Methods

Overview of Methods

Each monitoring method has its advantages and can be used for different purposes and in various study designs. Before deciding which SHS monitoring method to use for a study, consider the goals and objectives of the project. Many study designs use more than one monitoring method.

Approach	Advantages	Disadvantages
Observational	Low cost Rapid implementation Easily repeated over time Complements other forms of monitoring	Subjective Difficult to quantify Difficult to generalize Observed environment is not static, so cross-sectional observations may be misleading
Questionnaires	Long-term/lifelong exposure Multiple dimensions (can include time-activity patterns) Feasible in large populations Can integrate into existing surveys	Difficult to quantify intensity (semi-quantitative) Prone to underreporting or other bias (e.g. poor recall)
Air monitoring	Quantitative Can measure SHS in target locations Can also measure personal exposure Useful to evaluate policy implementation	Variability over space and time (may be dependent on building characteristics or background exposures) and may require repeat measures May require laboratory analysis (nicotine) Costly
Biomonitoring	Quantitative Measures internal dose to individuals Integrated across all exposure settings	Does not identify setting contributions to exposure Variability in uptake and metabolism Logistical issues (e.g. refusal of participants, storage and shipping of specimens) Requires laboratory analysis Costly

This project is funded by the Bloomberg Initiative to Reduce Tobacco Use and the Flight Attendant Medical Research Institute (FAMRI), developed in consultation with Roswell Park Cancer Institute and the University of Southern California, Institute for Global Health.