Carbon monoxide and respiratory symptoms in young adult passive smokers: a pilot study comparing waterpipe to cigarette

Int J Occup Med Environ Health. 2014 Aug;27(4):571-82. doi: 10.2478/s13382-014-0246-z. Epub 2014 Jul 7.


Objectives: Studies have correlated second hand smoke (SHS) with many diseases, especially respiratory effects. The goal of this study was to measure the impact of SHS on the respiratory symptoms and exhaled carbon monoxide.

Material and methods: The study population consisted of 50 young workers in restaurants serving waterpipes, 48 university students who sit frequently in the university cafeteria where cigarette smoking is allowed and 49 university students spending time in places where smoking is not allowed. Subjects completed questionnaires on socio-demographic characteristics, respiratory symptoms and exposure to SHS. Exhaled carbon monoxide levels were measured. ANOVA and Chi-square tests were used when applicable as well as linear and logistic regression analysis.

Results: Exposure to cigarette smoke in university (adjusted odds ratio (ORa) = 6.06) and occupational exposure to waterpipe smoke (ORa = 7.08) were predictors of chronic cough. Being married (ORa = 6.40), living near a heavy traffic road (ORa = 9.49) or near a local power generator (ORa = 7.54) appeared responsible for chronic sputum production. Moreover, predictors of chronic allergies were: being male (ORa = 7.81), living near a local power generator (ORa = 5.52) and having a family history of chronic respiratory diseases (ORa = 17.01). Carbon monoxide levels were augmented by the number of weekly hours of occupational exposure to waterpipe smoke (β = 1.46) and the number of daily hours of exposure to cigarette smoke (β = 1.14).

Conclusions: In summary, young non-smoker subjects demonstrated more chronic cough and elevated carbon monoxide levels when exposed to SHS while the effect of waterpipe was even more evident.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Carbon Monoxide / analysis*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Pilot Projects
  • Respiratory System / drug effects*
  • Surveys and Questionnaires
  • Tobacco Smoke Pollution / adverse effects*
  • Tobacco Smoke Pollution / analysis*
  • Young Adult


  • Tobacco Smoke Pollution
  • Carbon Monoxide