Toxicant inhalation among singleton waterpipe tobacco users in natural settings.


Journal

Tobacco control
ISSN: 1468-3318
Titre abrégé: Tob Control
Pays: England
ID NLM: 9209612

Informations de publication

Date de publication:
03 2019
Historique:
received: 29 12 2017
revised: 23 04 2018
accepted: 25 04 2018
pubmed: 29 5 2018
medline: 12 9 2019
entrez: 30 5 2018
Statut: ppublish

Résumé

Studies that assess waterpipe tobacco smoking behaviour and toxicant exposure generally use controlled laboratory environments with small samples that may not fully capture real-world variability in human behaviour and waterpipe products. This study aimed to conduct real-time sampling of waterpipe tobacco use in natural environments using an in situ device. We used the REALTIME sampling instrument: a validated, portable, self-powered device designed to sample automatically a fixed percentage of the aerosol flowing through the waterpipe mouthpiece during every puff. We recruited participants at café and home settings in Jordan and measured puffing behaviour in addition to inhalation exposure of total particulate matter (TPM), carbon monoxide (CO), nicotine, polycyclic aromatic hydrocarbons and volatile aldehydes. We correlated total inhaled volume with five selected toxicants and calculated the regression line of this relationship. Averaged across 79 singleton sessions (52% male, mean age 27.0, 95% home sessions), sessions lasted 46.9 min and participants drew 290 puffs and inhaled 214 L per session. Mean quantities of inhaled toxicants per session were 1910 mg TPM, 259 mg CO, 5.0 mg nicotine, 117 ng benzo[a]pyrene and 198 ng formaldehyde. We found positive correlations between total inhaled volume and TPM (r=0.472; p<0.001), CO (r=0.751; p<0.001), nicotine (r=0.301, p=0.035) and formaldehyde (r=0.526; p<0.001), but a non-significant correlation for benzo[a]pyrene (r=0.289; p=0.056). In the natural environment, waterpipe tobacco users inhale large quantities of toxicants that induce tobacco-related disease, including cancer. Toxicant content per waterpipe session is at least equal, but for many toxicants several magnitudes of order higher, than that of a cigarette. Health warnings based on early controlled laboratory studies were well founded; if anything our findings suggest a greater exposure risk.

Sections du résumé

BACKGROUND
Studies that assess waterpipe tobacco smoking behaviour and toxicant exposure generally use controlled laboratory environments with small samples that may not fully capture real-world variability in human behaviour and waterpipe products. This study aimed to conduct real-time sampling of waterpipe tobacco use in natural environments using an in situ device.
METHODS
We used the REALTIME sampling instrument: a validated, portable, self-powered device designed to sample automatically a fixed percentage of the aerosol flowing through the waterpipe mouthpiece during every puff. We recruited participants at café and home settings in Jordan and measured puffing behaviour in addition to inhalation exposure of total particulate matter (TPM), carbon monoxide (CO), nicotine, polycyclic aromatic hydrocarbons and volatile aldehydes. We correlated total inhaled volume with five selected toxicants and calculated the regression line of this relationship.
RESULTS
Averaged across 79 singleton sessions (52% male, mean age 27.0, 95% home sessions), sessions lasted 46.9 min and participants drew 290 puffs and inhaled 214 L per session. Mean quantities of inhaled toxicants per session were 1910 mg TPM, 259 mg CO, 5.0 mg nicotine, 117 ng benzo[a]pyrene and 198 ng formaldehyde. We found positive correlations between total inhaled volume and TPM (r=0.472; p<0.001), CO (r=0.751; p<0.001), nicotine (r=0.301, p=0.035) and formaldehyde (r=0.526; p<0.001), but a non-significant correlation for benzo[a]pyrene (r=0.289; p=0.056).
CONCLUSIONS
In the natural environment, waterpipe tobacco users inhale large quantities of toxicants that induce tobacco-related disease, including cancer. Toxicant content per waterpipe session is at least equal, but for many toxicants several magnitudes of order higher, than that of a cigarette. Health warnings based on early controlled laboratory studies were well founded; if anything our findings suggest a greater exposure risk.

Identifiants

pubmed: 29807946
pii: tobaccocontrol-2017-054230
doi: 10.1136/tobaccocontrol-2017-054230
pmc: PMC6563915
mid: NIHMS971077
doi:

Substances chimiques

Benzopyrenes 0
Particulate Matter 0
Smoke 0
Formaldehyde 1HG84L3525
Nicotine 6M3C89ZY6R
Carbon Monoxide 7U1EE4V452

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, U.S. Gov't, P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

181-188

Subventions

Organisme : NIDA NIH HHS
ID : P50 DA036105
Pays : United States
Organisme : NIDA NIH HHS
ID : R01 DA025659
Pays : United States

Informations de copyright

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2019. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Déclaration de conflit d'intérêts

Competing interests: None declared.

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Auteurs

Mohammed Jawad (M)

Public Health Policy Evaluation Unit, Imperial College London, Hammersmith, UK.

Thomas Eissenberg (T)

Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA.
Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA.

Rola Salman (R)

Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA.
Mechanical Engineering Department, American University of Beirut, Beirut, Lebanon.

Eric Soule (E)

Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA.
Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA.

Karem H Alzoubi (KH)

Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan.

Omar F Khabour (OF)

Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid, Jordan.
Faculty of Applied Medical Sciences, Taibah University, Medina, Saudi Arabia.

Nareg Karaoghlanian (N)

Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA.
Mechanical Engineering Department, American University of Beirut, Beirut, Lebanon.

Rima Baalbaki (R)

Department of Chemistry, American University of Beirut, Beirut, Lebanon.

Rachel El Hage (R)

Department of Chemistry, American University of Beirut, Beirut, Lebanon.

Najat A Saliba (NA)

Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA.
Mechanical Engineering Department, American University of Beirut, Beirut, Lebanon.

Alan Shihadeh (A)

Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA.
Mechanical Engineering Department, American University of Beirut, Beirut, Lebanon.

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