Handwashing Results in Incomplete Nicotine Removal from Fingers of Individuals who Smoke: A Randomized Controlled Experiment

Thomas F. Northrup; Angela L. Stotts; Robert Suchting; Amir M. Khan; Michelle R. Klawans; Charles Green; Eunha Hoh; Melbourne F. Hovell; Georg E. Matt; Penelope J. E. Quintana

doi:10.1055/s-0041-1736287

American Journal of Perinatology, Table of Contents

Am J Perinatol 2022; 39(15): 1634-1642
DOI: 10.1055/s-0041-1736287

Short Communication

Handwashing Results in Incomplete Nicotine Removal from Fingers of Individuals who Smoke: A Randomized Controlled Experiment

Thomas F. Northrup

¹Department of Family and Community Medicine, The University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston, Texas

,

Angela L. Stotts

²Department of Family and Community Medicine, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston, Texas

,

Robert Suchting

³Department of Psychiatry and Behavioral Sciences, UTHealth, McGovern Medical School, Houston, Texas

,

Amir M. Khan

⁴Department of Pediatrics, The University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston, Texas

,

Michelle R. Klawans

⁵Department of Family and Community Medicine, The University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston, Texas

,

Charles Green

⁶Department of Pediatrics, Center for Clinical Research and Evidence-Based Medicine, The University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston, Texas

,

Eunha Hoh

⁷Division of Environmental Health, School of Public Health, San Diego State University, San Diego, California

,

Melbourne F. Hovell

⁸Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, Division of Health Promotion and Behavioral Science, San Diego State University, San Diego, California

,

Georg E. Matt

⁹Department of Psychology, San Diego State University, San Diego, California

,

Penelope J. E. Quintana

¹⁰Division of Environmental Health, School of Public Health, San Diego State University, San Diego, California

› Author Affiliations

Abstract

Objective Tobacco residue, also known as third-hand smoke (THS), contains toxicants and lingers in dust and on surfaces and clothes. THS also remains on hands of individuals who smoke, with potential transfer to infants during visitation while infants are hospitalized in neonatal intensive care units (NICUs), raising concerns (e.g., hindered respiratory development) for vulnerable infants. Previously unexplored, this study tested handwashing (HW) and sanitization efficacy for finger-nicotine removal in a sample of adults who smoked and were visiting infants in an NICU.

Study Design A cross-sectional sample was recruited to complete an interview, carbon monoxide breath samples, and three nicotine wipes of separate fingers (thumb, index, and middle). Eligible participants (n = 14) reported current smoking (verified with breath samples) and were randomly assigned to 30 seconds of HW (n = 7) or alcohol-based sanitization (n = 7), with the order of finger wipes both counterbalanced and randomly assigned. After randomization, the first finger was wiped for nicotine. Participants then washed or sanitized their hands and finger two was wiped 5 minutes later. An interview assessing tobacco/nicotine use and exposure was then administered, followed by a second breath sample and the final finger wipe (40–60 minutes after washing/sanitizing).

Results Generalized linear mixed models found that HW was more effective than sanitizer for nicotine removal but failed to completely remove nicotine.

Conclusions Without proper protections (e.g., wearing gloves and gowns), NICU visitors who smoke may inadvertently expose infants to THS. Research on cleaning protocols are needed to protect vulnerable medical populations from THS and associated risks.

Key Points

NICU infants may be exposed to THS via visitors.
THS is not eliminated by HW or sanitizing.
THS removal protections for NICU infants are needed.

Keywords

thirdhand smoke - THS - neonatal ICU - THS removal - handwashing - sanitizer

Full Text

References

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