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VOLUME 53 , ISSUE 1 ( January-March, 2011 ) > List of Articles

Original Article

Breath Carbon Monoxide Levels in Different Forms of Smoking

Sheetu Singh, M Soumya, Anirudh Saini, Varun Mittal, Udai Veer Singh

Keywords : Hookah, Tobacco smoking, Bidi smoking, Chillum smoking, End-tidal carbon monoxide

Citation Information : Singh S, Soumya M, Saini A, Mittal V, Singh UV. Breath Carbon Monoxide Levels in Different Forms of Smoking. Indian J Chest Dis Allied Sci 2011; 53 (1):25-28.

DOI: 10.5005/ijcdas-53-1-25

License: CC BY-NC 4.0

Published Online: 10-06-2022

Copyright Statement:  Copyright © 2011; The Author(s).


Background and Objectives. Bidi, cigarette, hookah and chillum are common modes of tobacco smoking in India. Many people consider hookah and chillum smoking less toxic because smoke is filtered through water or wet cloth. We evaluated the toxicity of tobacco smoking by measuring end-tidal carbon monoxide (eCO) levels after various modes of smoking. Methods. Eighteen healthy smokers who smoked bidi, cigarette, hookah and chillum on six days were studied. They smoked one bidi, one cigarette, five minutes hookah, one serve (15 minutes) hookah, five minutes chillum and one serve (15 minutes) chillum on six days randomly. The eCO values were measured before initiation of smoking and for a period of one hour after the smoking session. Increase in eCO values in comparison to baseline after different modes of smoking was compared. Results. In comparison to baseline, mean eCO levels were raised by 4.94 (0.96) parts per million (ppm) immediately and 4.17 (1.07) ppm 60 minutes after cigarette smoking. Bidi smoking caused slightly less increase in mean eCO levels (3.17 [0.82]). One serve of hookah and chillum smoking caused elevation of mean eCO values by almost eight-folds higher than that of cigarette smoking. Five minutes of smoking with hookah (22.18 [5.29]) and one serve of hookah (33.0 [8.76]) and chillum (40.14 [12.73]) caused significantly higher values of mean increase in eCO in comparison to cigarette smoking (p<0.001). Conclusion. With regard to eCO levels, hookah and chillum smoking are much more toxic than cigarette smoking.

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  1. Food and Agriculture Organization of the United Nations. Issues in the global tobacco economy: selected case studies. Rome: Food and Agricultural Organization; 2003:p.54.
  2. World Health Organization. Tobacco: Deadly in any form or disguise – No Tobacco Day 2006. Geneva: World Health Organization; 2006: p. 21.
  3. Grekin ER, Ayna D. Argileh use among college students in the United States: an emerging trend. J Studies Alcohol Drugs 2008;69:472-5.
  4. Coburn RF, Forster RE, Kane PB. Considerations of the physiological variables that determine the blood carboxyhemoglobin concentration in man. J Clin Invest 1965;44:1899-1910.
  5. Mirza A, Eder V, Rochefort GY, Hyvelin JM, Machet MC, Fauchier L, et al. CO inhalation at dose corresponding to tobacco smoke worsens cardiac remodeling after experimental myocardial infarction in rats. Toxicol Sci 2005;85:976-82.
  6. Chattopadhyay A. Emperor Akbar as a healer and his eminent physicians. Bull Indian Institute Hist Med 2000; 30:151-8.
  7. Weiss W. The toxicity of tobacco smoke solutions for paramecium: the influence of various forms of filtration. Arch Environ Health 1965;10:904-9.
  8. Eissenberg T, Shihadeh A. Waterpipe tobacco and cigarette smoking: direct comparison of toxicant exposure. Am J Prevent Med 2009;37:518-23.
  9. Sajid KM, Akhter M, Malik GQ. Carbon monoxide fractions in cigarette and hookah smoke. J Pak Med Assoc 1993;43:179-82.
  10. Shafagoj YA, Mohammed FI. Levels of maximum endexpiratory carbon monoxide and certain cardiovascular parameters following hubble-bubble smoking. Saudi Med J 2002;23:953-8.
  11. World Health Organization. WHO study group on tobacco regulation (Tob Reg). (2005). Advisory Note: Waterpipe tobacco smoking: health effects, research needs and recommended action by regulators. Geneva: World Health Organization; 2005: p. 1.
  12. Knishkowy B, Amitai Y. Water-pipe (narghile) smoking: an emerging health risk behavior. Pediatrics 2005;116:e113-19.
  13. United States Centre for Disease Control. Bidi use among urban youth: Massachusetts, March-April 1999. MMWR Morb Mortal Wkly Rep 1999;48:796-9.
  14. Malson JL, Sims K, Murty R, Pickworth WB. Comparison of the nicotine content of tobacco used in beedis and conventional cigarettes. Tob Control 2001;10:181-3.
  15. Kumar R, Prakash S, Kushwah AS, Vijayan VK. Breath carbon monoxide concentration in cigarette and bidi smokers in India. Indian J Chest Dis Allied Sci 2010;52:19-24.
  16. Healton C, Messeri P, Reynolds T, Wolfe C, Stokes C, Ross J. Tobacco use among middle and high school students – US, 1999. MMWR Morb Mortal Wkly Rep 2000;49:49-53.
  17. Rahman M, Fukui T. Bidi smoking and health. Public Health 2000;114:123-7.
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