Effects of exposure to direct and secondhand hookah and e-cigarette aerosols on ambient air quality and cardiopulmonary health in adults and children: protocol for a panel study.

Introduction:
This text discusses a study on the effects of e-cigarette and hookah use on home ambient air quality and human health. The study aims to fill gaps in knowledge on the exposure atmosphere in homes where these products are used, as well as assess measurements of cardiopulmonary function changes and biomarkers of effect in individuals actively and passively exposed to smoke and aerosols from hookah and e-cigarettes.

Key Points:

* The study uses a pre/post exposure design with two test groups (hookah and e-cigarettes) and two control groups (non-smoking/non-vaping and cigarette).
* Participants include both smoking/vaping adults and non-smoking/non-vaping adults and/or children.
* air quality measures, cardiopulmonary measures, and biological samples are taken during and after a smoking/vaping session, as well as 24 hours later.
* The study includes both environmental and biological measures for individuals actively and passively exposed to smoke and aerosols.
* Two control groups are included to provide nuance in interpreting results.
* The study does not restrict the amount or frequency of smoke or aerosol produced, or the brand/type of product used.
* The study does not include a random sample of individuals, and may not be representative of the New York metro area.

Main Message:
This study aims to provide valuable information on the effects of e-cigarette and hookah use on home ambient air quality and human health, specifically in the context of passive exposure. By including both environmental and biological measures, the study is well-suited to measuring actual human exposure. The inclusion of two control groups also allows for more nuanced interpretation of results. however, the study is not without its limitations, such as the lack of randomization and potential brand/type variation in products used. Overall, the study has the potential to contribute to our understanding of the health impacts of e-cigarette and hookah use.

Shearston J, Lee L, Eazor J, et al. Effects of exposure to direct and secondhand hookah and e-cigarette aerosols on ambient air quality and cardiopulmonary health in adults and children: protocol for a panel study. BMJ Open. 2019;9:e029490. doi:10.1136/bmjopen-2019-029490