title: Significance of smoking machine toxicant yields to blood-level exposure in water pipe tobacco smokers.
abstract: BACKGROUND
  The global increase in tobacco smoking with a water pipe (hookah, narghile, or shisha) has made understanding its health consequences imperative. One key to developing this understanding is identifying and quantifying carcinogens and other toxicants present in water pipe smoke. To do so, the toxicant yield of machine-generated water pipe smoke has been measured. However, the relevance of toxicant yields of machine-generated smoke to actual human exposure has not been established.
  
  
  METHODS
  In this study, we examined whether carbon monoxide (CO) and nicotine yields measured with a smoking machine programmed to replicate the puffing behavior of 31 human participants who smoked a water pipe could reliably predict these participants' blood-level exposure. In addition to CO and nicotine, yields of polyaromatic hydrocarbons, volatile aldehydes, nitric oxide (NO), and "tar" were measured.
  
  
  RESULTS
  We found that when used in this puff-replicating manner, smoking machine yields are highly correlated with blood-level exposure (nicotine: r > 0.76, P < 0.001; CO: r > 0.78, P < 0.001). Total drawn smoke volume was the best predictor of toxicant yield and exposure, accounting for approximately 75% to 100% of the variability across participants in yields of NO, CO, volatile aldehydes, and tar, as well as blood-level CO and normalized nicotine.
  
  
  CONCLUSIONS
  Machine-based methods can be devised in which smoke toxicant yields reliably track human exposure.
  
  
  CONCLUSIONS
  This finding indicates the basic feasibility of valid analytic laboratory evaluation of tobacco products for regulatory purposes.
authors.affiliation: Department of Mechanical Engineering, Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon.
authors.forename: Alan L
authors.initials: AL
authors.lastname: Shihadeh
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Eissenberg
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000097:blood*; D012906:Smoke / Q000032:analysis*; D012907:Smoking / Q000097:blood* / Q000453:epidemiology; D014028:Tobacco Smoke Pollution; D055815:Young Adult; D014026:Nicotiana
chemical_list: D012906:Smoke; D014028:Tobacco Smoke Pollution; D009538:Nicotine