title: Waterpipe tobacco products: nicotine labelling versus nicotine delivery.
abstract: BACKGROUND
  Waterpipe tobacco package labelling typically indicates "0.0% tar" and "0.05% or 0.5% nicotine".
  
  
  OBJECTIVE
  To determine the extent to which nicotine labeling is related to nicotine delivery.
  
  
  METHODS
  110 waterpipe smokers engaged in a 45-minute waterpipe smoking session. Puff topography and plasma nicotine were measured. Three waterpipe tobacco brands were used: Nakhla (0.5% nicotine), Starbuzz (0.05% nicotine), and Al Fakher (0.05% nicotine). Data were analyzed by one-way ANOVA.
  
  
  RESULTS
  Topography did not differ across brands. Peak plasma nicotine varied significantly across brands. Al Fakher had the highest nicotine delivery (11.4 ng/ml) followed by Nakhla (9.8 ng/ml) and Starbuzz (5.8 ng/ml).
  
  
  CONCLUSIONS
  Nicotine labelling on waterpipe tobacco products does not reflect delivery; smoking a brand with a "0.05% nicotine" label led to greater plasma nicotine levels than smoking a brand with a "0.5% nicotine" label. Waterpipe tobacco products should be labelled in a manner that does not mislead consumers.
authors.affiliation: Department of Pharmacology and Toxicology, Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Box 980205, Richmond, VA 23298, USA. arvansickel@vcu.edu
authors.forename: Andrea R
authors.initials: AR
authors.lastname: Vansickel
authors.forename: Alan
authors.initials: A
authors.lastname: Shihadeh
authors.forename: Thomas
authors.initials: T
authors.lastname: Eissenberg
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D019570:Inhalation Exposure / Q000032:analysis; D008297:Male; D009538:Nicotine / Q000032:analysis* / Q000097:blood; D011356:Product Labeling / Q000592:standards*; D012907:Smoking / Q000097:blood*; D014867:Water; D055815:Young Adult; D014026:Nicotiana
chemical_list: D014867:Water; D009538:Nicotine