third-hand smoke: an emerging healthcare challenge

THIRD-HAND SMOKE: AN EMERGING HEALTHCARE

CHALLENGE

Maher Mouzer Teresa Goncalves

OUTLINE

Background Underlying Dangers Project focus and methods Project plan Future applications

BACKGROUND – HARM TO SMOKER In 1964 it was officially acknowledged the harmful effects

of cigarette smoking General belief was that the damaging effects of tobacco

was restricted to the smoker

BACKGROUND SECOND-HAND SMOKE

In 1981, Japanese epidemiologist Takeshi Hirayama published a ground-breaking study relating an increased incidence of lung cancer among non-smoking women married to men who smoked - Second-hand smoking

Widespread denial from the tobacco industry Hirayama’s work has stood the test of time and reinforced

efforts to protect non-smokers from second-hand exposure to tobacco

Chemicals Identified for second hand smoke.

BACKGROUND SECOND-HAND SMOKE

Statistics Canada (2008)

BACKGROUND – HARM TO SMOKER Tobacco-related illnesses will continue to be a leading

cause of death worldwide (Jha, P., 2009)

Nature Reviews Cancer 9, 655-664 (September 2009); doi:10.1038/nrc2703

BACKGROUND THIRD-HAND SMOKE In 2009, investigators at the Mass General Hospital for

Children in Boston devised a new term,

Third-hand smoke

Refers to the residual gas and particles that remain trapped on hair, skin, and surfaces long after a cigarette is extinguished

UNDERLYING DANGERS – HIGH EXPOSURE Increased risk of exposure for non-smokers

Much higher than second hand smoking Stay and accumulate indefinitely

Cannot be removed by ventilation and soap cleaners Nicotine requires special detergents to be removed from

surfaces Volatile Organic Compounds (VOCs) can strongly bind to

fabric and ceilings Multiple Routes of entry

skin breathing ingestion

Infants are at high risk Crawling and touching surfaces Physical contact with parents that smoke

UNDERLYING DANGERS – TOXIC CHEMICALS Chemicals that may pose health risks in third-hand

smoking are similar to second hand smoking like VOC’s, heavy metals, gases and radioactive material

Secondary potent cancer-causing compounds from tobacco-derived toxicants: Accumulated nicotine on surfaces reacts with ambient

nitrous acid generated by certain appliances to form carcinogenic tobacco-specific nitrosamines (TSNAs)

(Sleiman M., 2010)

REFERENCES Rabin, R. C. (2009) A new cigarette hazard: Third-hand smoke.

Accessed from http://www.nytimes.com/2009/01/03/health/research/03smoke.html?_r=1&, on March 22, 2013.

Matt GE, Quintana PJ, Hovell MF, Bernert JT, Song S, Novianti N, Juarez T, Floro J, Gehrman C, Garcia M, Larson S. (2004) Households contaminated by environmental tobacco smoke: sources of infant exposures. Tob Control. 13(1):29-37

Sleiman, M., Gundel, L. A., Pankow, J. F., Peyton, J., Singer, B., Destaillats, H. (2010) Formation of carcinogens indoors by surface-mediated reactions of nicotine with nitrous acid, leading to potential thirdhand smoke hazards. PNAS Early Edition 1-6

Winickoff, J. P., Friebely, J., Tanski, S. E., Sherrod, C., Matt, G.E., Hovell, M.F., McMille, R.C. (2009) Beliefs About the Health Effects of ''Thirdhand'' Smoke and Home Smoking Bans. Pediatrics 123:e73-e79

Kuschner, W.G., Reddy, S., Mehrotra, N., Paintal, H.S. (2011) Electronic cigarettes and thirdhand tobacco smoke: two emerging healthcare challenges for the primary care provider. Int. J. of Gen. Med. 4:115-120

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