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## Smoking & Tobacco

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# Smoke-Free Hotel Rooms Aren't, Study Finds

By Salynn Boyles, Contributing Writer, MedPage Today
Published: May 15, 2013
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse Planner

Travelers who want to avoid exposure to tobacco pollutants may want to search for hotels that are completely smoke-free, results of a recent study suggested.

Air levels of the tobacco byproduct 3-ethynylpyridine (3EP) were more than seven times higher in nonsmoking guest rooms in hotels where smoking was permitted than in rooms in smoke-free hotels (6.4 ng/m3 versus 0.8 ng/m3; P=0.049), according to Georg E. Matt, PhD, of San Diego State University in California, and colleagues.

And nonsmokers who who stayed overnight in nonsmoking rooms in hotels that allowed smoking showed elevated levels of the tobacco byproduct nicotine on finger-wipe analysis, compared with when they stayed overnight in completely smoke-free hotels (11.9 versus 2.4 ng/wipe; P=0.029), they wrote in the online journal Tobacco Control.

The findings suggest that partial smoking bans in hotels do not protect nonsmokers from exposure to so-called "third-hand" smoke -- the residue from cigarettes that remains in the air and on surfaces long after the smoke has cleared.

"Guests who wish to protect themselves from exposure to tobacco smoke should avoid hotels that permit smoking and instead stay in completely smoke-free hotels," the researchers wrote.

About 43 million people in the U.S., or 19% of the adult population, still smoke cigarettes, according to the CDC. And while many large hotel chains -- including Westin Hotels, Marriott, Wyndham and Hyatt Place -- have gone completely smoke-free, many others still permit smoking in designated guest rooms.

In an effort to examine the effectiveness of partial smoking bans in hotels, Matt and colleagues conducted air and surface tests in randomly selected rooms in 10 San Diego hotels with smoking bans and 30 hotels that allowed smoking in some rooms but not others.

Surfaces and air were analyzed for nicotine and 3EP, and nonsmoking study participants who stayed overnight in the hotels provided urine and finger wipe samples to determine exposure to nicotine and the tobacco-specific carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone as measured by their metabolites cotinine NNAL, respectively.

The analysis revealed that:

- Compared with hotels that did not allow smoking, hotels with smoking permitted in some rooms had higher surface nicotine levels and higher air 3EP levels in both smoking guest rooms and nonsmoking rooms.
- Surface nicotine levels were more than twice as high in nonsmoking rooms of hotels with partial bans as in rooms with total bans (3.7 mcg/m2 compared with 1.4 mcg/m2, P= 0.048).
- Surface and air nicotine levels in rooms where previous guests had smoked were 35 and 22 times higher than those of rooms in hotels with smoking bans, and hallway surfaces outside smoking rooms also showed higher nicotine levels than those outside nonsmoking rooms (9.3 mcg/m2 versus 1.2 mcg/m2, P=0.008).

The mean level of 3EP in the air was 63.6 ng/m3 in smoking rooms -- about 10 times higher than the mean level in nonsmoking rooms of hotels that allowed smoking (P<0.001) and 75 times higher than in rooms in hotels that banned smoking completely (P=0.003).

Nonsmoking study participants who stayed overnight in hotel guest rooms that allowed smoking had the highest concentrations of nicotine as measured by finger-wipe analysis (60.3 ng/wipe).

For the 10 most polluted rooms examined, based on surface nicotine levels, the researchers determined urinary levels of tobacco-exposure biomarker NNAL in a group of nonsmokers before and after their overnight stays in the rooms.

Levels of the biomarker increased by an average of 0.39 pg NNAL/mg creatinine (P=0.003), from 0.86 pg NNAL/mg creatinine before the 12-to-14-hour stay to 1.24 pg NNAL/mg creatinine after the overnight stay.

"It is not uncommon for nonsmokers to be offered designated smoking rooms when a hotel has a shortage of designated nonsmoking rooms," Matt and colleagues wrote. "Findings from this study suggest that this practice should be abandoned because designated smoking rooms are highly polluted with third-hand smoke and lead to tobacco smoke exposure, including exposure to the potent tobacco-specific lung carcinogen NNK (assessed through measuring its metabolite NNAL in urine)."

This research was supported by funds from the California Tobacco-Related Disease Research Grants Program Office of the University of California.

The researchers report no competing interests.

Primary source: Tobacco Control
Source reference:
Matt G, et al "Thirdhand smoke and exposure in California hotels: non-smoking rooms fail to protect non-smoking hotel guests from tobacco smoke exposure" Tob Control 2013; DOI: 10.1136/tobaccocontrol-2012-050824.

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