Investigation Of Tobacco Consumption In Jinlin Province Based On Sewage Epidemiology

China is the largest consumer of tobacco in the world with an estimated 301 million smokers in 2010.More tobacco-control programs and initiatives are needed to reduce the smoking rate.Monitoring tobacco consumption is essential for evaluating the effectiveness of tobacco-control programs and initiatives.Cross-sectional household surveys are the main sources of cross-sectional smoking prevalence estimate.In part to overcome these issues of time-consuming,high costs and labours,a new method of sewage epidemiology based on wastewater analysis has been developed to investigate tobacco consumption.In this study,we developed and used a new model on the estimation tobacco use in 8 cities of Jilin privence and assess the uncertainty and variability of tobacco consumption using a new method of Monte Carlo simulation.A total of 10 wastewater treatment plants(WWTPs)were selected and sampled.By detection and quantification of principal metabolites of nicotine(NIC)and cotinine(COT)in raw wastewater,back calculation of tobacco use in the population of WWTPs can be realized.NIC and COT were detected in the entire set of analysed samples with an average concentration of 14.6±13.4 and 1.82±0.50 ?g/L,respectively.The mean mass load of absorbed NIC during the sampling period was 1.82 mg/day/capita.Using these datas,we estimated that an average consumption of consumed cigarette number is 14 cigarettes/day/capita for active smoker.Uncertainty and variability analysis by Monte Carlo simulation was used to refine this estimate:the procedure concluded that smokers in Jilin smoked between 9 and 27 cigarettes per day.The value obtained from sewage analysis showeds good agreement with estimates from the number of cigarettes investigated by epidemiological research.Sewage-based epidemiology may be a useful additional tool for the large-scale monitoring of patterns of nicotine tobacco use.