Cigarette Smoking, Smokeless Tobacco Use Prevalence, and Secondhand Smoke Exposure Evaluated Using Serum Cotinine Levels in the Time-frame of the Cheyenne River Sioux Tribal Clean Air Ordinance

摘要

Cheyenne River Sioux Tribal partners and communities sought academic partnerships as early as in 2000 in order to address concerns of immunotoxicity associated with mining waste metals to public water sources and PM exposures. The Cheyenne River Sioux Tribe is among the first Tribal Nations in the U. S. actively controlling tobacco exposures in public since 2015. Cigarette smoking is also a contributor of metal exposures. We collected cigarette smoking, smokeless tobacco and second hand smoke (SHS) information from 225 CRST adults (53% males, 47% females; mean age: 42.9 years (range: 18-77 yrs) enrolled to our Tribal environmental health study in addition to fishing and land-use surveys. Blood and urine samples were obtained for personal biomonitoring of metals and metalloids. We explored the effects of the new tobacco policy among participants enrolled into our study by describing tobacco use, ETS prevalence, and identified predictors of serum cotinine (SC) concentrations. Quantile regression modeling (QRM) of SC natural log values was utilized to provide estimates robust against SC outliers. Interaction term between active smoking and tobacco chewing was also included in the QRM. From all participants, 51% (N=114) reported current smoking and 58% (N=129) had current SHS exposure, of those 35 participants were non-tobacco users. Among tobacco chewers, 44% also smoked cigarettes. Significant differences in SC median concentrations were found among participants with and without current SHS exposure. Extremely high SC concentrations (～100 times larger than the median) were also detected in some non-tobacco users. After implementing the smoke-free air policy, SC decreased in CRST participants with intermediate (3-15 ng/ml) and high (>15 ng/ml) SC levels showing association with an abatement of opportunities for SHS exposure. Significant predictors of SC levels were sampling year, current smoking, and smokeless tobacco use. No gender differences were observed in SC.