Switching people who smoke to unfiltered cigarettes: Effects on smoking topography.

Introduction: Smoking topography (ST) describes smoking behavior and patterns. Removal of the cigarette filter and subsequent impact on ST has not been investigated. This is the first clinical trial comparing ST for filtered and unfiltered cigarettes in a naturalistic experiment. Methods: We conducted a crossover clinical trial following established people who smoke cigarettes (n = 32) for two weeks under filtered and unfiltered smoking experimental conditions. Participants (50 % female, mean age 38.3 yr.) smoked in each experimental condition followed by a 3-week post-washout period. ST (puff count, volume, duration, peak and average flow) was measured at six time-points. Statistical analysis included a linear repeated mixed-effects model of smoking experimental conditions by visit number and sex. Results: Average flow (ml/sec) was significantly less for filtered smoking (-6.92 lower (95 % CI: -13.44 to -0.39), p < 0.05), thus demonstrating more resistance on inhalation. No significant differences were found between filtered or unfiltered experimental conditions for other ST variables. However, average volume and average peak flow were somewhat higher in unfiltered smoking, and lower mean puff counts/cigarette were observed for unfiltered compared to filtered smoking. Conclusion: Lower average flow rates were associated with filtered cigarette smoking. No significant differences were found for other ST variables between smoking experimental conditions. ST measurements comparing cigarette smoking conditions may determine if product regulatory changes, such as removing the cigarette filter could impact smoking behavioral patterns among people who smoke. This proof-of-principle study measuring ST may be replicated in larger trials to determine potential behavioral changes in smoking unfiltered cigarettes.

Influence of tobacco product wastes in a protected coastal reserve adjacent to urbanization.

The present study, conducted at the Kendall-Frost Mission Bay Marsh Reserve in San Diego, California, aimed to assess tobacco-related pollutants in urban waters, a topic with limited prior research. Across 26 events occurring between November 2019 and February 2022, encompassing both wet and dry seasons at two outfall sites (Noyes St. and Olney St.), water and sediment samples were subjected to analysis for nicotine and cotinine levels, with Noyes St. displaying wide variation in nicotine concentrations, reaching a peak of 50.75 ng/L in water samples, whereas Olney St. recorded a peak of 1.46 ng/L. Wet seasons consistently had higher nicotine levels in water, suggesting the possibility of tobacco litter entering the reserve through stormwater runoff. Cotinine was detected in both sites in both water and sediment samples; however, these levels were considerably lower in comparison to nicotine concentrations. Limited research assesses aquatic environmental pollution from tobacco use and disposal, especially in protected areas like urban natural reserves. This study was conducted at the Kendall-Frost Mission Bay Marsh Reserve in San Diego, California, to evaluate tobacco-related pollutants in San Diego's urban waters. Twenty-six sampling events between November 2019 and February 2022, spanning wet and dry seasons at two outfall sites, were conducted. Nicotine and cotinine, a major ingredient of tobacco and its metabolite, were analyzed in the collected water and sediment samples. Nicotine concentrations differed substantially between the outfall locations (Noyes St. and Olney St.), with Noyes St. displaying wide variations, averaging at 9.31 (±13.24) ng/L with a maximum concentration of 50.75 ng/L, and Olney St. at 0.53 (±0.41) ng/L with a maximum concentration of 1.46 ng/L in water samples. In both locations, the nicotine concentrations in water samples were higher during wet seasons than dry seasons, and this pattern was more significant at Noyes St. outfall than at Olney St. outfall, which received not only stormwater runoff but also was connected to Mission Bay. Although this pattern did not directly align with sediment nicotine levels at both sites, maximum nicotine concentration in Noyes St. sediments during wet seasons was approximately 120 times higher than in Olney St. sediments. Regarding cotinine, Noyes St. outfall water averaged 3.17 ng/L (±1.88), and Olney St. water averaged 1.09 ng/L (±1.06). Similar to nicotine, the cotinine concentrations were higher in Noyes St. water and sediment compared to Olney St., but overall, the cotinine concentrations in both water and sediment were much lower than the corresponding nicotine concentrations. The study identifies urban stormwater runoff as a potential source of nicotine and cotinine pollution in a protected reserve, implicating tobacco product litter and human tobacco use as contributing factors.

First report on BTEX leaching from waterpipe tobacco wastes (WTWs) into aquatic environment.

Waterpipe tobacco wastes (WTWs) may contain considerable levels of hazardous contaminants such as BTEX (benzene, toluene, ethylbenzene, o-xylene, and m/p-xylene). However, no research has been carried out on BTEX levels in WTWs and the release of these pollutants into the water environment. This research examined the levels of BTEX in WTWs of flavored/local tobacco and also the release rate of these toxins into three kinds of water, including seawater (SW), tap water (TW), and distilled water (DW) with different leaching times (15, 30 min, 1.2, 4, 8 h, and 1, 2, and 4 days). The mean contents of BTEX in WTW samples of Al-Mahmoud, Al-Fakher, Mazaya, Al-Ayan brands, and local tobacco samples were 17.0 ± 4.14, 19.1 ± 4.65, 19.6 ± 4.19, 18.8 ± 4.14, and 3.16 ± 0.63 µg/kg, respectively. The mean BTEX levels in flavored tobacco samples were considerably greater than that of local tobacco (p < 0.05). The WTWs leaching experiments showed that the levels of BTEX ranged from 5.26 to 6.12, 5.02-5.60, and 3.83-5.46 µg/L in DW, TW, and SW, respectively. All target compounds were found for all exposure times in DW, TW, and SW samples. After adding sodium azide as an antibacterial agent to water samples (simulating biodegradation processes), higher levels of BTEX compounds were detected in SW. Further research is needed to address the potential environmental hazards due to WTWs leaching into aquatic environments.

Leached Compounds from Smoked Cigarettes and Their Potential for Bioaccumulation in Rainbow Trout (Oncorhynchus mykiss).

Cigarette butts are one of the most prevalent forms of litter worldwide and may leach toxic compounds when deposited in aquatic environments. Previous studies demonstrated that smoked cigarette leachate is toxic toward aquatic organisms. However, the specific bioavailable chemicals from the leachate and the potential for human and wildlife exposure through the food chain were unknown. Using a nontargeted analytical approach based on GC×GC/TOF-MS, 43 compounds were confirmed to leach from smoked cigarettes when exposed to a water source. Additionally, the bioaccumulation potential of organic contaminants in an edible fish, rainbow trout (Oncorhynchus mykiss), was assessed through direct exposure to the leachate of smoked cigarettes at 0.5 CB/L for 28 days. There was a significant reduction in fish mass among the exposed rainbow trout vs the control group (χ2 (1) = 5.3, p = 0.021). Both nontargeted and targeted chemical analysis of representative fish tissue identified four tobacco alkaloids, nicotine, nicotyrine, myosmine, and 2,2'-bipyridine. Their average tissue concentrations were 466, 55.4, 94.1, and 70.8 ng/g, respectively. This study identifies leached compounds from smoked cigarettes and demonstrates the uptake of specific chemicals in rainbow trout, thus suggesting a potential for accumulation in food webs, resulting in human and wildlife exposure.

Policy-relevant differences between secondhand and thirdhand smoke: strengthening protections from involuntary exposure to tobacco smoke pollutants.

Starting in the 1970s, individuals, businesses and the public have increasingly benefited from policies prohibiting smoking indoors, saving thousands of lives and billions of dollars in healthcare expenditures. Smokefree policies to protect against secondhand smoke exposure, however, do not fully protect the public from the persistent and toxic chemical residues from tobacco smoke (also known as thirdhand smoke) that linger in indoor environments for years after smoking stops. Nor do these policies address the economic costs that individuals, businesses and the public bear in their attempts to remediate this toxic residue. We discuss policy-relevant differences between secondhand smoke and thirdhand smoke exposure: persistent pollutant reservoirs, pollutant transport, routes of exposure, the time gap between initial cause and effect, and remediation and disposal. We examine four policy considerations to better protect the public from involuntary exposure to tobacco smoke pollutants from all sources. We call for (a) redefining smokefree as free of tobacco smoke pollutants from secondhand and thirdhand smoke; (b) eliminating exemptions to comprehensive smoking bans; (c) identifying indoor environments with significant thirdhand smoke reservoirs; and (d) remediating thirdhand smoke. We use the case of California as an example of how secondhand smoke-protective laws may be strengthened to encompass thirdhand smoke protections. The health risks and economic costs of thirdhand smoke require that smokefree policies, environmental protections, real estate and rental disclosure policies, tenant protections, and consumer protection laws be strengthened to ensure that the public is fully protected from and informed about the risks of thirdhand smoke exposure.

Post-consumption waterpipe tobacco waste as an unrecognized source of toxic metal(loid)s leachates into aquatic environments.

Waterpipe is a common form of tobacco smoking, and recently, its use has been increasing globally. Therefore, concern arises regarding the large quantity of post-consumption waterpipe tobacco waste produced and released into the environment and which can contain high levels of dangerous pollutants such as toxic meta(loid)s. This study reports the concentrations of meta(loid)s in waste from fruit-flavoured and traditional tobacco smoking as well as the release rate of these pollutants from waterpipe tobacco waste into three types of water. These include distilled water, tap water, and seawater and contact times ranging from 15 min to 70 days. The mean concentration levels of Æ©metal(loid)s in waste samples of Al-mahmoud, Al-Fakher, Mazaya, Al-Ayan brands and traditional tobacco brands were 212 ± 92.8, 198 ± 94.4, 197 ± 75.7, 214 ± 85.8 and 40.6 ± 16.1 µg/g, respectively. The concentration levels of Æ©metal(loid)s in fruit-flavoured tobacco samples were significantly higher than for traditional tobacco samples (p < 0.05). It was found that waterpipe tobacco wastes leached toxic metal(loid)s into different water samples with similar trends. In addition distribution coefficients showed that most metal(loid)s are highly likely to enter the liquid phase. The concentration levels of these pollutants (except Ni and As) in deionized water and tap water exceeded the surface fresh water standards for sustaining aquatic life during long contact time (up to 70 days). In seawater, concentration levels of Cu and Zn exceeded the recommended standards for maintaining aquatic life in the sea. Therefore, due to the possibility of contamination by soluble metal(loid)s through disposal of waterpipe tobacco waste in wastewater, there is concern that these toxic chemicals might enter the human food chain. Appropriate regulatory measures for disposal of waterpipe tobacco waste are necessary to prevent environmental pollution due to discarded wastes into aquatic ecosystems.

Cellulose acetate cigarette filter is hazardous to human health.

The World No Tobacco Day 2022 theme emphasised tobacco's adverse environmental effects, including through agriculture, manufacturing, distribution, use and the disposal of tobacco product waste. A main concern regarding this toxic waste is the cigarette filter, which is attached to nearly all commercial cigarettes and is predominantly made from a plant-based plastic (cellulose acetate). Laboratory studies have demonstrated the chemical toxicity of discarded cigarette butts, and there is growing public concern regarding environmental plastic pollution resulting from single-use cellulose acetate filters. Important considerations are whether the filter has any protective role against the harms of smoking and whether it should be regulated as a plastic environmental pollutant. There is persistent misunderstanding among smokers and policy makers about the implied value of the cigarette filter. The cellulose acetate filter is simply a marketing tool that encourages smoking initiation and reduces intentions to quit smoking. This is because it makes smoking easier and implies added safety through the presumed filtration of inhaled smoke. The sale of filtered cigarettes should be prohibited to protect public health and the environment.

Polycyclic aromatic hydrocarbon (PAH) leachates from post-consumption waterpipe tobacco waste (PWTW) into aquatic environment- a primary study.

Post-consumption waterpipe tobacco waste (PWTW) is an unrecognized type of hazardous waste that is produced and released in large quantities into the aquatic environment. It may contain high amounts of various pollutants including PAH, and to date, there has been no research on the potential for contamination by PAH from PWTW leaching into aquatic environments. In this study, the concentrations of PAH via PWTW of fruit-flavored and traditional tobacco leachate into three water types, including distilled water (DW), tap water (TW) and sea water (SW) at different contact times were evaluated. There were significantly higher concentration levels of Æ©PAH in waters with leachates from fruit-flavored PWTW than traditional tobacco (P-value<0.05). The concentration levels of Æ©PAH in DW, TW and SW at a total contact time of two months ranged from 0.13 to 3.51, 0.12 to 3.63 and 0.11-3.64 µg/L, respectively. Lower molecular weight PAH such as naphthalene (Naph), acenaphthylene (Acen) and fluorine (Flu) were detected in leachates immediately after a short contact time of 15 min. Higher molecular weight PAH including benzo [a]anthracene (BaA), benzo [b]fluoranthene (BbF), benzo [k]fluoranthene (BkF), chrysene (Chr), and benzo [a]pyrene (BaP) were detected after one month contact time, while indeno [1,2,3-cd] pyrene (Indp), benzo [ghi]perylene (BghiP) and dibenz [a,h]anthracene (DahA) were only observed at the contact time measurement of two months. By adding sodium azide as an antimicrobial agent and chemical preservative to SW samples, higher concentrations of PAH including IP, DahA and BghiP were observed. The concentration levels of PAH in water samples after two months contact time were higher than water quality standards provided by the World Health Organization (WHO) and other international organizations.

Toxic effect of cigarette butts leachates on blood markers of Periophthalmus waltoni species from the Persian Gulf region.

Cigarette butts (CBs) are one of the most common, long-lasting, and toxic forms of marine and coastal area debris. Although the significance of CBs and the toxic contents of this waste items are well recognized, but there is still a lack of information about the effects of this waste on the aquatic organisms. Therefore in this study, the in-vivo toxic effects of various CBs leachates (smoked cigarette butts with tobacco [SCBs], smoked CBs without tobacco [SFs], and unsmoked filters [USFs]) on cellular and chemical hematologic markers in fish (Periophthalmus waltoni) were evaluated. In three acute, sub-acute, and sub-chronic exposure measurements, P. waltoni exposed to different CBs leachates showed a significant increase in white blood cells, creatine kinase, lactate dehydrogenase, alkaline phosphatase, alanine transaminase, and aspartate transaminase, as well as a decrease in hemoglobin (Hb) levels. The mean ± SD values of Hb in P. waltoni species exposed to different CBs leachates (control, SCBs, SFs and USFs) in acute (1 day) phase were 7.15 ± 0.34, 6.02 ± 0.29, 6.25 ± 0.25 and 6.89 ± 0.1 g/dl respectively. These values in subacute (28 days) phase were 6.70 ± 0.15, 5.19 ± 0.24, 5.67 ± 0.30 and 6.10 ± 0.24 g/dl and in sub chronic exposure (42 days) phase were 7.20 ± 0.40, 5.16 ± 0.30, 5.88 ± 0.34 and 6.60 ± 0.33 g/dl respectively. Our results showed that CBs leachates act as a stressor, leading to changes in some hematologic markers in P. waltoni species. Because of the continued deposition of CBs waste into global aquatic environments, policies to mitigate this waste in coastal areas are needed to prevent potentially negative effects on fish and other aquatic organisms.

Chemical contents and toxicity of cigarette butts leachates in aquatic environment: A case study from the Persian Gulf region.

Cigarette butts (CBs) are one of the most commonly found types of litter contaminating the aquatic environment. However, the environmental risks posed by CBs need further investigation. In this study, the in-vivo toxic effects of various concentrations of CB leachates on juvenile (5.45 ± 1.36 gr and 7.08 ± 1.12 cm) fish (Periophthalmus waltoni) were evaluated. The LC50 values of CB leachate from smoked cigarette butts with tobacco (SCB) were 3.75, 3.0, 1.94, and 1.37 CBs/L in 24, 48, 72, and 96 h exposure times, respectively. The LC50 values for leachate of smoked CBs without tobacco (SF) were 7.58, 6.22, 4.73, and 2.9 CBs/L at 24, 48, 72, and 96 h exposure times, respectively. In the case of leachate from unsmoked filters (USF), LC50 values were 14.68, 12.44, 10.19, and 7.46 CBs/L in 24, 48, 72, and 96 h exposure time, respectively. The mean concentrations of heavy metals and polycyclic aromatic hydrocarbons in SCBs leachates were higher than in SF and USF leachates. Our findings report that even low concentrations of CBs leachates can led to lethality of P. waltoni and may pose a threat to their population density.

Depression, Anxiety, and Cigarette Smoking Among Patients with Tuberculosis.

Smoking adversely affects tuberculosis (TB) outcomes and may be associated with depression and anxiety among people diagnosed with TB in Botswana. We conducted a cross-sectional study among patients newly diagnosed with TB in Gaborone, Botswana, evaluating factors associated with self-reported cigarette smoking. We performed Poisson regression analyses with robust variance to examine whether depressive and anxiety symptoms were associated with smoking. Among 180 participants with TB enrolled from primary health clinics, depressive symptoms were reported in 47 (26.1%) participants and anxiety symptoms were reported in 85 (47.2%) participants. Overall, 45 (25.0%) participants reported current smoking. Depressive symptoms were associated with a higher prevalence of smoking (adjusted prevalence ratio [aPR]: 2.04; 95% confidence interval [CI]: 1.29-3.25) in the adjusted analysis. The association between anxiety symptoms and smoking did not reach statistical significance (aPR: 1.26; 95% CI: 0.77-2.05). Future studies should further investigate these associations when addressing TB care.

Switching people who smoke to unfiltered cigarettes: perceptions, addiction and behavioural effects in a cross-over randomised controlled trial.

BACKGROUND: Behavioural research is needed to inform a ban on sales of filtered cigarettes that could reduce plastic waste due to discarded filters. This study reports on differences in perceptions, nicotine dependence and behaviour among participants in a cross-over randomised trial of filtered compared with unfiltered cigarettes. METHOD: This proof-of-concept study involved 43 people who smoke filtered cigarettes (41.9% women, mean age 36.7 years). Participants were provided 2 weeks' supply of filtered cigarettes, 2 weeks of the same brand of unfiltered cigarettes and randomly assigned to starting conditions. Measures included the Modified Cigarette Evaluation Questionnaire; single-item cigarette perception questions; Fagerström Test of Nicotine Dependence; 7-day cigarette consumption, urinary cotinine and intention to quit. Analyses included linear and ordinal repeated measures mixed-effects models and paired t-tests. RESULTS: Filtered cigarettes were perceived as better tasting, more satisfying, more enjoyable, less aversive, less harsh, less potent and less negatively reinforcing than unfiltered cigarettes. Filtered cigarettes were smoked at a higher rate during the trial than unfiltered cigarettes (p<0.05). There was no difference in cotinine, dependence or intention to quit between filtered versus unfiltered cigarette conditions (p>0.05). CONCLUSION: People who smoke perceived unfiltered cigarettes as having greater nicotine effects and less desirable sensory effects than filtered cigarettes, and they smoked fewer of these during the trial. Although cotinine, dependence and intention to quit were similar for smoking unfiltered and filtered cigarettes in this small trial, results suggest that banning the sale of filtered cigarettes might make smoking less attractive overall to people who smoke. TRIAL REGISTRATION NUMBER: NCT03749876.

Support for cigarette filter waste policies among US adults.

INTRODUCTION: Little is known on whether cigarette filter-related knowledge or beliefs are associated with support for policies to reduce their environmental impact. METHODS: A cross-sectional, population-based sample of US adults aged 18-64 years (n=2979) was used to evaluate filter-related knowledge and beliefs by smoking status using data collected between 24 October 2018 and 17 December 2018. Multivariate logistic regression models explored whether these knowledge and belief items were associated with support for two policies, a US$0.75 litter fee and a ban on sales of filtered cigarettes, controlling for demographic characteristics and smoking status. RESULTS: Regardless of smoking status, 71% did not know plastic was a cigarette filter component and 20% believed filters were biodegradable. Overall, 23% believed filters reduce health harms and 60% believed filters make it easier to smoke; 90% believed cigarette butts are harmful to the environment. Individuals believing cigarette butts harmed the environment were more likely to support a litter fee (adjusted OR (aOR)=2.33, 95% CI: 1.71 to 3.17). Individuals believing that filters are not biodegradable had higher odds of supporting a litter fee (OR=1.47, 95% CI: 1.15 to 1.88). Respondents believing that filters do not make cigarettes less harmful were more likely to support a litter fee (aOR=1.50, 95% CI: 1.20 to 1.88) and filter ban (aOR=2.03, 95% CI: 1.64 to 2.50). Belief that filters make it easier to smoke was associated with decreased support for a filter ban (aOR=0.69, 95% CI: 0.58 to 0.83). CONCLUSIONS: Comprehensive efforts are needed to educate the public about the impact of cigarette filters in order to build support for effective tobacco product waste policy.

Paediatric trauma education in low- and middle-income countries: A systematic literature review.

Background: Trauma-specific training improves clinician comfort and reduces patient morbidity and mortality; however, curricular content, especially with regard to paediatric trauma, varies greatly by region and income status. We sought to understand how much paediatric education is included in trauma curricula taught in low- and middle-income countries (LMICs). Methods: We conducted a systematic literature review in October 2020 and in July 2022 based on PRISMA guidelines, utilizing seven databases: MEDLINE, Scopus, Web of Science, CINAHL, Cochrane Reviews, Cochrane Trials, and Global Index Medicus. Reports were limited to those from World Bank-designated LMICs. Key information reviewed included use of a trauma curriculum, patient-related outcomes, and provider/participant outcomes. Results: The search yielded 2008 reports, with 987 included for initial screening. Thirty-nine of these were selected for review based on inclusion criteria. Sixteen unique trauma curricula used in LMICs were identified, with only two being specific to paediatric trauma. Seven of the adult-focused trauma programmes included sections on paediatric trauma. Curricular content varied significantly in educational topics and skills assessed. Among the 39 included curricula, 33 were evaluated based on provider-based outcomes and six on patient-based outcomes. All provider-based outcome reports showed increased knowledge acquisition and comfort. Four of the five patient-based outcome reports showed reduction in trauma-related morbidity and mortality. Conclusion: Trauma curricula in LMICs positively impact provider knowledge and may decrease trauma-related morbidity and mortality; however, there is significant variability in existing trauma curricula regarding to paediatric-specific content. Trauma education in LMICs should expand paediatric-specific education, as this population appears to be underserved by most existing curricula.

Modelling the global economic costs of tobacco product waste.

Tobacco smoking continues to cause considerable premature mortality and morbidity worldwide. Most of the approximately six trillion cigarettes sold globally each year are discarded improperly as toxic environmental waste. Tobacco product waste, including cigarette butts, is the most commonly collected waste item worldwide. Of particular concern is the cellulose acetate filter, a poorly degradable plastic additive attached to most commercially manufactured cigarettes. This filter was introduced by the tobacco industry to reduce smokers' perception of harm and risk but it has no health benefit. To inform health policy and practice and improve public health outcomes, governments and society can benefit from cost estimates of preventing, properly disposing of and/or cleaning up tobacco product waste. Estimating the costs of tobacco product waste to communities and responsible authorities could encourage the development of health, environmental and fiscal policy interventions and shift accountability for the costs of tobacco product waste onto the global tobacco industry. To support health and environmental policy-making, we therefore propose an empirical approach to estimate the economic costs of tobacco product waste based on its negative environmental externalities. We first present general estimates for six representative countries and then identify data gaps that need to be addressed to develop global estimates. Interventions against tobacco product waste may be new channels to regulate tobacco products across sectors - for example, health, environment and finance - and consequently reduce overall tobacco use.

Le tabagisme continue à entraîner un taux de morbidité et de mortalité précoce considérable à travers le monde. La plupart des quelque six billions de cigarettes vendues chaque année à l'échelle planétaire ne sont pas correctement éliminées et deviennent une source de pollution environnementale toxique. Les déchets liés aux produits du tabac, notamment les mégots, sont les résidus les plus fréquemment collectés dans le monde. C'est surtout le filtre qui pose problème car il est composé d'acétate de cellulose, un additif plastique difficilement biodégradable que l'on retrouve dans la majorité des cigarettes commercialisées. Ce filtre a été introduit par l'industrie du tabac afin de donner aux fumeurs l'impression qu'ils courent moins de risques, alors qu'il n'a aucun effet bénéfique sur la santé. Les gouvernements et la société pourraient récolter les fruits d'une estimation des coûts engendrés par la prévention, l'élimination correcte et/ou le nettoyage des déchets liés aux produits du tabac, qui leur permettrait de mieux orienter les politiques et pratiques en la matière, mais aussi d'améliorer les résultats de santé publique. Estimer l'impact de ces déchets sur les communautés et les autorités compétentes pourrait encourager à adopter des mesures sanitaires, environnementales et fiscales, et pousser à responsabiliser davantage l'industrie mondiale du tabac vis-à-vis des coûts qu'ils entraînent. En vue de soutenir l'élaboration de politiques sanitaires et environnementales, nous proposons donc une approche empirique visant à déterminer les conséquences économiques des déchets générés par les produits du tabac en nous fondant sur l'influence néfaste qu'ils exercent sur l'environnement. Nous commençons par présenter des estimations globales pour six pays représentatifs, puis nous identifions les lacunes à combler dans les données afin de produire des estimations mondiales. Prendre des mesures de lutte contre ce type de déchets pourrait constituer un nouveau moyen de réglementer les produits du tabac dans différents secteurs comme la santé, l'environnement et les finances par exemple ­ et, par conséquent, faire diminuer la consommation de tabac en général.

El tabaquismo sigue causando una considerable tasa de mortalidad y morbilidad prematura en todo el mundo. La mayor parte de los casi seis billones de cigarrillos que se venden cada año en el mundo se desechan de forma inadecuada como residuos tóxicos para el medio ambiente. Los residuos de los productos del tabaco, incluidas las colillas, son los que más se recogen en todo el mundo. Un aspecto especialmente preocupante es el filtro de acetato de celulosa, un aditivo plástico poco degradable que se adhiere a la mayoría de los cigarrillos fabricados en el mercado. La industria del tabaco introdujo este filtro para reducir la percepción de daño y riesgo de los fumadores, pero no tiene ningún beneficio para la salud. A fin de fundamentar las políticas y prácticas sanitarias y mejorar los resultados en materia de salud pública, los gobiernos y la sociedad se pueden beneficiar de las estimaciones de costes de la prevención, la eliminación adecuada o la limpieza de los residuos de productos del tabaco. La estimación de los costes de los residuos de productos del tabaco para las comunidades y las autoridades responsables podría fomentar el desarrollo de intervenciones de política sanitaria, medioambiental y fiscal y trasladar la responsabilidad de los costes de los residuos de productos del tabaco a la industria del tabaco mundial. Para apoyar la elaboración de políticas sanitarias y medioambientales, se propone un enfoque empírico para estimar los costes económicos de los residuos de los productos del tabaco en función de sus consecuencias negativas para el medio ambiente. En primer lugar, se presentan estimaciones generales para seis países representativos y, a continuación, se identifican las deficiencias de información que se deben abordar para desarrollar estimaciones globales. Las intervenciones contra los residuos de productos del tabaco pueden constituir canales nuevos para regular los productos del tabaco en todos los sectores, por ejemplo, la salud, el medio ambiente y las finanzas, y, en consecuencia, reducir el consumo general de tabaco.

Naturalistic Topography Assessment in a Randomized Clinical Trial of Smoking Unfiltered Cigarettes: Challenges, Opportunities, and Recommendations.

Smoking topography (ST) is a set of measures profiling the behavioral characteristics of smoking in various settings. The CReSS portable device can measure ST in the natural environment. No standard protocol exists for measuring ST longitudinally with the CReSS. This study examined the utilization of the CReSS to measure ST and highlights challenges and opportunities in a naturalistic setting. This study is part of a randomized cross-over clinical trial of smoking filtered or unfiltered cigarettes. Participants (n = 43) smoked in each study condition for two weeks using the CReSS device for five days in their naturalistic smoking setting. The devices were calibrated and cleaned during the washout period, and data were downloaded every visit. Five test puffs were administered to calibrate each device. Moderate compliance rates (74.1%) were found with device usage, and the issues encountered were overheating/clogging, incorrectly registered date/time-stamped data, and device repair/replacement. Routine inspection/cleaning and training in device usage were instrumental in mitigating device malfunctioning. The CReSS device proved to be a feasible tool to examine naturalistic smoking topography and the potential impact of changes in tobacco product design on smoking unfiltered cigarettes. This is the first study to examine ST variables longitudinally, measured at multiple time points, and using unfiltered cigarettes.

Remediating Thirdhand Smoke Pollution in Multiunit Housing: Temporary Reductions and the Challenges of Persistent Reservoirs.

INTRODUCTION: Toxic tobacco smoke residue, also known as thirdhand smoke (THS), can persist in indoor environments long after tobacco has been smoked. This study examined the effects of different cleaning methods on nicotine in dust and on surfaces. AIMS AND METHODS: Participants had strict indoor home smoking bans and were randomly assigned to: dry/damp cleaning followed by wet cleaning 1 month later (N = 10), wet cleaning followed by dry/damp cleaning (N = 10) 1 month later, and dry/damp and wet cleaning applied the same day (N = 28). Nicotine on surfaces and in dust served as markers of THS and were measured before, immediately after, and 3 months after the cleaning, using liquid chromatography with triple quadrupole mass spectrometry (LC-MS/MS). RESULTS: Over a 4-month period prior to cleaning, surface nicotine levels remained unchanged (GeoMean change: -11% to +8%; repeated measures r = .94; p < .001). Used separately, dry/damp and wet cleaning methods showed limited benefits. When applied in combination, however, we observed significantly reduced nicotine on surfaces and in dust. Compared with baseline, GeoMean surface nicotine was 43% lower immediately after (z = -3.73, p < .001) and 53% lower 3 months later (z = -3.96, p < .001). GeoMean dust nicotine loading declined by 60% immediately after (z = -3.55, p < .001) and then increased 3 months later to precleaning levels (z = -1.18, p = .237). CONCLUSIONS: Cleaning interventions reduced but did not permanently remove nicotine in dust and on surfaces. Cleaning efforts for THS need to address persistent pollutant reservoirs and replenishment of reservoirs from new tobacco smoke intrusion. THS contamination in low-income homes may contribute to health disparities, particularly in children. IMPLICATIONS: Administered sequentially or simultaneously, the tested cleaning protocols reduced nicotine on surfaces by ~50% immediately after and 3 months after the cleaning. Nicotine dust loading was reduced by ~60% immediately after cleaning, but it then rebounded to precleaning levels 3 months later. Cleaning protocols were unable to completely remove THS, and pollutants in dust were replenished from remaining pollutant reservoirs or new secondhand smoke intrusion. To achieve better outcomes, cleaning protocols should be systematically repeated to remove newly accumulated pollutants. New secondhand smoke intrusions need to be prevented, and remaining THS reservoirs should be identified, cleaned, or removed to prevent pollutants from these reservoirs to accumulate in dust and on surfaces.

Perceptions About the Impact of Cigarette Filters on the Environment and Smoking-Related Behaviors.

PURPOSE: Examine adolescents' and young adults' (AYAs) knowledge and perceptions about the composition and environmental harms of cigarette filters and determine how perceptions are associated with support for policy interventions. METHODS: Cross-sectional, convenience sample from 10 California schools. AYAs (N = 429; 70% < 21 years) were surveyed about tobacco use, perceptions of cigarette filters, their impact on the environment, and cigarette sales bans. RESULTS: Most agreed that filters are harmful to the environment and not biodegradable (89%, n = 383 respectively); fewer knew filters are made of plastic (43%, n = 185). AYAs who agreed that filters are harmful to the environment were more supportive of cigarette sales bans (OR = 2.78 [95% CI: 1.18, 6.58]). CONCLUSIONS: Knowledge of the environmental harms of cigarettes among AYAs may strengthen support for tobacco control. More research is needed to further understand the knowledge and attitudes about the environmental impact of tobacco and to clarify how this might add support for tobacco-related policies.