfaces outside of smoking rooms also showed higher levels of nicotine than those outside of non-smoking rooms."

The study concludes as follows: "Partial smoking bans in hotels do not protect non-smoking guests from exposure to tobacco smoke and tobacco-specific carcinogens. Non-smokers are advised to stay in hotels with complete smoking bans. Existing policies exempting hotels from complete smoking bans are ineffective."

The Rest of the Story

Readers of the conclusions of this study might be surprised to find out that the study found no significant difference in air nicotine levels in nonsmoking rooms in hotels with partial smoking bans and those in nonsmoking rooms in hotels with complete smoking bans.

In fact, the most significant finding of the study with regards to significant health effects was that the mean level of air nicotine in nonsmoking rooms in hotels with partial smoking bans was 28.9 ng/m3 (95% confidence interval, 14.2-57.9), compared to a mean level of 20.5 ng/m3 (95% confidence interval, 7.4-54.2) in nonsmoking rooms in hotels with complete smoking bans. These confidence intervals greatly overlap and the differences in mean air nicotine levels are not significantly different.

In contrast, the mean air nicotine level in smoking rooms was 452.4 ng/m3.

A reasonable interpretation of these data is that there was no evidence that staying in a nonsmoking room in a hotel with a partial smoking ban posed any significant health effects, as it was not associated with any significant increase in exposure to airborne tobacco smoke.

How, then, can the authors conclude that designated nonsmoking rooms in hotels are not sufficient to protect nonsmokers?

Well, they rely upon the finding that nonsmoking rooms in hotels with partial smoking bans had slightly higher levels of surface nicotine. The surface nicotine levels averaged 3.7 ug/m2, as opposed to 1.4 ug/m2, and compared to an average of 51.8 ug/m2 in smoking rooms. This slight increase in surface nicotine resulted in higher finger nicotine levels. However, it did not result in increased nicotine exposure, as the urine cotinine levels were not significantly higher in nonsmoking confederates who stayed in hotels with a partial smoking ban compared to hotels with a complete smoking ban.

Thus, the study has demonstrated that there is no significant difference in nicotine exposure (and presumably exposure to other constituents of tobacco smoke) among nonsmokers who stay in a hotel with a partial smoking ban compared to those who stay in a hotel with a complete smoking ban.

That major finding would lead me to conclude that there is no significant health risk associated with staying in a nonsmoking room in a hotel that allows smoking in some rooms. It would also lead me to conclude that partial smoking bans do indeed work in terms of preventing tobacco smoke exposure for guests staying in nonsmoking rooms.

That the paper suggests the opposite is in conflict with the actual findings of the paper and suggests that there was a pre-determined conclusion and a pre-determined agenda that guided this research.

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