title: Comparison of nicotine and carcinogen exposure with water pipe and cigarette smoking.
abstract: BACKGROUND
  Smoking tobacco preparations in a water pipe (hookah) is widespread in many places of the world and is perceived by many as relatively safe. We investigated biomarkers of toxicant exposure with water pipe compared with cigarette smoking.
  
  
  METHODS
  We conducted a crossover study to assess daily nicotine and carcinogen exposure with water pipe and cigarette smoking in 13 people who were experienced in using both products.
  
  
  RESULTS
  When smoking an average of 3 water pipe sessions compared with smoking 11 cigarettes per day (cpd), water pipe use was associated with a significantly lower intake of nicotine, greater exposure to carbon monoxide (CO), and a different pattern of carcinogen exposure compared with cigarette smoking, with greater exposure to benzene, and high molecular weight polycyclic aromatic hydrocarbon (PAH), but less exposure to tobacco-specific nitrosamines, 1,3-butadiene, acrolein, acrylonitrile, propylene oxide, ethylene oxide, and low molecular weight PAHs.
  
  
  CONCLUSIONS
  A different pattern of carcinogen exposure might result in a different cancer risk profile between cigarette and water pipe smoking. Of particular concern is the risk of leukemia related to high levels of benzene exposure with water pipe use.
  
  
  CONCLUSIONS
  Smoking tobacco in water pipes has gained popularity in the United States and around the world. Many believe that water pipe smoking is not addictive and less harmful than cigarette smoking. We provide data on toxicant exposure that will help guide regulation and public education regarding water pipe health risk.
authors: Division of Clinical Pharmacology, University of California, San Francisco, San Francisco General Hospital, Building 100, Room 235, San Francisco, CA 94110, USA. peyton.jacob@ucsf.edu
authors: Peyton
authors: P
authors: Jacob
authors: Ahmad H
authors: AH
authors: Abu Raddaha
authors: Delia
authors: D
authors: Dempsey
authors: Christopher
authors: C
authors: Havel
authors: Margaret
authors: M
authors: Peng
authors: Lisa
authors: L
authors: Yu
authors: Neal L
authors: NL
authors: Benowitz
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D002273:Carcinogens / Q000008:administration & dosage* / Q000032:analysis / Q000493:pharmacokinetics; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D008297:Male; D009538:Nicotine / Q000008:administration & dosage* / Q000032:analysis / Q000097:blood; D012907:Smoking; D062789:Tobacco Products / Q000032:analysis*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D002273:Carcinogens; D009538:Nicotine