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All Rights Reserved [Search All ] [ ] Input Search Term [ ] Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In full text icon Full Text contents icon Contents figure icon Figures / Tables multimedia icon Multimedia attach icon Supplemental Content references icon References related icon Related comments icon Comments Download PDF Comment Top of Article * Introduction * Methods * Results * Discussion * Article Information * References Figure. Continuous Fine Particulate Matter (PM[2.5]) Concentrations During 8 Household Smoking (HS) Sessions When Doors Were Closed View LargeDownload Each HS session is delineated by a colored line. The dashed blue line represents the mean concentration. Active smoking lasted 90 to 170 minutes. The dashed red line denotes the US Environmental Protection Agency (EPA) national ambient air quality standard for 98th percentile 24-hour PM[2.5] exposure (35 mg/m^3). Table. PM[2.5] Secondhand Cannabis and Tobacco Smoke Exposure Concentrations in Homes^a View LargeDownload Supplement. eMethods. Supplemental Methods for Measuring Secondhand Cannabis Smoke eReference 1. Glantz SA, Halpern-Felsher B, Springer ML. Marijuana, secondhand smoke, and social acceptability. JAMA Intern Med. 2018;178 (1):13-14. doi:10.1001/jamainternmed.2017.5301 PubMedGoogle Scholar Crossref 2. Keyhani S, Steigerwald S, Ishida J, et al. Risks and benefits of marijuana use: a national survey of U.S. adults. Ann Intern Med. 2018;169(5):282-290. doi:10.7326/M18-0810 PubMedGoogle Scholar Crossref 3. Office on Smoking and Health (US). The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Centers for Disease Control & Prevention; 2006. 4. Wang X, Derakhshandeh R, Liu J, et al. One minute of marijuana secondhand smoke exposure substantially impairs vascular endothelial function. J Am Heart Assoc. 2016;5(8):e003858. doi:10.1161/ JAHA.116.003858 PubMedGoogle Scholar 5. Shearston JA, Eazor J, Lee L, et al. Effects of electronic cigarettes and hookah (waterpipe) use on home air quality. Tob Control. 2021;tobaccocontrol-2020-056437. doi:10.1136/ tobaccocontrol-2020-056437 PubMedGoogle Scholar 6. Acevedo-Bolton V, Ott WR, Cheng KC, Jiang RT, Klepeis NE, Hildemann LM. Controlled experiments measuring personal exposure to PM[2.5] in close proximity to cigarette smoking. Indoor Air. 2014; 24(2):199-212. doi:10.1111/ina.12057 PubMedGoogle ScholarCrossref See More About Public Health Adolescent Medicine Pediatrics Addiction Medicine Tobacco and e-Cigarettes Lifestyle Behaviors --------------------------------------------------------------------- Sign Up for Emails Based on Your Interests Select Your Interests Customize your JAMA Network experience by selecting one or more topics from the list below. * Acid Base, Electrolytes, Fluids * Addiction Medicine * Allergy and Clinical Immunology * Anesthesiology * Anticoagulation * Art and Images in Psychiatry * Bleeding and Transfusion * Cardiology * Caring for the Critically Ill Patient * Challenges in Clinical Electrocardiography * Clinical Challenge * Clinical Decision Support * Clinical Implications of Basic Neuroscience * Clinical Pharmacy and Pharmacology * Complementary and Alternative Medicine * Consensus Statements * Coronavirus (COVID-19) * Critical Care Medicine * Cultural Competency * Dental Medicine * Dermatology * Diabetes and Endocrinology * Diagnostic Test Interpretation * Diversity, Equity, and Inclusion * Drug Development * Electronic Health Records * Emergency Medicine * End of Life * Environmental Health * Ethics * Facial Plastic Surgery * Gastroenterology and Hepatology * Genetics and Genomics * Genomics and Precision Health * Geriatrics * Global Health * Guide to Statistics and Medicine * Guidelines * Hair Disorders * Health Care Delivery Models * Health Care Economics, Insurance, Payment * Health Care Quality * Health Care Reform * Health Care Safety * Health Care Workforce * Health Disparities * Health Inequities * Health Informatics * Health Policy * Hematology * History of Medicine * Humanities * Hypertension * Images in Neurology * Implementation Science * Infectious Diseases * Innovations in Health Care Delivery * JAMA Infographic * Law and Medicine * Leading Change * Less is More * LGBTQ * Lifestyle Behaviors * Medical Coding * Medical Devices and Equipment * Medical Education * Medical Education and Training * Medical Journals and Publishing * Melanoma * Mobile Health and Telemedicine * Narrative Medicine * Nephrology * Neurology * Neuroscience and Psychiatry * Notable Notes * Nursing * Nutrition * Nutrition, Obesity, Exercise * Obesity * Obstetrics and Gynecology * Occupational Health * Oncology * Ophthalmic Images * Ophthalmology * Orthopedics * Otolaryngology * Pain Medicine * Pathology and Laboratory Medicine * Patient Care * Patient Information * Pediatrics * Performance Improvement * Performance Measures * Perioperative Care and Consultation * Pharmacoeconomics * Pharmacoepidemiology * Pharmacogenetics * Pharmacy and Clinical Pharmacology * Physical Medicine and Rehabilitation * Physical Therapy * Physician Leadership * Poetry * Population Health * Preventive Medicine * Professional Well-being * Professionalism * Psychiatry and Behavioral Health * Public Health * Pulmonary Medicine * Radiology * Regulatory Agencies * Research, Methods, Statistics * Resuscitation * Rheumatology * Risk Management * Scientific Discovery and the Future of Medicine * Shared Decision Making and Communication * Sleep Medicine * Sports Medicine * Stem Cell Transplantation * Surgery * Surgical Innovation * Surgical Pearls * Teachable Moment * Technology and Finance * The Art of JAMA * The Arts and Medicine * The Rational Clinical Examination * Tobacco and e-Cigarettes * Toxicology * Trauma and Injury * Treatment Adherence * Ultrasonography * Urology * Users' Guide to the Medical Literature * Vaccination * Venous Thromboembolism * Veterans Health * Violence * Women's Health * Workflow and Process * Wound Care, Infection, Healing Get the latest research based on your areas of interest. 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JAMA Netw Open. 2022;5 (3):e224744. doi:10.1001/jamanetworkopen.2022.4744 Download citation file: Ris (Zotero) EndNote BibTex Medlars ProCite RefWorks Reference Manager Mendeley (c) 2022 * Permissions Research Letter Public Health March 30, 2022 Fine Particulate Matter Exposure From Secondhand Cannabis Bong Smoking Patton Khuu Nguyen, MPH^1; S. Katharine Hammond, PhD^1 Author Affiliations Article Information * ^1Environmental Health Sciences Division, School of Public Health, University of California, Berkeley JAMA Netw Open. 2022;5(3):e224744. doi:10.1001/ jamanetworkopen.2022.4744 visual abstract icon Visual Abstract editorial comment icon Editorial Comment related articles icon Related Articles author interview icon Interviews multimedia icon Multimedia Introduction Secondhand cannabis smoke (SHCS) is a novel exposure source uncharacterized in homes but containing known health risk factors.^1 Although 27% of young adults believe SHCS exposure is safe,^2 cannabis smoke has several hundred toxic chemicals, carcinogens, and fine particulate matter (PM[2.5]), many at higher concentrations than tobacco smoke.^1 Decades of secondhand tobacco smoke (SHTS) research demonstrate causal links to cancer, respiratory and cardiovascular diseases, preterm birth, and decreased immune function.^3 These concerns have not translated to cannabis bong smoking, a popular consumption method in social settings among young adults, wherein smoke is drawn through water. However, like SHTS, 1 minute of SHCS caused significant endothelial dysfunction in rats.^4 This cohort study measured PM[2.5] levels from social bong smoking; it is the first, to our knowledge, to quantify SHCS levels from social cannabis smoking in the home. Methods Levels of PM[2.5] were measured before, during, and after 8 cannabis social-smoking sessions in one 20-m^2 household living room (eMethods in the Supplement). An aerosol monitor (SidePak AM510; TSI Inc) measured PM[2.5] concentrations where a nonsmoker might sit. The University of California, Berkeley, Office for the Protection of Human Subjects deemed this study not human participants research and waived review. This study followed the STROBE reporting guideline. The Wilcoxon rank sum 2-sided test assessed statistical differences between PM[2.5] concentrations before and during smoking. Analysis was performed using RStudio, version 1.4 (RStudio). Two-sided P < .05 indicated statistical significance. Results Home cannabis bong smoking significantly increased PM[2.5] from background levels (conditions existing before the smoking began) in all sessions by 100-fold to 1000-fold for 6 of 8 sessions; the other 2 sessions had high background and significantly increased PM[2.5] more than 20-fold (P < .001 for all 8 sessions). During the first 10 minutes of smoking, mean (SD) PM[2.5] concentrations increased to 410 (220) mg/m^3, after 15 minutes to 570 (290) mg/m^3, after 30 minutes to 1000 (320) mg/m^3, and went as high as 2500 mg/m^3 in 1 session ( Figure). The concentration during smoking increased to a mean (SD) of 1300 (280) mg/m^3 (Table). During 2-hour smoking sessions, mean (SD) 5-minute peak PM[2.5] concentration was 1700 (460) mg/m^3 and remained half that 90 minutes after smoking ceased. Each half hour after smoking ceased, mean concentration declined to 78% of peak value, then 60%, then 40%, and, after 110 minutes, 31%. In the 1 session monitored for 12 hours after smoking stopped, PM[2.5] remained elevated at 50 mg/m^3, more than 10 times the background concentration. Cannabis bong smoking in the home generated 4 times greater PM[2.5] concentrations than cigarette or tobacco hookah (waterpipe) smoking (Table). Discussion The PM[2.5] concentrations generated in a home during social cannabis bong smoking to which a nonsmoking resident might be exposed were greatly increased compared with background levels, and PM[2.5] decayed only gradually after smoking ceased. After 15 minutes of smoking, mean PM[2.5] (570 mg/m^3) (Figure) was more than twice the US Environmental Protection Agency (EPA) hazardous air quality threshold (>250 mg/m^3). If one assumes the exposure concentrations were at the mean levels observed, a single home smoking session with no other exposures would generate an estimated mean daily concentration (200 mg/m^3) that greatly exceeds the average in cigarette-smoking homes (44 mg/m^3), nonsmoking homes (15 mg/m^3), and the US EPA daily standard (35 mg/m^3).^3 A strength of this study is that measurements were made during actual social bong smoking sessions without artificial constraints. Limitations include that cannabis smoking was not directly observed. This cohort study suggests that, contrary to popular beliefs, bong smoking is not safe. Decades ago, many people thought SHTS presented no health risk to nonsmokers. Scientific research since then changed this perception and led to smoke-free environments.^3 Incorrect beliefs about SHCS safety promote indoor cannabis smoking.^1^,2 Nonsmokers are exposed to even higher concentrations of SHCS materials during "hot-boxing," the popular practice in which cannabis smokers produce high volumes of smoke in an enclosed environment. This study's findings suggest SHCS in the home is not safe and that public perceptions of SHCS safety must be addressed. Back to top Article Information Accepted for Publication: February 9, 2022. Published: March 30, 2022. doi:10.1001/jamanetworkopen.2022.4744 Open Access: This is an open access article distributed under the terms of the CC-BY License. (c) 2022 Nguyen PK et al. JAMA Network Open . Corresponding Author: S. Katharine Hammond, PhD, Environmental Health Sciences Division, School of Public Health, University of California, Berkeley, 2121 Berkeley Way #5302, Berkeley, CA 94720 ( hammondk@berkeley.edu). Author Contributions: Both authors had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Concept and design: Both authors. Acquisition, analysis, or interpretation of data: Both authors. Drafting of the manuscript: Both authors. Critical revision of the manuscript for important intellectual content: Both authors. Statistical analysis: Nguyen. Obtained funding: Both authors. Administrative, technical, or material support: Both authors. Supervision: Hammond. Conflict of Interest Disclosures: None reported. Funding/Support: This work was funded by the University of California (UC) Smoke- and Tobacco-Free Student Fellowship from the UC Office of the President (UCOP). Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Additional Contributions: We thank Elizabeth Noth, PhD, Charles Perrino, MS, Sa Liu, PhD, Beverly Shen, PhD, and the rest of the Berkeley Exposure Assessment Research Group for advising the chemistry work and data analysis. None received financial compensation for their contributions. The UCOP Fellowship contributed to the salary of Mr Perrino, the laboratory manager; the others were not financially compensated for their contributions. References 1. Glantz SA, Halpern-Felsher B, Springer ML. Marijuana, secondhand smoke, and social acceptability. JAMA Intern Med. 2018;178 (1):13-14. doi:10.1001/jamainternmed.2017.5301 PubMedGoogle Scholar Crossref 2. Keyhani S, Steigerwald S, Ishida J, et al. Risks and benefits of marijuana use: a national survey of U.S. adults. Ann Intern Med. 2018;169(5):282-290. doi:10.7326/M18-0810 PubMedGoogle Scholar Crossref 3. Office on Smoking and Health (US). The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Centers for Disease Control & Prevention; 2006. 4. Wang X, Derakhshandeh R, Liu J, et al. One minute of marijuana secondhand smoke exposure substantially impairs vascular endothelial function. J Am Heart Assoc. 2016;5(8):e003858. doi:10.1161/ JAHA.116.003858 PubMedGoogle Scholar 5. Shearston JA, Eazor J, Lee L, et al. Effects of electronic cigarettes and hookah (waterpipe) use on home air quality. Tob Control. 2021;tobaccocontrol-2020-056437. doi:10.1136/ tobaccocontrol-2020-056437 PubMedGoogle Scholar 6. Acevedo-Bolton V, Ott WR, Cheng KC, Jiang RT, Klepeis NE, Hildemann LM. Controlled experiments measuring personal exposure to PM[2.5] in close proximity to cigarette smoking. 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