title: Children's exposure to secondhand and thirdhand smoke carcinogens and toxicants in homes of hookah smokers.
abstract: BACKGROUND
  We examined homes of hookah-only smokers and nonsmokers for levels of indoor air nicotine (a marker of secondhand smoke) and indoor surface nicotine (a marker of thirdhand smoke), child uptake of nicotine, the carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), and the toxicant acrolein by analyzing their corresponding metabolites cotinine, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) and NNAL-glucuronides (total NNAL) and 3-hydroxypropylmercapturic acid.
  
  
  METHODS
  Data were collected at 3 home visits during a 7-day study period from a convenience sample of 24 households with a child 5 years or younger. Three child urine samples and 2 air and surface samples from the living room and the child bedroom were taken in homes of nonsmokers (n = 5) and hookah-only smokers (n = 19) comprised of daily hookah smokers (n = 8) and weekly/monthly hookah smokers (n = 11).
  
  
  RESULTS
  Nicotine levels in indoor air and on surfaces in the child bedrooms in homes of daily hookah smokers were significantly higher than in homes of nonsmokers. Uptake of nicotine, NNK, and acrolein in children living in daily hookah smoker homes was significantly higher than in children living in nonsmoker homes. Uptake of nicotine and NNK in children living in weekly/monthly hookah smoker homes was significantly higher than in children living in nonsmoker homes.
  
  
  CONCLUSIONS
  Our data provide the first evidence for uptake of nicotine, the tobacco-specific lung carcinogen NNK, and the ciliatoxic and cardiotoxic agent acrolein in children living in homes of hookah smokers. Our findings suggest that daily and occasional hookah use in homes present a serious, emerging threat to children's long-term health.
authors.affiliation: Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, Division of Health Promotion, San Diego State University, San Diego, CA; nadakassem@hotmail.com.
authors.forename: Nada O F
authors.initials: NO
authors.lastname: Kassem
authors.affiliation: Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, Division of Health Promotion, San Diego State University, San Diego, CA;
authors.forename: Reem M
authors.initials: RM
authors.lastname: Daffa
authors.affiliation: Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, Division of Health Promotion, San Diego State University, San Diego, CA;
authors.forename: Sandy
authors.initials: S
authors.lastname: Liles
authors.affiliation: Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, Division of Health Promotion, San Diego State University, San Diego, CA;
authors.forename: Sheila R
authors.initials: SR
authors.lastname: Jackson
authors.affiliation: Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, Division of Health Promotion, San Diego State University, San Diego, CA;
authors.forename: Noura O
authors.initials: NO
authors.lastname: Kassem
authors.affiliation: Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, Division of Health Promotion, San Diego State University, San Diego, CA;
authors.forename: Maram A
authors.initials: MA
authors.lastname: Younis
authors.affiliation: Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, Division of Health Promotion, San Diego State University, San Diego, CA;
authors.forename: Setoo
authors.initials: S
authors.lastname: Mehta
authors.affiliation: Masonic Cancer Center, University of Minnesota, Minneapolis, MN;
authors.forename: Menglan
authors.initials: M
authors.lastname: Chen
authors.affiliation: Departments of Medicine and Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, CA;
authors.forename: Peyton
authors.initials: P
authors.lastname: Jacob
authors.affiliation: Masonic Cancer Center, University of Minnesota, Minneapolis, MN;
authors.forename: Steve G
authors.initials: SG
authors.lastname: Carmella
authors.affiliation: Department of Chemistry, San Diego State University, San Diego, CA;
authors.forename: Dale A
authors.initials: DA
authors.lastname: Chatfield
authors.affiliation: Departments of Medicine and Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, CA;
authors.forename: Neal L
authors.initials: NL
authors.lastname: Benowitz
authors.affiliation: Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, Division of Health Promotion, San Diego State University, San Diego, CA; Department of Psychology, San Diego State University, San Diego, CA.
authors.forename: Georg E
authors.initials: GE
authors.lastname: Matt
authors.affiliation: Masonic Cancer Center, University of Minnesota, Minneapolis, MN;
authors.forename: Stephen S
authors.initials: SS
authors.lastname: Hecht
authors.affiliation: Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, Division of Health Promotion, San Diego State University, San Diego, CA;
authors.forename: Melbourne F
authors.initials: MF
authors.lastname: Hovell
mesh_terms: D000111:Acetylcysteine / Q000031:analogs & derivatives / Q000652:urine; D000388:Air / Q000032:analysis; D015415:Biomarkers / Q000652:urine; D002273:Carcinogens / Q000032:analysis*; D002675:Child, Preschool; D003367:Cotinine / Q000652:urine; D003430:Cross-Sectional Studies; D004781:Environmental Exposure / Q000032:analysis*; D005191:Family Characteristics; D005260:Female; D006798:Housing; D006801:Humans; D008297:Male; D009538:Nicotine / Q000032:analysis; D009602:Nitrosamines / Q000032:analysis / Q000652:urine; D011725:Pyridines / Q000652:urine; D012907:Smoking; D014028:Tobacco Smoke Pollution / Q000032:analysis*
chemical_list: D015415:Biomarkers; D002273:Carcinogens; D009602:Nitrosamines; D011725:Pyridines; D014028:Tobacco Smoke Pollution; D009538:Nicotine; C016583:4-(N-methyl-N-nitrosamino)-1-(3-pyridyl)-1-butanone; C001423:S-(3-hydroxypropyl)cysteine N-acetate; C099565:4-(methylnitrosamino)-1-(3-pyridyl)-1-butan-1-ol; D003367:Cotinine; D000111:Acetylcysteine