Using Sewage Epidemiology To Investigate Tobacco Consumption In A City

China is the largest producer and consumer of tobacco in the world,has more than 300 million smokers in China,the number of smokers around one-third per cent of the global number of smokers.Tobacco not only has a great deal of harm to human health,and smoking also increase in the country's public health economic burden that tobacco consumption data for tobacco control policy development is of great significance.Mainly on questionnaire investigation of tobacco consumption drawbacks such as traditional methods are time-consuming,this study presents the method based on volume of sewage epidemiology survey of tobacco consumption.In this study,we developed and used a new model on the estimation tobacco use in a city and assess the uncertainty and variability of tobacco consumption using a new method of Monte Carlo simulation.A total of 11 wastewater treatment plants(WWTPs)(serving 2.2 million population people;representing 83%of urban population in Dalian)were selected and sampled.By detection and quantification of principal metabolites of nicotine,cotinine(COT)and trans-3'-hydroxycotinine(OH-COT),in raw wastewater,back calculation of tobacco use in the population of WWTPs can be realized.COT and OH-COT were detected in the entire set of analysed samples with an average concentration of 2.33±0.30 and 2.76±0.91 ?g/L,respectively.The mass load of absorbed nicotine during the sampling period ranged from 0.25 to 4.22 mg/day/capita with an average of 1.92 mg/day/capita.Using these data,we estimated that an average consumption of consumed cigarette number is 14.6 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 Dalian smoked between 10 and 27 cigarettes per day.The value obtained from sewage analysis showed 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.