Measuring Indoor Air Quality of Hookah Lounges

Many states have implemented smoke-free workplace laws to protect employees and customers from exposure to secondhand smoke. However, exemptions in these laws have allowed indoor tobacco smoking in hookah lounges to proliferate in recent years. To describe the amount of secondhand smoke in hookah lounges, we measured the indoor air quality of 10 hookah lounges in Oregon. Air quality measurements ranged from “unhealthy” to “hazardous” according to Environmental Protection Agency standards, indicating a potential health risk for patrons and employees.Hookahs are pipes used to smoke flavored, sweetened tobacco. Hookah tobacco smoke contains tar, carbon monoxide and other toxins found in cigarette smoke, and in a typical hookah session, smokers inhale more than 40 times the volume of smoke produced by a cigarette.1–3 Hookah lounges are businesses that provide an indoor environment for hookah smoking and sell hookah tobacco in dozens of candy and fruit flavors.4 Indoor smoking in hookah lounges can expose employees and customers to secondhand smoke. Many states have implemented comprehensive smoke-free workplace laws that protect employees and patrons from exposure to secondhand smoke.5 Whereas some laws ban all tobacco use, others include exemptions which have allowed hookah lounges to proliferate.6,7Tobacco smoke is a mixture of chemical compounds that are bound to aerosol particles or are free in the gas phase.8 The concentration of particulate matter in the air is a strong indicator of pollution from tobacco smoke. Studies have measured particulate matter from cigarette smoke in bars and restaurants that allow indoor smoking, revealing employees and customers were exposed to hazardous levels of air pollution.9–11 Hookah smoke contains many of the same toxins as cigarette smoke2,3 and has been associated with lung cancer, respiratory illness, low birth weight, and periodontal disease.12 Laboratory studies have measured the chemical components of hookah smoke, and carbon monoxide levels have been measured in patrons exiting a hookah lounge.1–3,13 However, no study to date has described the concentration of particulate matter in the air inside hookah lounges. This study fills a research gap by analyzing the air quality inside hookah lounges in Oregon.