title: Does switching to a tobacco-free waterpipe product reduce toxicant intake? A crossover study comparing CO, NO, PAH, volatile aldehydes, "tar" and nicotine yields.
abstract: Waterpipe (hookah, narghile, shisha) use has become a global phenomenon, with numerous product variations. One variation is a class of products marketed as "tobacco-free" alternatives for the "health conscious user". In this study toxicant yields from waterpipes smoked using conventional tobacco-based and tobacco-free preparations were compared. A human-mimic waterpipe smoking machine was used to replicate the puffing sequences of 31 human participants who completed two double-blind ad libitum smoking sessions in a controlled clinical setting: once with a tobacco-based product of their choosing and once with a flavor-matched tobacco-free product. Outcome measures included yields of carbon monoxide, nitric oxide, volatile aldehydes, nicotine, tar, and polycyclic aromatic hydrocarbons. Smoke from both waterpipe preparations contained substantial quantities of toxicants. Nicotine yield was the only outcome that differed significantly between preparations. These findings contradict advertising messages that "herbal" waterpipe products are a healthy alternative to tobacco products.
authors.affiliation: Mechanical Engineering Department, American University of Beirut, Beirut, Lebanon. as20@aub.edu.lb
authors.forename: Alan
authors.initials: A
authors.lastname: Shihadeh
authors.forename: Rola
authors.initials: R
authors.lastname: Salman
authors.forename: Ezzat
authors.initials: E
authors.lastname: Jaroudi
authors.forename: Najat
authors.initials: N
authors.lastname: Saliba
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Sepetdjian
authors.forename: Melissa D
authors.initials: MD
authors.lastname: Blank
authors.forename: Caroline O
authors.initials: CO
authors.lastname: Cobb
authors.forename: Thomas
authors.initials: T
authors.lastname: Eissenberg
mesh_terms: D000447:Aldehydes / Q000032:analysis* / Q000633:toxicity; D002248:Carbon Monoxide / Q000032:analysis* / Q000633:toxicity; D018592:Cross-Over Studies; D006801:Humans; D009538:Nicotine / Q000032:analysis*; D009569:Nitric Oxide / Q000032:analysis* / Q000633:toxicity; D011083:Polycyclic Compounds / Q000032:analysis* / Q000633:toxicity; D012906:Smoke; D014026:Nicotiana
chemical_list: D000447:Aldehydes; D011083:Polycyclic Compounds; D012906:Smoke; D009569:Nitric Oxide; D009538:Nicotine; D002248:Carbon Monoxide