title: Design and Validation of a Research-Grade Waterpipe Equipped With Puff Topography Analyzer.
abstract: BACKGROUND
  Worldwide, commercially available waterpipes vary widely in design and durability, including differences in fabrication materials, degree of leak-tight fit, and flow path diameter. Little is known about how the components of the waterpipe may influence puffing behavior and user's exposure to toxins. To systematically evaluate exposure, it is necessary to use a standardized research-grade waterpipe (RWP) when conducting clinical and laboratory-based trials.
  
  
  METHODS
  We developed a RWP that is configured with an in-line topography system which allows real-time measurement and recording of the smoke volume drawn through the RWP. The RWP was calibrated across the flow rate range expected for waterpipe tobacco smoking and the calibration was verified for known puff volumes using a smoking machine. Operation of the RWP was qualified in a cohort of experienced waterpipe smokers, each smoker using the RWP ad libitum in a laboratory setting while smoker topography and subjective effects data were collected.
  
  
  RESULTS
  RWP machine smoking was highly reproducible and yielded puff volumes that agreed well with true values. User acceptance was comparable, and puffing behavior was similar in pattern, with more frequent puffing in the beginning of the session, but significantly different in intensity from that used to estimate the majority of toxicant exposure reported in the literature.
  
  
  CONCLUSIONS
  The RWP operates with known precision and accuracy and is well accepted by experienced smokers. This tool can be used to determine the extent to which puffing behaviors are affected by the waterpipe design, components, and/or accessories, tobacco nicotine content, sweet flavorings and/or additives known to increase addictiveness.
  
  
  CONCLUSIONS
  This study describes a standardized RWP, equipped with a puffing topography analyzer, which can operate with known precision and accuracy, and is well-accepted by experienced smokers in terms of satisfaction and reward. The RWP is an important tool for determining if puffing behaviors, and thus estimated toxin exposures, are affected by the waterpipe design, components, and/or accessories, tobacco nicotine content, sweet flavorings, and/or additives that are known to increase addictiveness.
authors.affiliation: Public Health Center for Tobacco Research, Battelle, Columbus, OH; Health and Analytics, Battelle, Columbus, OH; brinkmmc@battelle.org.
authors.forename: Marielle C
authors.initials: MC
authors.lastname: Brinkman
authors.affiliation: Public Health Center for Tobacco Research, Battelle, Columbus, OH; Health and Analytics, Battelle, Seattle, WA;
authors.forename: Hyoshin
authors.initials: H
authors.lastname: Kim
authors.affiliation: Public Health Center for Tobacco Research, Battelle, Columbus, OH; Health and Analytics, Battelle, Columbus, OH;
authors.forename: Sydney M
authors.initials: SM
authors.lastname: Gordon
authors.affiliation: Public Health Center for Tobacco Research, Battelle, Columbus, OH; Health and Analytics, Battelle, Columbus, OH;
authors.forename: Robyn R
authors.initials: RR
authors.lastname: Kroeger
authors.affiliation: Public Health Center for Tobacco Research, Battelle, Columbus, OH;
authors.forename: Iza L
authors.initials: IL
authors.lastname: Reyes
authors.affiliation: Health and Analytics, Battelle, Columbus, OH;
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Deojay
authors.affiliation: Public Health Center for Tobacco Research, Battelle, Columbus, OH;
authors.forename: Caleb
authors.initials: C
authors.lastname: Chitwood
authors.affiliation: Applied Biology and Aerosol Technology, Battelle, Columbus, OH;
authors.forename: Timothy E
authors.initials: TE
authors.lastname: Lane
authors.affiliation: School of Public Health, University of Maryland, College Park, MD.
authors.forename: Pamela I
authors.initials: PI
authors.lastname: Clark
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005421:Flavoring Agents; D015386:Hazardous Substances; D006801:Humans; D019570:Inhalation Exposure / Q000032:analysis* / Q000592:standards*; D008297:Male; D009538:Nicotine / Q000032:analysis; D015203:Reproducibility of Results; D012906:Smoke / Q000032:analysis; D012907:Smoking / Q000453:epidemiology; D062789:Tobacco Products / Q000032:analysis* / Q000592:standards*; D055815:Young Adult
chemical_list: D005421:Flavoring Agents; D015386:Hazardous Substances; D012906:Smoke; D009538:Nicotine