Urinary NNAL and nicotine contamination in homes of hookah smokers

This pilot study compared homes of hookah smokers (n=19) with homes of nonsmokers (n=5) on levels of nicotine contamination of household surfaces, and levels of urinary NNAL in resident children. Methods: Three urine samples were taken from a child, and surface wipe samples were taken from window sills in the living room and the child's sleeping area. The mean age of children was 2.86 years (SD=0.97). One-way analysis of variance was performed on geometric means of measured values. Results: The highest urinary NNAL level normalized with creatinine of 3 spot urine samples collected over one week was significantly higher in children living in homes of hookah smokers who smoke only outdoors, n=11, (10.09pg/mg, 95%CI:3.95-23.86) versus children living in homes of hookah smokers who smoke indoors, n=8, (6.74pg/mg, 95%CI:1.24-23.76) and versus children living in nonsmoker homes, n=5, (0.56pg/mg, 95%CI:0.20-1.03). Levels of nicotine contamination of household surfaces in homes of hookah smokers who smoke only outdoors (living room, 28.19µg/m2, 95%CI:8.07-92.97; child's room, 18.54µg/m2, 95%CI:7.79-42.41), and hookah smokers who smoke indoors (living room, 38.01µg/m2, 95%CI:6.31-207.3; child's room, 141.18µg/m2, 95%CI:26.32-739.06) were significantly higher than in nonsmoker homes (living room, 1.37µg/m2, 95%CI:0.0-5.85; child's room, 1.36µg/m2, 95%CI:0.0-6.61). However, given the wide confidence intervals and the small sample size, there was no significant difference in nicotine contamination of household surfaces between living room and child's room within homes of all hookah smokers, or across homes by location of hookah smoking: indoors versus outdoors. Conclusion: Findings inform estimates of health risks for children exposed to hookah secondhand smoke.