Tobacco and Public Health - TCSC Indonesia

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PASSIVE SMOKING AND HEALTH
mechanisms; and specific effects reflecting pharmacologic consequences of specific
components, e.g. nicotine, and reduction of oxygen-carrying capacity from carbon
monoxide in tobacco smoke.
Exposure to secondhand smoke
Environmental tobacco smoke concentrations
Tobacco smoke is a complex mixture of gases and particles that contains myriad
chemical species (US Department of Health Education and Welfare, US Environmental
Protection Agency (EPA), and National Center for Health Statistics 1979; US
Department of Health and Human Services 1984; Guerin et al. 1992; Jenkins et al.
2000). Not surprisingly, tobacco smoking in indoor environments increases levels of
respirable particles, nicotine, polycyclic aromatic hydrocarbons, carbon monoxide
(CO), acrolein, nitrogen dioxide (NO2 ), and many other substances. Tables 17.2 and
17.3 provide a summary of data from a number of recent studies (Hammond 1999).
The extent of the increase in concentrations of these markers varies with the number
of smokers, the intensity of smoking, the rate of exchange between the indoor air space
and with the outdoor air, and the use of air-cleaning devices. Ott (1999) has used mass
balance models to characterize factors influencing concentrations of tobacco smoke
indoors. Using information on the source strength (i.e. the generation of emissions by
cigarettes) and on the air exchange rate, researchers can apply mass balance models to
predict tobacco smoke concentrations. Such models can be used to estimate exposures
and to project the consequences of control measures.
Several components of cigarette smoke have been measured in indoor environments
as markers of the contribution of tobacco combustion to indoor air pollution.
Particles, a nonspecific marker, have been measured most often because both sidestream
and mainstream smoke contain high concentrations of particles in the
respirable size range (National Research Council and Committee on Passive Smoking
1986; US Department of Health and Human Services 1986). Other, more specific
markers have also been measured, including nicotine, solanesol, and ultraviolet light
(UV) absorption of particulate matter (Jenkins et al. 2000). Nicotine can be measured
with active sampling methods and also using passive diffusion badges (Leaderer and
Hammond 1991; Jenkins et al. 2000). Studies of levels of secondhand smoke components
have been conducted largely in public buildings; fewer studies have been
conducted in homes and offices (National Research Council 1986; US Department
of Health and Human Services 1986).
The contribution of various environments to personal exposure to tobacco smoke
varies with the time–activity pattern, namely the distribution of time spent in different
locations. Time–activity patterns may heavily influence lung airway exposures in
particular environments for certain groups of individuals. For example, exposure
in the home predominates for infants who do not attend day care (Harlos et al. 1987).