Nargile ve sigara içim şekillerinin ve maruz kalım oranlarının karşılaştırılması

Yıl 2014, Cilt: 12 Sayı: 3, 140 - 152, 30.12.2014

Erdem Pulcu Ann Mcneill

https://doi.org/10.20518/thsd.21703

Öz

Amaç: Küresel olarak nargile kullanıcılarının sayısı yaklaşık 100 milyon kişi olmasına karşın, sigara içimi ile kıyaslandığında nargile ile ilgili daha az bilimsel çalışma bulunmaktadır. Bu araştırmanın amacı, nargile kullanımın giderek arttığı düşünülen Türkiye’de, nargile kullanıcılarının sigara kullanıcılarına kıyasla dumana maruz kalım ve içim dinamiklerinin değerlendirilmesidir. 

Yöntem:  İstanbul’dan olasılıklı olmayan örnekleme yöntemi ile nargile (n=20) ve sigara içicisi (n=110) kişiler çalışmaya dahil edilmiştir. Gerek nargile gerekse sigara içicileri benzer protokollerle takip edilerek, iki kez laboratuvar testine tabi tutulmuş, içim dinamikleri ve nefeslerindeki karbon monoksit (CO) oranının yanı sıra tükürük ve idrar örneklerinde sırasıyla kotinin ve 1-hidroksipiren (1-HOP) ölçümleri yapılmıştır. Sigara içenler iki laboratuar izlemi sırasında ve arada geçen 24 saatlik süre zarfında içtikleri bütün sigaralar için, nargile içenler ise özel tasarlanmış benzer bir içim kayıt cihazını iki kez sadece laboratuar ortamında kullanmışlardır. 

Bulgular: Ortalama olarak, her bir nargile içiminde inhale edilen duman hacmi sigara içicilerine göre 20 kat daha fazla olup, ölçümler sırasıyla 1077.63 ml (± 486.03)' ye karşı 55.96 ml (± 15.12)’dir. Nargile içicilerinde sigara içicilerine kıyasla nargile içimini takiben anlamlı olarak daha yüksek CO artışı görülmüştür (ortalamalar: 42.9'a karşı 4.2; p<0.001).  Sigara içicilerine kıyasla nargile içicilerinde daha düşük kotinin ve 1-Hidroksipiren (1-HOP) düzeyleri gözlenmiştir (p<0.001). 

Sonuç: Türkiye’de nargile içimi sırasında kullanıcılar daha fazla miktarda dumana ve daha yüksek CO düzeylerine maruz kalmaktadır. Ancak nargilenin kullanıcılar tarafından rapor edilen daha az sıklıkta içimine bağlı olarak, kullanıcıların diğer duman bileşenlerine sigaraya göre daha az düzeyde maruz kaldığı gözlenmektedir.  Nargile içimi esnasında maruz kalınan yüksek duman hacmi toplum sağlığı açısından endişe vericidir.

Anahtar Kelimeler

sigara içme, nargile karbon monoksit, kotinin, 1- hidroksipiren

Smoking patterns in waterpipe smokers compared with cigarette smokers: an exploratory study of puffing dynamics and smoke exposure

Öz

Aim: It is estimated that globally there are about 100 million people who smoke waterpipes daily yet exposure resulting from smoking waterpipes is under-researched relative to cigarette smoking. This exploratory study assesses smoke exposure and puffing profiles among waterpipe smokers in comparison with cigarette smokers in Turkey, where there is a concern that waterpipe smoking prevalence is increasing. 

Method: A convenience sample of waterpipe (n=20) and cigarette smokers (n=110) was recruited from Istanbul, Turkey. Both waterpipe and cigarette smokers followed broadly a similar protocol with two visits to the laboratory where puff recordings, measurements of expired air carbon monoxide (CO) as well as saliva and urine samples for measurements of cotinine and 1-hydroxypyrene (1-HOP) were taken. Both group of smokers used specially designed puff recording devices to establish puffing profiles unique for cigarettes and waterpipes.

Results: On average, the volume of smoke inhaled from each puff of a waterpipe was almost 20 times greater than that from a manufactured cigarette: 1077.63 ml (±486.03) versus 55.96 ml (±15.12) respectively. Waterpipe smokers experienced significantly higher boosts of expired air CO following smoking a waterpipe in the laboratory compared with those smoking a cigarette, (means 42.9 versus 4.2; p<0.001). Lower levels of cotinine and 1-HOP were observed in waterpipe smokers compared with cigarette smokers (p<0.001). 

Conclusion: Waterpipe smokers in Turkey are exposed to larger volumes of smoke and higher CO levels, but less frequent nature of their smoking seems to be reflected in lower levels of exposure to other smoke constituents. The high smoke intake during waterpipe smoking is of public health concern.

Anahtar Kelimeler

Smoking, waterpipe, carbon monoxide, cotinine, 1-Hydroxypyrene

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