Change in carbon monoxide exposure among water pipe bar patrons


Introduction: Water pipe (also known as "hookah") smoking is increasing around the world, including the United States, where water pipe bars have sprung up rapidly around college campuses. Users are exposed to several toxicants, including carbon monoxide (CO). We evaluated change in exhaled CO and estimated carboxyhemoglobin levels among water pipe bar patrons in Tampa, FL. Methods: Exhaled breath samples were obtained immediately before entering and after leaving 6 water pipe bars in Tampa, FL to measure CO boost and factors affecting CO change. Demographics, cigarette use status, and characteristics of water pipe use during the bar visit also were assessed. Results: Among the sample of 166 participants, mean CO increased from 6.5 parts per million (p.p.m.) to 58.2 p.p.m. (a 795% relative boost; p < .001). CO change was higher for patrons who were dual (water pipe plus cigarette) smokers compared with water pipe-only smokers, and significant factors of CO change were frequency of water pipe use, number of charcoals, number of tobacco bowls, and time spent in the bar (all p-values < .05). Conclusion: U.S. water pipe bar patrons are exposed to considerable amounts of CO, which could put them at risk of acute illness and chronic heart and lung diseases. Environmental and policy controls are needed to curb this increasingly popular tobacco use method in the United States. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved.

Publication Title

Nicotine and Tobacco Research