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Research letter
Carbon monoxide levels in water pipe smokers in rural Laos PDR
  1. Jaime Rivas Lopez1,
  2. Khamphithoune Somsamouth2,
  3. Boualoy Mounivong2,
  4. Ryan Sinclair3,
  5. Pramil N Singh1,4,5
  1. 1Department of Epidemiology and Biostatistics, School of Public Health, Loma Linda University, Loma Linda, California, USA
  2. 2Center for Information Education for Health, Ministry of Health, Vientiane, Laos PDR
  3. 3Department of Environmental Health, School of Public Health, Loma Linda University, Loma Linda, California, USA
  4. 4Department of Global Health, School of Public Health, Loma Linda University, Loma Linda, California, USA
  5. 5Center for Health Research, School of Public Health, Loma Linda University, Loma Linda, California, USA
  1. Correspondence to Dr Pramil N Singh, Center for Health Research, School of Public Health, Loma Linda University, Loma Linda, CA 92354, USA; psingh{at}llu.edu

https://doi.org/10.1136/tobaccocontrol-2012-050431

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    Regional trends indicate that tobacco waterpipe (TWP) smoking is common in the Eastern Mediterranean Region (EMR) and is increasing in global popularity.1–4 EMR TWP smokers use a commercially manufactured pipe (figure 1A)5 that is loaded with tobacco and sold in pre-weighed packages of 50 g or more. The EMR TWP user inhales a combination of tobacco and charcoal smoke after it has passed through water. Despite the mistaken belief that the water bath of the EMR TWP filters out harmful and/or addictive components,3 ,6–8 recent data indicates that EMR TWP smokers are exposed to biologically harmful levels of nicotine, tar, metals, volatile aldehydes, polycyclic aromatic hydrocarbons, volatile organic compounds and expired carbon monoxide (CO).9

    Figure 1

    (A) Eastern mediterranean tobacco waterpipe (left), (B) Asian tobacco waterpipe (right).

    In the Western Pacific Region, the Asian tobacco water pipe (ATWP, figure 1B) is a homemade pipe that consists of a tube (made of …

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    Footnotes

    • Funding This study was supported by grant R03 TWOO7345-01 from Fogarty/NIH (PI: Pramil Singh).

    • Competing interests None.

    • Patient consent Obtained.

    • Ethics approval Ethics review and approval was obtained by the Institutional Review Board of Loma Linda University and the Ethics Committee on Research, Ministry of Health, Vientiane Capital, Laos PDR.

    • Provenance and peer review Not commissioned; externally peer reviewed.