Nicotine exposure in daily waterpipe smokers and its relation to puff topography

Abstract

Waterpipe tobacco smoking is increasing in popularity worldwide and available evidence point to its addictive and harmful potential. This study is conducted to assess nicotine exposure in daily waterpipe users smoking the waterpipe according to their usual routine. The correlation between nicotine exposure and puff topography parameters has also not been explored systematically. Sixty-one waterpipe tobacco smokers (56 males; mean age ± SD, 30.9 ± 9.5 years; mean number of weekly waterpipe smoking episodes 7.8 ± 5.7) abstained from smoking for at least 24 hrs, and then smoked tobacco from a waterpipe ad libitum in a laboratory setting. During the session puff topography parameters were monitored continuously, and pre- and post-smoking expired-air CO was measured. Before and after smoking, venous blood was sampled for the assessment of plasma nicotine using Gas Chromatography-Mass Spectrometry. Average pre- and post-smoking expired-air CO was 4 ± 1.7 and 35.5 ± 32.7 ppm, respectively (i.e., a CO boost of 31.5 ppm, p < .01). Mean plasma nicotine concentration increased from 3.07±3.05 ng/ml pre-smoking to 15.7 ± 8.7 ng/ml post-smoking (p < .01). Plasma nicotine boost was correlated with total session time (Pearson correlation coefficient r = .31, p = .04), cumulative puff duration (r = .37, p = .01), mean puff duration (r = .34, p = .02), and total smoke inhaled in the session (r = .34, p = .02. These data show considerable nicotine exposure in daily waterpipe smokers, and that nicotine exposure is a function of waterpipe smoking patterns.

Adverse Effects of Cigarette and Noncigarette Smoke Exposure on the Autonomic Nervous System

“…The cardiac risks of waterpipe smoking have not been systematically studied but are likely to be significant.Compared with tobacco cigarette smoking, waterpipe tobacco smoking has been associated with greater smoke exposure and increased nicotine and carbon monoxide blood levels. The effects of waterpipe tobacco smoking on the autonomic nervous system can be assumed to be virtually the same as those with cigarette smoking, and emerging evidence supports this assumption(68,69). Acute waterpipe tobacco smoking markedly impairs baroreflex control of the heart rate in otherwise healthy chronic waterpipe users(70).…”

The Waterpipe; a New Way of Hooking Youth on Tobacco

“…001). 11 In another lab study, nicotine exposure was compared between waterpipe and cigarette among dual waterpipe/cigarette smokers using a 2-condition crossover design (ie, if the 1st session was waterpipe the 2nd was cigarette and vice versa). While peak plasma nicotine levels did not differ between the two conditions (cigarette, waterpipe), the dynamics of nicotine exposure and cumulative dose was different between waterpipe and cigarette (eg, slower rise, and more protracted and larger cumulative nicotine exposure for the waterpipe compared to cigarette, Fig.…”

Effects of User Puff Topography, Device Voltage, and Liquid Nicotine Concentration on Electronic Cigarette Nicotine Yield: Measurements and Model Predictions

“…The study of "puff topography" parameters (e.g., puff volume, puff velocity, interpuff interval) has long been important in understanding the toxicant content of tobacco smoke [18][19][20][21][22][23][24] and the toxicant delivery to tobacco smokers. 11,25 With ECIGs, differences in topography may help explain the fact that sometimes these products deliver nicotine and sometimes they do not.…”