Exploitation of Sewage Epidemiological Survey to Investigate Tobacco Consumption in Dalian

Objective  To develop a method for the investigation on urban tobacco consumption based on the sewage epidemiological survey, and to provide a basis for nationwide study of tobacco consumption.

Methods  A total of 11 sewage treatment plants in Dalian were selected. The levels of cotinine (the principle metabolite of nicotine) in sewage was used to explore the tobacco consumption in the population served by each sewage treatment plant.

Results  The levels of cotinine in sewage samples were from (0.77~2.82) μg/L. An estimation on consumption of nicotine was in the range of (0.23~4.17) mg/day/capita with an average of 1.5 mg/day/capita. The uncertainty and variability were analyzed by the Monte Carlo method, which showed that the number of cigarettes consumed per smoker in the city was varied in the range of (8.8~28.3)/d with a median of 14.9/d.

Conclusions  There was a good agreement on the level obtained from cotinine in sewage with the number of cigarette consumption investigated by the authors epidemiological survey. Sewage-based epidemiology survey on nicotine use may be a meaningful tool for the large-scale monitoring of tobacco consumption in urban areas.