An examination of exposure to environmental tobacco smoke in public places and risk of lung cancer and heart disease

A three phase study examined environmental tobacco smoke (ETS) exposure and subsequent long-term risk of lung cancer and heart disease. Nicotine and cotinine were markers for the chemicals in ETS. Comparisons were made between airborne nicotine concentrations in casinos with differing levels of smoking restrictions. Measurement of nicotine using ceiling and breathing zone monitors was also conducted. Nicotine and cotinine concentrations in saliva and urine of exposed volunteers were measured concurrently. Concentrations of nicotine and cotinine were then used to calculate risk of lung cancer and heart disease. Results demonstrated that 1) levels of airborne nicotine were lower where smoking was restricted, 2) airborne nicotine measurements should be conducted in the breathing zone, and 3) conclusions based on salivary cotinine concentrations should be based on measurements averaged from groups of exposed individuals. Calculated risk levels for lung cancer ranged from 3.9 per million exposed to 1 per 10 persons exposed.