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Bakker-'t Hart IME, Bakker F, Pennings JLA, Weibolt N, Eising S, Talhout R. Flavours and flavourings in waterpipe products: a comparison between tobacco, herbal molasses and steam stones. Tob Control 2023; 32:627-634. [PMID: 35241500 PMCID: PMC10447401 DOI: 10.1136/tobaccocontrol-2021-056955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 02/17/2022] [Indexed: 11/04/2022]
Abstract
ObjectivesFlavoured products are especially appealing to youth and contribute to the onset of waterpipe smoking and continued use of waterpipe tobacco. The goal of database and chemical analysis was to provide a clear overview of commonly used flavours and flavourings in tobacco and related waterpipe products, that is, herbal molasses and steam stones. METHODS In 2019, 249 waterpipe tobacco products were registered in the European Common Entry Gate by manufacturers to be marketed in The Netherlands. Flavour categories were assigned to the registered products based on their brand names and product descriptions. Nicotine and eleven 1111 flavourings were identified and quantified in waterpipe tobacco (n=8), herbal molasses (n=7) and steam stones (n=4) by extraction and gas chromatography-mass spectrometry (GC-MS) analysis. RESULTS Flavour categories could be assigned to 237 of 249 registered waterpipe tobacco products. Eight flavour main categories and 48 unique subcategories were identified and presented in a flavour wheel. All registered waterpipe tobacco products were flavoured, and the majority (78%) was fruit flavoured. Herbal molasses contained similar median flavouring levels, and steam stones contained lower median levels compared with waterpipe tobacco. Flavourings in waterpipe products were almost exclusively fruity and sweet, often in combination with menthol/mint flavourings. CONCLUSIONS This study is the first to present a waterpipe tobacco flavour wheel, providing a quick overview of waterpipe tobacco flavours and thereby aiding communication among experts around the globe. GC-MS analysis revealed that the most prevalent flavourings are present in similar levels in herbal and tobacco waterpipe products. Banning flavourings in all waterpipe products would be a good strategy to reduce waterpipe smoking among youth.
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Affiliation(s)
- Ingrid M E Bakker-'t Hart
- Centre for Health Protection, National Institute for Public Health and the Environment, Bilthoven, Utrecht, The Netherlands
| | - Frank Bakker
- Centre for Health Protection, National Institute for Public Health and the Environment, Bilthoven, Utrecht, The Netherlands
| | - Jeroen L A Pennings
- Centre for Health Protection, National Institute for Public Health and the Environment, Bilthoven, Utrecht, The Netherlands
| | - Naömi Weibolt
- Centre for Health Protection, National Institute for Public Health and the Environment, Bilthoven, Utrecht, The Netherlands
| | - Selma Eising
- Centre for Health Protection, National Institute for Public Health and the Environment, Bilthoven, Utrecht, The Netherlands
| | - Reinskje Talhout
- Centre for Health Protection, National Institute for Public Health and the Environment, Bilthoven, Utrecht, The Netherlands
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Lim DH, Ahmadi Y, Kim YH, Kim KH. The extent of harmful volatile organic compounds released when smoking after breaking the flavor capsules of heat-not-burn (HNB) cigarette products. ENVIRONMENTAL RESEARCH 2023; 216:114501. [PMID: 36220443 DOI: 10.1016/j.envres.2022.114501] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/22/2022] [Accepted: 10/02/2022] [Indexed: 06/16/2023]
Abstract
A number of flavored capsule heat-not-burn (FC-HNB) tobacco products such as IQOS, Lil, and Glo have been introduced as a new generation of cigarettes. As they can release various types of volatile organic compounds (VOCs), it is important to assess the harmfulness associated with their use. Thus, the composition of VOCs in HNB cigarette vapor was evaluated to investigate the interactive roles of key variables controlling the relationships between VOC composition and capsule breaking, particularly the compositional changes induced by capsule breaking and release of flavor from FC-HNB cigarettes relative to regular products. As the capsules of FC-HNB cigarettes were broken, the total VOC concentrations increased by as high as eight times from 60.3 ± 0.48 to 488 ± 21.8 μg cig-1. The key VOC components released after breaking the flavored capsules were identified as ethyl butyrate (157 ± 13.6 μg cig-1; Lil), isoamyl acetate (76.9 ± 1.98 μg cig-1; Lil), and limonene (52.3 ± 3.29 μg cig-1; Glo). If the primary health risks of FC-HNB cigarette vapor are assessed using National Institute for Occupational Safety & Health (NIOSH) guidelines, 2,3-butanedinone exceeds the maximum daily intake limit (i.e., 0.05 mg day-1). Our study is expected to offer valuable insights into the harmful effects of direct and indirect exposure to various VOCs in FC-HNB products.
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Affiliation(s)
- Dae-Hwan Lim
- Department of Civil and Environmental Engineering, Hanyang University, 222 Wangsimni-ro, Seongdong-Gu, Seoul, 04763, Republic of Korea
| | - Younes Ahmadi
- Department of Civil and Environmental Engineering, Hanyang University, 222 Wangsimni-ro, Seongdong-Gu, Seoul, 04763, Republic of Korea; Department of Analytical Chemistry, Kabul University, Kabul, 1001, Afghanistan
| | - Young-Hyun Kim
- Department of Environmental Engineering, Jeonbuk National University, 567 Baekje-daero, Deokjin, Jeonju, Jeollabukdo, 54896, Republic of Korea; Department of Environment and Energy, Jeonbuk National University, 567 Baekje-daero, Deokjin, Jeonju, Jeollabukdo, 54896, Republic of Korea
| | - Ki-Hyun Kim
- Department of Civil and Environmental Engineering, Hanyang University, 222 Wangsimni-ro, Seongdong-Gu, Seoul, 04763, Republic of Korea.
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Wu S, Kim E, Vethanayagam D, Zhao R. Indoor partitioning and potential thirdhand exposure to carbonyl flavoring agents added in e-cigarettes and hookah tobacco. ENVIRONMENTAL SCIENCE. PROCESSES & IMPACTS 2022; 24:2294-2309. [PMID: 36408779 DOI: 10.1039/d2em00365a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Flavoring agents added to the e-cigarettes and hookah tobacco have increased the attractiveness of novel nicotine products. Many widely used flavorings are carbonyls, which are toxic to humans. In an indoor environment, residents can be exposed to such harmful flavorings previously emitted to the surrounding environment, through a process termed thirdhand exposure. The recent discovery of a large volume of indoor reservoirs emphasizes the importance of indoor partitioning, which is responsible for thirdhand exposure. Indoor partitioning can be expressed with partitioning coefficients, such as Henry's law solubility constant (H). However, reliable H values for many key flavorings are currently lacking. To better understand their environmental behavior, this study experimentally determined the effective Henry's law constant (Hcps,eff) using the inert gas stripping (IGS) method. Further, the influence of the hydration process for target flavorings was quantified using proton nuclear magnetic resonance (1H NMR) spectroscopy. We found that hydration of α-dicarbonyls (diacetyl and 2,3-pentanedione) enhanced their Hcps,eff from their intrinsic Henry's law constant (Hcps) by a factor of 3.52 and 2.88, respectively. The two-dimensional partitioning plots were employed to simulate the indoor phase distribution and evaluate the pathways of human exposure. Our findings show that the indoor partitioning of many harmful flavorings is highly sensitive to temperature and the size of indoor reservoirs, indicating that residents are likely to experience third-hand exposure.
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Affiliation(s)
- Shuang Wu
- Department of Chemistry, University of Alberta, Edmonton, Alberta, T6G 2G2, Canada.
| | - Erica Kim
- Department of Chemistry, University of Alberta, Edmonton, Alberta, T6G 2G2, Canada.
| | - Dilini Vethanayagam
- Department of Medicine, University of Alberta, Edmonton, Alberta, T6G 2G2, Canada
| | - Ran Zhao
- Department of Chemistry, University of Alberta, Edmonton, Alberta, T6G 2G2, Canada.
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Discussion of waterpipe tobacco smoking on reddit. Heliyon 2022; 8:e10635. [PMID: 36177232 PMCID: PMC9513777 DOI: 10.1016/j.heliyon.2022.e10635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 08/01/2022] [Accepted: 08/08/2022] [Indexed: 11/21/2022] Open
Abstract
Objectives This study aimed to examine public discussions of waterpipe tobacco smoking, as well as the potential associations of different waterpipe flavors with health symptoms, using Reddit data. Study design This is an observational infodemiology study. Methods Using keywords such as “waterpipe”, “hookah”, and “shisha”, Reddit posts were extracted from Reddit Archive (pushshift.io) between February 1, 2016, and December 31, 2020. Temporal analysis was used to understand the longitudinal trend of the discussions about waterpipe tobacco smoking. Topic modeling using the Latent Dirichlet Allocation (LDA) model was performed to examine the topics on waterpipe tobacco. We estimated the conditional probability of having each health problem for each given waterpipe flavor. Results The discussion of waterpipe on Reddit was slowly decreasing from 2016 to 2018 and surged until May 2020. The fruit was the most popular waterpipe flavor and the neurological symptom was the most mentioned health category in waterpipe-related Reddit posts. The most popular topics included “Friends spending time together at night with waterpipe smoking”, “Playing games and smoking waterpipe at a hookah bar”, and “Discussing waterpipe flavors and related products”. Some waterpipe flavors were more associated with certain health problems than others. For example, mint/menthol flavor had a high probability to be associated with symptoms related to throat and mouth. Conclusion This study provided longitudinal surveillance of waterpipe tobacco smoking discussed on Reddit. We showed the potential relationship between waterpipe flavors and health symptoms, which provides preliminary evidence about the potential health effects of waterpipe tobacco smoking.
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Hsieh JR, Mekoli ML, Edwards RL. Levels of Chemical Toxicants in Waterpipe Tobacco and Waterpipe Charcoal Solid Waste. JOURNAL OF ENVIRONMENTAL PROTECTION 2021; 12:913-938. [PMID: 34881071 PMCID: PMC8649808 DOI: 10.4236/jep.2021.1211054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This work provides insights on waterpipe tobacco and waterpipe charcoal as potential sources of environmental toxicants. Selected harmful and potentially harmful constituents (HPHCs) from ten U.S. commercial waterpipe tobacco filler products (before and after electric heating) and five waterpipe charcoal products (before and after burning) were investigated. The differences in quantities of HPHCs between the evaluated products appear to be affected by raw material properties and/or the manufacturing processes involved in product production. Trace metal quantities in waterpipe tobacco and charcoal products were observed after heating or burning conditions compared to unheated or unburned conditions, which could impact the environment through the generation of toxic tobacco product waste. This study demonstrates that waterpipe tobacco and waterpipe charcoal contain substantial quantities of benzo[a]pyrene (B[a]P) and trace metals (i.e., selenium, arsenic, cadmium, chromium, cobalt, lead, nickel) before use and that extensive and varied changes in trace metal quantities take place as a result of heating, and more studies are needed to estimate the magnitude of the environmental impact of waterpipe tobacco use.
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Affiliation(s)
- Jason R. Hsieh
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Calverton, MD, USA
| | - Megan L. Mekoli
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Calverton, MD, USA
| | - Ronald L. Edwards
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Calverton, MD, USA
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Li R, Wei M, Guo G, Li Y, Pan X, Song X, Rong L, Chen Y, Chen B. Analysis of Main Components in Jujube and Mulberry Extracts by High-Sensitive HPLC-ESI-Q-TOF-MS/MS. J Chromatogr Sci 2021; 59:806-812. [PMID: 33598689 DOI: 10.1093/chromsci/bmaa133] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 11/09/2020] [Accepted: 12/14/2020] [Indexed: 11/14/2022]
Abstract
In order to comprehensively reflect the cigarette quality, a method combining direct injection of diluted sample with high sensitive high-performance liquid chromatography (HPLC)- electrospray (ESI)- quadrupole (Q)- time of flight (TOF)- tandem mass spectrometry (MS/MS) was developed for the identification of major components of cigarette essences (jujube and mulberry extracts). Based on the observed relative molecular mass, MS/MS fragmentation behavior, MS/MS database and related literatures, the components of the jujube extract and mulberry extract were identified. The result shows that the composition of jujube extract and mulberry extract has some similarity. They all mainly contain amino acids, free amino compounds and Maillard reaction products, which are the main constituents of a cigarette essence.
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Affiliation(s)
- Ran Li
- Technology Center, China Tobacco Hubei Industrial Co., Ltd., Wuhan 430040, P.R. China
| | - Min Wei
- Technology Center, China Tobacco Hubei Industrial Co., Ltd., Wuhan 430040, P.R. China
| | - Guoning Guo
- Technology Center, China Tobacco Hubei Industrial Co., Ltd., Wuhan 430040, P.R. China
| | - Yi Li
- Key Laboratory of Analytical Chemistry for Biology and Medicine (Ministry of Education), Department of Chemistry, Wuhan University, Wuhan 430072, P R China
| | - Xi Pan
- Technology Center, China Tobacco Hubei Industrial Co., Ltd., Wuhan 430040, P.R. China
| | - Xuyan Song
- Technology Center, China Tobacco Hubei Industrial Co., Ltd., Wuhan 430040, P.R. China
| | - Lin Rong
- Technology Center, China Tobacco Hubei Industrial Co., Ltd., Wuhan 430040, P.R. China
| | - Yi Chen
- Technology Center, China Tobacco Hubei Industrial Co., Ltd., Wuhan 430040, P.R. China
| | - Beibei Chen
- Key Laboratory of Analytical Chemistry for Biology and Medicine (Ministry of Education), Department of Chemistry, Wuhan University, Wuhan 430072, P R China
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Hamadeh RR, Lee J, Abu-Rmeileh NME, Darawad M, Mostafa A, Kheirallah KA, Yusufali A, Thomas J, Salama M, Nakkash R, Salloum RG. Gender differences in waterpipe tobacco smoking among university students in four Eastern Mediterranean countries. Tob Induc Dis 2020; 18:100. [PMID: 33299390 PMCID: PMC7720794 DOI: 10.18332/tid/129266] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 10/27/2020] [Accepted: 10/29/2020] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Males have a higher prevalence of waterpipe tobacco smoking (WTS) than females in most Eastern Mediterranean Region (EMR) countries, with a smaller gender gap than that of cigarette smoking. The objective of this study was to determine gender differences among university students with respect to WTS initiation, smoking behavior, tobacco flavors, and expenditure on WTS, in four EMR countries. METHODS A cross-sectional online survey was conducted based on convenient samples of ever waterpipe smokers among university students in four EMR countries (Egypt, Jordan, Occupied Palestinian Territories, and the United Arab Emirates) in 2016. The total samples included 2470 participants. Study participants were invited through flyers, university portals, emails and Facebook, followed by emails with links to the internet survey. RESULTS Females (80.4%) were more likely than males (66.4%, p<0.001) to be in the younger age group (18–22 years) and they were less likely to be current waterpipe smokers (females, 60.0%; males 69.5%, p<0.001). Two-thirds of students across both genders smoked their first waterpipe at the age of 15–19 years, with more females starting with family members. Over one-third of males and 14.9% of the females usually smoked ≥10 heads (p<0.001). About half (46.6%) of females smoked for less than half an hour compared to 30.5% of males (p<0.001). Only 1% of females smoked non-flavored tobacco compared to 11% of males (p<0.001). There was a significant (p=0.05) positive correlation (r=0.808) with respect to tobacco flavor usually smoked between males and females with apple/double apple being the most popular. CONCLUSIONS There were gender differences in WTS in several aspects. The study has implications for educational establishments, tobacco control and women civil society groups, as well as policymakers.
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Affiliation(s)
- Randah R Hamadeh
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Juhan Lee
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, United States
| | - Niveen M E Abu-Rmeileh
- Institute of Community and Public Health, Birzeit University, Birzeit, Occupied Palestinian Territories
| | | | - Aya Mostafa
- Department of Community, Environmental and Occupational Medicine, Ain Shams University, Cairo, Egypt
| | - Khalid A Kheirallah
- Department of Public Health, Jordan University of Science and Technology, Irbid, Jordan
| | | | - Justin Thomas
- Department of Psychology, Zayed University, Abu Dhabi, United Arab Emirates
| | - Mohamed Salama
- Institute of Global Health and Human Ecology, The American University in Cairo, New Cairo, Egypt
| | - Rima Nakkash
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Ramzi G Salloum
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, United States
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Kassem NOF, Peterson LA, Liles S, Kassem NO, Zaki FK, Lui KJ, Vevang KR, Dodder NG, Hoh E, Hovell MF. Urinary metabolites of furan in waterpipe tobacco smokers compared to non-smokers in home settings in the US. Toxicol Lett 2020; 333:202-210. [PMID: 32814080 PMCID: PMC10883161 DOI: 10.1016/j.toxlet.2020.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/23/2020] [Accepted: 08/03/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Determine uptake of furan, a potential human carcinogen, in waterpipe tobacco (WPT) smokers in home settings. METHODS We analysed data from a US convenience sample of 50 exclusive WPT smokers, mean age 25.3 years, and 25 non-smokers, mean age 25.5 years. For WPT smokers, data were collected at a home visit by research assistants during which participants smoked one WPT head of one brand for a mean of 33.1 min in their homes. Research assistants provided and prepared a WP for participants by weighing and loading 10 g of WPT in the WP head. At the completion of the smoking session, research assistants measured the remaining WPT. Cotinine and six furan metabolites were quantified in first morning urine samples provided on 2 consecutive days for non-smokers, and on the morning of a WPT smoking session and on the following morning for smokers. RESULTS WPT smokers consumed a mean of 2.99 g WPT. In WPT smokers, urinary cotinine levels increased significantly 26.1 times the following morning; however, urinary metabolites of furan did not increase significantly. Compared to non-smokers, 2 furan metabolites, N-acetyl-S-[1-(5-acetylamino-5-carboxylpentyl)-1H-pyrrol-3-yl]-L-cysteine and N-acetyl-S-[1-(5-amino-5-carboxypentyl)-1H-pyrrol-3-yl]-L-cysteine sulfoxide, were significantly higher in WPT smokers in pre and in post WPT smoking levels. CONCLUSIONS To enable a more rigorous assessment of furan exposure from WPT smoking, future research should determine furan concentrations in WPT smoke, quantify furan metabolites from users of various WPT brands; and extend the investigation to social settings where WPT smoking is habitually practiced.
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Affiliation(s)
- Nada O F Kassem
- Center for Behavioral Epidemiology and Community Health (CBEACH), Hookah Tobacco Studies Division, San Diego State University Research Foundation, San Diego, CA, 92123, United States.
| | - Lisa A Peterson
- Division of Environmental Health Sciences and the Masonic Cancer Center, University of Minnesota, Minneapolis, MN, 55455, United States
| | - Sandy Liles
- Center for Behavioral Epidemiology and Community Health (CBEACH), Hookah Tobacco Studies Division, San Diego State University Research Foundation, San Diego, CA, 92123, United States
| | - Noura O Kassem
- Center for Behavioral Epidemiology and Community Health (CBEACH), Hookah Tobacco Studies Division, San Diego State University Research Foundation, San Diego, CA, 92123, United States
| | - Flora K Zaki
- Center for Behavioral Epidemiology and Community Health (CBEACH), Hookah Tobacco Studies Division, San Diego State University Research Foundation, San Diego, CA, 92123, United States
| | - Kung-Jong Lui
- San Diego State University Research Foundation, 5250 Campanile Dr., San Diego, CA 92182, United States
| | - Karin R Vevang
- Division of Environmental Health Sciences and the Masonic Cancer Center, University of Minnesota, Minneapolis, MN, 55455, United States
| | - Nathan G Dodder
- San Diego State University Research Foundation, 5250 Campanile Dr., San Diego, CA 92182, United States
| | - Eunha Hoh
- School of Public Health, San Diego State University, 5500 Campanile Dr., San Diego, CA 92182, United States
| | - Melbourne F Hovell
- Center for Behavioral Epidemiology and Community Health (CBEACH), Hookah Tobacco Studies Division, San Diego State University Research Foundation, San Diego, CA, 92123, United States
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Altindis M, Koroglu M, Demiray T, Yilmaz K, Baran Inci M, Olmez M, Altindis S, Erkorkmaz U. Microbial contamination and infection risks of narghile besides hazards of tobacco. Cent Eur J Public Health 2020; 28:74-78. [PMID: 32228822 DOI: 10.21101/cejph.a5814] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 03/20/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Water-pipe smoking has become a serious public health threat worldwide. In order to raise awareness of adverse effects and transmission of bacteria via water-pipe smoking, we aimed to identify the bacteria and their antimicrobial resistance profiles that colonize different parts of waterpipes. METHODS We examined totally 182 water pipes from 7 lounges (in Turkey) used in public places and we collected 728 culture samples in total by microbiological methods. We used disposable sterile swabs to sample the inside and outside of the mouthpiece, and the handling piece and sterile injectors were used to collect 5 mL of water from the water pipe bowl. RESULTS There was a significant (p < 0.05) difference in microbial contamination (growth/presence of bacteria and fungi) among the parts of the water pipes sampled. There was a significant (p < 0.05) difference in the number of bacteria growing (microbial load) among the parts of the water pipes. Only one narghile lounge out of seven, which had 13 water pipes, had a hygiene procedure. The water jars are often contaminated with Gram-negative bacteria. CONCLUSION Water pipes, especially the interior and outer part of the mouthpieces and the handle, are colonized by microbes and pose a risk of infection. Procedures for water pipe hygiene should be developed, periods should be defined, and the owners and employees of establishments and water-pipe smokers should be educated in this regard. Water-pipe smoking is a threat to public health and should be regulated by the state.
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Nemmar A, Al-Salam S, Beegam S, Yuvaraju P, Zaaba NE, Yasin J, Ali BH. Waterpipe Tobacco Smoke Inhalation Triggers Thrombogenicity, Cardiac Inflammation and Oxidative Stress in Mice: Effects of Flavouring. Int J Mol Sci 2020; 21:E1291. [PMID: 32075078 PMCID: PMC7072969 DOI: 10.3390/ijms21041291] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 12/29/2019] [Accepted: 01/02/2020] [Indexed: 12/26/2022] Open
Abstract
The consumption of water-pipe smoking (WPS) has been promoted by the use of flavoured tobacco. However, little is known about the impact of flavouring on the cardiovascular toxicity induced by WPS inhalation. Here, we compared the cardiovascular effects and underlying mechanism of actions of plain (P) (unflavoured) versus apple-flavoured (AF) WPS (30 minutes/day, 5 days/week for 1 month) in mice. Control mice were exposed to air. Both P- and AF-WPS inhalation induced an increase in systolic blood pressure, thrombogenicity and plasma concentration of fibrinogen and von Willebrand factor. In heart homogenates, AF-WPS inhalation caused an increase of 8-isoprostane and a decrease in the levels of reduced glutathione (GSH) and superoxide dismutase (SOD). Nevertheless, P-WPS decreased only the activity of SOD. The concentrations of tumour necrosis factor α and interleukin 1β were increased only in heart homogenates of mice exposed to AF-WPS. Although both P- and AF-WPS increased the concentration of troponin I in heart homogenates and induced DNA damage, the concentration of cleaved caspase 3 was only increased in mice exposed to AF-WPS. Immunohistochemical analysis of the hearts showed that both P- and AF- WPS inhalation decreased the expression of SOD. Moreover, the expression of nuclear factor erythroid-derived 2-like 2 at nuclear level in the heart was higher in both AF-WPS and P-WPS compared with control group, and the effect observed in AF-WPS group was more significant than that seen in P-WPS group. Likewise, the concentration of heme oxygenase-1 was significantly increased in both P-WPS and AF-WPS groups compared with control group, and the effect seen in AF-group was higher than that observed in P-WPS group. In conclusion, our findings showed that both P- and AF-WPS induce thrombogenicity and cardiac injury, and that this toxicity is potentiated by the presence of flavouring.
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Affiliation(s)
- Abderrahim Nemmar
- Department of Physiology, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 17666 Al Ain, UAE; (S.B.); (P.Y.); (N.E.Z.)
- Zayed Center for Health Sciences, United Arab Emirates University, P.O. Box 17666 Al Ain, UAE
| | - Suhail Al-Salam
- Department of Pathology, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 17666 Al Ain, UAE;
| | - Sumaya Beegam
- Department of Physiology, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 17666 Al Ain, UAE; (S.B.); (P.Y.); (N.E.Z.)
| | - Priya Yuvaraju
- Department of Physiology, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 17666 Al Ain, UAE; (S.B.); (P.Y.); (N.E.Z.)
| | - Nur Elena Zaaba
- Department of Physiology, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 17666 Al Ain, UAE; (S.B.); (P.Y.); (N.E.Z.)
| | - Javed Yasin
- Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 17666 Al Ain, UAE;
| | - Badreldin H. Ali
- Department of Pharmacology and Clinical Pharmacy, College of Medicine & Health Sciences, Sultan Qaboos University, P.O. Box 35, Muscat 123, Al-Khod, Oman;
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Aljadani RH, Algabbani AM, Alamir JA, Alqahtani AS, BinDhim NF. Waterpipe Tobacco Chemical Content, Microbial Contamination, and Genotoxic Effects: A Systematic Review. Int J Toxicol 2020; 39:256-262. [DOI: 10.1177/1091581820905108] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The spread of tobacco smoking has increased over time at the global and national levels. One of the widely spread tobacco products is waterpipe. Recent studies showed that waterpipe tobacco smoke contains toxic substances, including carbon monoxide and nicotine. Some of them are genotoxic carcinogen, such as formaldehyde. This study aims to provide comprehensive insight into the types and depth of the scientific literature on waterpipe tobacco smoke chemical content, its genotoxic effects, and waterpipe device microbial contamination. We conducted a systematic comprehensive review of articles published between 1986 and December 2018. Primary research articles focusing on the content of waterpipe smoke, including chemical, genotoxic, and microbial contaminants, were eligible for inclusion. Of the 1,286 studies generated, 22 studies were included. Twenty-three chemical families were extracted from waterpipe smoke. Aldehydes were the most identified chemical family in 6 studies, and next is polycyclic hydrocarbons, found in 5 studies. About 206 chemical compounds were identified. Flavobacterium, Pseudomonas, coagulase-negative Staphylococci, and Streptococcus were the most abundant pathogen contaminants. Waterpipe smoke had elevated levels of many DNA damage markers (8-hydroxy-2′-deoxyguanosine and cytochrome P450 1A1) and inhibited levels of many DNA repair genes ( OGG1 and XRCC1) in waterpipe smokers. Waterpipe smoke is associated with the genotoxic effect, which elevates the levels of many DNA damage markers and inhibits the levels of many DNA repair genes. In addition, waterpipe smoking can expose smokers to a range of pathogenic bacteria.
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Brinkman MC, Teferra AA, Kassem NO, Kassem NO. Effect of electric heating and ice added to the bowl on mainstream waterpipe semivolatile furan and other toxicant yields. Tob Control 2020; 29:s110-s116. [PMID: 31542776 PMCID: PMC7050391 DOI: 10.1136/tobaccocontrol-2019-054961] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 06/10/2019] [Accepted: 06/13/2019] [Indexed: 12/27/2022]
Abstract
OBJECTIVES We examined mainstream total particulate matter, nicotine, cotinine, menthol, pyrene, carbon monoxide (CO) and semivolatile furan yields from a commercial waterpipe with two methods for heating the tobacco, quick-light charcoal (charcoal) and electric head (electric) and two water bowl preparations: with (ice) and without ice (water). METHODS Emissions from a single brand of popular waterpipe tobacco (10 g) were generated using machine smoking according to a two-stage puffing regimen developed from human puffing topography. Tobacco and charcoal consumption were calculated for each machine smoking session as mass lost, expressed as a fraction of presmoking mass. RESULTS The heating method had the greatest effect on toxicant yields. Electric heating resulted in increases in the fraction of tobacco consumed (2.4 times more, p<0.0001), mainstream nicotine (1.4 times higher, p=0.002) and semivolatile furan yields (1.4 times higher, p<0.03), and a decrease in mainstream CO and pyrene yields (8.2 and 2.1 times lower, respectively, p<0.001) as compared with charcoal. Adding ice to the bowl resulted in higher furan yields for electric heating. Menthol yields were not different across the four conditions and averaged 0.16±0.03 mg/session. 2-Furaldehyde and 5-(hydroxymethyl)-2-furaldehyde yields were up to 230 and 3900 times higher, respectively, than those reported for cigarettes. CONCLUSION Waterpipe components used to heat the tobacco and water bowl preparation can significantly affect mainstream toxicant yields. Mainstream waterpipe tobacco smoke is a significant source of inhalation exposure to semivolatile furans with human carcinogenic and mutagenic potential. These data highlight the need for acute and chronic inhalation toxicity data for semivolatile furans and provide support for the establishment of limits governing sugar additives in waterpipe tobacco and educational campaigns linking waterpipe tobacco smoking behaviours with their associated harm.
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Affiliation(s)
| | - Andreas A Teferra
- College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - Noura O Kassem
- School of Public Health, San Diego State University, San Diego, California, USA
| | - Nada Of Kassem
- School of Public Health, San Diego State University, San Diego, California, USA
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Comparative Study on Pulmonary Toxicity in Mice Induced by Exposure to Unflavoured and Apple- and Strawberry-Flavoured Tobacco Waterpipe Smoke. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2020; 2020:6450450. [PMID: 32025277 PMCID: PMC6983288 DOI: 10.1155/2020/6450450] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 12/05/2019] [Accepted: 12/10/2019] [Indexed: 12/24/2022]
Abstract
The use of flavoured tobacco products in waterpipe smoking (WPS) has increased its attractiveness and consumption. Nonetheless, the influence of flavourings on pulmonary toxicity caused by WPS remains unclear. Here, the pulmonary toxicity induced by plain (P)-WPS, apple-flavoured (AF)-WPS, and strawberry-flavoured (SF)-WPS (30 minutes/day, 5 days/week for 1 month) was investigated in mice. Control mice were exposed to air. Exposure to P-WPS or AF-WPS or SF-WPS induced a dose-dependent increase of airway hyperreactivity to methacholine. The histological evaluation of the lungs in all the WPS groups revealed the presence focal areas of dilated alveolar spaces and foci of widening of interalveolar spaces with inflammatory cells. In the lung, the activity of neutrophil elastase and myeloperoxidase and the concentrations of tumor necrosis factor-α and glutathione were increased by the exposure to P-WPS, AF-WPS, or SF-WPS. However, the levels of interleukin-6 and catalase were only increased in the AF-WPS and SF-WPS groups, while nitric oxide activity was only increased in the SF-WPS group. DNA injury was increased in all the WPS groups, but the concentration of cleaved caspase-3 was only elevated in the SF-WPS group. The exposure to either P-WPS or AF-WPS or SF-WPS increased the expression of nuclear factor kappa-B (NF-κB) in the lung. In conclusion, the exposure to P-WPS or AF-WPS or SF-WPS induces alterations in lung function and morphology and causes oxidative stress and inflammation via mechanisms that include activation of NF-κB. Overall, the toxicity of flavoured tobacco WPS, in particular SF-WPS, was found to be greater than that of unflavoured WPS.
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Marusich JA, Wiley JL, Silinski MAR, Thomas BF, Meredith SE, Gahl RF, Jackson KJ. Comparison of cigarette, little cigar, and waterpipe tobacco smoke condensate and e-cigarette aerosol condensate in a self-administration model. Behav Brain Res 2019; 372:112061. [PMID: 31254537 PMCID: PMC6664429 DOI: 10.1016/j.bbr.2019.112061] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 06/24/2019] [Accepted: 06/25/2019] [Indexed: 12/15/2022]
Abstract
The pharmacological effects of tobacco products are primarily mediated by nicotine; however, research suggests that several non-nicotine tobacco constituents may alter the reinforcing effects of nicotine. This study evaluated the reinforcing effects of aqueous solutions of smoke/aerosol condensate from cigarettes, little cigars, electronic cigarettes (e-cigarettes), and waterpipe tobacco in a self-administration procedure to determine if abuse liability of these tobacco products differed. Adult male Sprague-Dawley rats (n = 64 total) were trained to self-administer intravenous nicotine (30 μg/kg/infusion) on a fixed ratio 5 schedule of reinforcement. Following nicotine dose-effect assessment (1, 7.5, 15, and 30 μg/kg/infusion), rats were given access to smoke/aerosol condensate derived from their assigned tobacco product. Rats responded for smoke/aerosol condensate containing 1, 7.5, 15, and 30 μg/kg/infusion nicotine, with the ratio of nicotine:non-nicotine constituents held constant across doses for each tobacco product. Responding for nicotine or smoke/aerosol condensate was also assessed on a progressive ratio schedule of reinforcement. Cigarette, little cigar, and e-cigarette smoke/aerosol condensates shifted the nicotine dose-effect curve leftward, whereas waterpipe tobacco smoke condensate shifted the dose-effect curve rightward. Smoke/aerosol condensate from all tobacco products produced similar levels of responding compared to nicotine alone during the progressive ratio phase. Results suggest that non-nicotine constituents in cigarettes, little cigars, and e-cigarettes differentially enhance nicotine's reinforcing potency. In contrast, waterpipe tobacco blunted nicotine's reinforcing potency, suggesting that it may contain unique constituents that dampen nicotine's reinforcing effects.
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Affiliation(s)
- Julie A Marusich
- Center for Drug Discovery, RTI International, 3040 Cornwallis Rd, Research Triangle Park, NC, 27709, USA.
| | - Jenny L Wiley
- Center for Drug Discovery, RTI International, 3040 Cornwallis Rd, Research Triangle Park, NC, 27709, USA
| | - Melanie A R Silinski
- Analytical Sciences, RTI International, 3040 Cornwallis Rd, Research Triangle Park, NC, 27709, USA
| | - Brian F Thomas
- Analytical Chemistry and Pharmaceutics, RTI International, 3040 Cornwallis Rd, Research Triangle Park, NC, 27709, USA
| | - Steven E Meredith
- U.S. Food and Drug Administration, Center for Tobacco Products, 10903 New Hampshire Ave., Silver Spring, MD, 20993, USA
| | - Robert F Gahl
- U.S. Food and Drug Administration, Center for Tobacco Products, 10903 New Hampshire Ave., Silver Spring, MD, 20993, USA
| | - Kia J Jackson
- U.S. Food and Drug Administration, Center for Tobacco Products, 10903 New Hampshire Ave., Silver Spring, MD, 20993, USA
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15
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Naddafi K, Nabizadeh R, Rostamy R, Ebrahimi Kalan M, Hassanvand MS, Fazlzadeh M. Indoor air quality in waterpipe cafés: exposure level to particulate matter. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:26605-26616. [PMID: 31290048 DOI: 10.1007/s11356-019-05546-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 05/21/2019] [Indexed: 05/11/2023]
Abstract
Waterpipe is increasingly being used worldwide. Despite waterpipe cafés gaining popularity among Iranian population, there is a paucity of research measuring exposures and assessing the health effects of waterpipe smoke in these places. The objective of the current study was to investigate the exposure to PM10, PM2.5, and PM1 concentrations and risk assessment of PM2.5 exposures in different age groups in the indoor air of waterpipe cafés. The study samples were taken from indoor air of 50 waterpipe cafés in Ardabil, Iran. The PM10, PM2.5, and PM1 concentrations were assessed using a portable GRIMM dust monitors. The mean (±SD) concentrations of indoor air PM10, PM2.5, and PM1 were 765 ± 352, 624 ± 327, and 500 ± 305 μg/m3, respectively. The mean of HQ (hazard quotient) for PM2.5 in all age groups of 16 and older was > 1, which corresponds to an unacceptably high risk for human health. Also, the mean of ELCRs (excess lifetime cancer risk) for PM2.5 in different age groups exceeded the limit value by the USEPA. The results indicated that the PM concentration is significantly influenced by the number of waterpipe smokers, type of ventilation system, and kind of tobacco. Therefore, waterpipe cafés are a potential source for exposure to PM10, PM2.5, and PM1 and increase the risk of respiratory diseases and cardiovascular problems among waterpipe smokers.
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Affiliation(s)
- Kazem Naddafi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Nabizadeh
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Roohollah Rostamy
- Research Center for Health Sciences and Technologies, Semnan University of Medical Sciences, Semnan, Iran
| | - Mohammad Ebrahimi Kalan
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | - Mohammad Sadegh Hassanvand
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran.
| | - Mehdi Fazlzadeh
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran.
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Kassem NO, Kassem NO, Liles S, Reilly E, Kas-Petrus F, Posis AIB, Hovell MF. Waterpipe device cleaning practices and disposal of waste associated with waterpipe tobacco smoking in homes in the USA. Tob Control 2019; 29:s123-s130. [PMID: 31326957 DOI: 10.1136/tobaccocontrol-2019-054959] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 04/23/2019] [Accepted: 05/01/2019] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To quantify postsmoking waterpipe tobacco (WPT) waste and describe postsmoking waterpipe (WP) device cleaning practices and disposal of associated waste in home settings. METHODS We analysed data from a US convenience sample of 50 exclusive WPT smokers, mean age 25.3 years. Data were collected at a home visit during which participants smoked one WPT head and completed a self-administered questionnaire on WP cleaning practices and disposal of waste associated with WPT use. Research assistants provided and prepared a WP for participants by weighing and loading 10 g of WPT in the WP head and placing 470 mL of water in the WP bowl. At the completion of the smoking session, research assistants measured the remaining WPT and water. Descriptive analyses were performed. RESULTS Of the 10 g of fresh WPT used for each smoking session, 70.1% (mean=7.01 g) was discarded postsmoking as waste; for each 470 mL of water used in the WP bowl, 94.3% (mean=443 mL) was discarded. WP device cleaning practices ranged from never cleaning the device to cleaning it after each smoking session. Respondents reported discarding smoked WPT residue in the trash (81.6%) or the kitchen sink (14.3%) and discarding postsmoking charcoal in the trash (57.6%), the kitchen sink (27.3%) or backyard soil (9.1%). Respondents reported discarding smoked WP water in the kitchen sink (76.5%), bathroom sink (14.7%), toilet (2.9%) and backyard soil (5.9%). CONCLUSIONS Interventions and regulations are needed to inform proper WP device cleaning practices and disposal of waste associated with WPT use. TRIAL REGISTRATION NUMBER NCT03253653.
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Affiliation(s)
- Nada Of Kassem
- San Diego State University Research Foundation, San Diego, California, USA
| | - Noura O Kassem
- San Diego State University Research Foundation, San Diego, California, USA
| | - Sandy Liles
- San Diego State University Research Foundation, San Diego, California, USA
| | - Erin Reilly
- San Diego State University Research Foundation, San Diego, California, USA
| | - Flora Kas-Petrus
- San Diego State University Research Foundation, San Diego, California, USA
| | | | - Melbourne F Hovell
- San Diego State University Research Foundation, San Diego, California, USA
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Perraud V, Lawler MJ, Malecha KT, Johnson RM, Herman D, Staimer N, Kleinman MT, Nizkorodov SA, Smith JN. Chemical Characterization of Nanoparticles and Volatiles Present in Mainstream Hookah Smoke. AEROSOL SCIENCE AND TECHNOLOGY : THE JOURNAL OF THE AMERICAN ASSOCIATION FOR AEROSOL RESEARCH 2019; 53:1023-1039. [PMID: 33041429 PMCID: PMC7546025 DOI: 10.1080/02786826.2019.1628342] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Waterpipe smoking is becoming more popular worldwide and there is a pressing need to better characterize the exposure of smokers to chemical compounds present in the mainstream smoke. We report real-time measurements of mainstream smoke for carbon monoxide, volatile organic compounds and nanoparticle size distribution and chemical composition using a custom dilution flow tube. A conventional tobacco mixture, a dark leaf unwashed tobacco and a nicotine-free herbal tobacco were studied. Results show that carbon monoxide is present in the mainstream smoke and originates primarily from the charcoal used to heat the tobacco. Online measurements of volatile organic compounds in mainstream smoke showed an overwhelming contribution from glycerol. Gas phase analysis also showed that very little filtration of the gas phase products is provided by the percolation of mainstream smoke through water. Waterpipe smoking generated high concentrations of 4-100 nm nanoparticles, which were mainly composed of sugar derivatives and especially abundant in the first 10 min of the smoking session. These measured emissions of volatiles and particles are compared with those from a reference cigarette (3R4F) and represent the equivalent of the emission of one or more entire cigarettes for a single puff of hookah smoke. Considerations related to the health impacts of waterpipe smoking are discussed.
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Affiliation(s)
- Véronique Perraud
- Department of Chemistry, University of California, Irvine, California, USA
| | - Michael J. Lawler
- Department of Chemistry, University of California, Irvine, California, USA
| | - Kurtis T. Malecha
- Department of Chemistry, University of California, Irvine, California, USA
| | | | - David Herman
- School of Medicine, University of California, Irvine, California, USA
| | - Norbert Staimer
- Department of Epidemiology, University of California, Irvine, California, USA
| | | | | | - James N. Smith
- Department of Chemistry, University of California, Irvine, California, USA
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18
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Hookah use as a predictor of other tobacco product use: A longitudinal analysis of Texas college students. Addict Behav 2018; 87:131-137. [PMID: 30016762 DOI: 10.1016/j.addbeh.2018.06.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 06/26/2018] [Accepted: 06/26/2018] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Hookah use is particularly prevalent among U.S. college students; however, few studies have investigated whether hookah use is a risk factor for the initiation of other tobacco products. This study examined whether hookah use predicted subsequent initiation of other combustible tobacco products (conventional cigarettes and cigar products) and Electronic Nicotine Delivery Systems (ENDS) among Texas college students during a 2.5-year study period. METHODS This study involved a longitudinal analysis of data from Waves 1-6, with 6 months between each wave, of the Marketing and Promotions Across Colleges in Texas Project (Project M-PACT). Two separate multilevel discrete-time survival analyses were used to model the associations between past 30-day hookah use and subsequent initiation of 1) other combustible tobacco products, and 2) ENDS during the 2.5 year study period, after controlling for demographic, other tobacco use, and risk-taking personality characteristics (i.e. sensation seeking and impulsivity). RESULTS After controlling for covariates, past 30-day hookah use was associated with significantly higher odds of subsequent initiation of other combustible tobacco products. Past 30-day hookah use also predicted subsequent initiation of ENDS after controlling for covariates. CONCLUSIONS This study is one of the first to demonstrate that hookah use is a predictor of subsequent initiation of other combustible tobacco products and ENDS among college students. These findings suggest that hookah may prime individuals to use other tobacco products, which has important implications for prevention programs and future research.
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Farag MA, Elmassry MM, El-Ahmady SH. The characterization of flavored hookahs aroma profile and in response to heating as analyzed via headspace solid-phase microextraction (SPME) and chemometrics. Sci Rep 2018; 8:17028. [PMID: 30451904 PMCID: PMC6242864 DOI: 10.1038/s41598-018-35368-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 11/05/2018] [Indexed: 12/11/2022] Open
Abstract
Flavors profiling in flavored hookah tobacco is an issue of increasing scrutiny for the health sector owing to its adverse effects on humans, especially being heated to produce smoke. This study aims at tackling the components involved in the flavored hookah tobacco from a chemical and biological point of view. Detecting individual flavor compounds, within a complex hookah tobacco matrix was accomplished using headspace solid phase microextraction (SPME). A total of 114 volatiles were identified in 13 flavored hookah tobacco products, with esters amounting for the major component up to 40%. Whereas oxygenated monoterpenes presented another major volatile class, contributing up to 23%, including (E)-anethole. Superheating flavored hookah tobacco at 190 °C resulted in the release of a mixture of phenol derivatives and polycyclic aromatic compounds that are indicative of coal tar, a major component produced during hookah tobacco usage with potential health hazards. This study provides the first comprehensive volatile profile of hookah tobacco products from different origins identifying chemical components involved in flavors. It is expected to serve as informative grounds for the better understanding of hookah tobacco production and usage. The information presented is also expected to raise awareness on the health risks of hookah tobacco smoking.
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Affiliation(s)
- Mohamed A Farag
- Pharmacognosy Department, Faculty of Pharmacy, Cairo University, Cairo, Egypt.
- Department of Chemistry, School of Sciences & Engineering, The American University in Cairo, New Cairo, 11835, Egypt.
| | - Moamen M Elmassry
- Department of Biological Sciences, Texas Tech University, Lubbock, TX, USA
| | - Sherweit H El-Ahmady
- Pharmacognosy Department, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt
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20
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Szyfter K, Napierala M, Florek E, Braakhuis BJM, Takes RP, Rodrigo JP, Rinaldo A, Silver CE, Ferlito A. Molecular and health effects in the upper respiratory tract associated with tobacco smoking other than cigarettes. Int J Cancer 2018; 144:2635-2643. [DOI: 10.1002/ijc.31846] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 06/14/2018] [Accepted: 07/26/2018] [Indexed: 12/12/2022]
Affiliation(s)
| | - Marta Napierala
- Laboratory of Environmental Research, Department of ToxicologyPoznan University of Medical Sciences Poznan Poland
| | - Ewa Florek
- Laboratory of Environmental Research, Department of ToxicologyPoznan University of Medical Sciences Poznan Poland
| | | | - Robert P. Takes
- International Head & Neck Scientific Group Padua Italy
- Department of Otolaryngology‐Head and Neck Surgery, Radboud University Medical CentreRadboud Institute for Health Sciences Nijmegen the Netherlands
| | - Juan P. Rodrigo
- International Head & Neck Scientific Group Padua Italy
- Department of Otolaryngology, Hospital Universitario Central de Asturias, IUOPAUniversity of Oviedo, CIBERONC Oviedo Spain
| | - Alessandra Rinaldo
- International Head & Neck Scientific Group Padua Italy
- Department of OtolaryngologyUniversity of Udine School of Medicine Udine Italy
| | - Carl E. Silver
- International Head & Neck Scientific Group Padua Italy
- Department of SurgeryUniversity of Arizona College of Medicine Phoenix AZ
| | - Alfio Ferlito
- Coordinator of the International Head & Neck Scientific Group Padua Italy
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21
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Javed F, ALHarthi SS, BinShabaib MS, Gajendra S, Romanos GE, Rahman I. Toxicological impact of waterpipe smoking and flavorings in the oral cavity and respiratory system. Inhal Toxicol 2017; 29:389-396. [PMID: 29039225 PMCID: PMC5927775 DOI: 10.1080/08958378.2017.1384084] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Waterpipe smoking (WS), an emerging trend has major health concerns. It is prevalent worldwide as a recreational activity both indoors and outdoors. The aim of this review was to assess the impact of waterpipe smoke on the oral and respiratory system (oral cavity and pulmonary tissues). A number of studies have shown that periodontal health status is compromised in waterpipe smokers when compared with nonsmokers. Some studies have associated WS with oral premalignant and malignant lesions; however, due to the poor quality of these studies, the presented outcomes should be interpreted with caution. Although cigarette smoking has been considered as a potential risk factor for dental caries; there are no studies in indexed literature that have shown an association to exist between dental caries and WS. Inhaled waterpipe smoke imposes oxidative stress and inflammatory responses and compromises the ventilatory capacity of the lungs and may lead to an increased risk of decline in lung function. WS may cause oral and pulmonary diseases, such as periodontal disease and chronic obstructive airway disease, respectively. The association between WS and development of dental caries and oral pre-cancer and their relationships with chronic airways disease requires investigations. This review discusses the current evidence of waterpipe smoke effects on the oral health and respiratory system based on basic and clinical science and provides future directions for research and regulatory science on how WS can affect the oral cavity and the respiratory/pulmonary system.
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Affiliation(s)
- Fawad Javed
- Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, NY, USA
| | - Shatha Subhi ALHarthi
- Department of Periodontology, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia
| | - Munerah Saleh BinShabaib
- Department of Periodontology, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia
| | - Sangeeta Gajendra
- Department of Community Dentistry, Eastman Institute for Oral Health, University of Rochester, NY, USA
| | - Georgios E. Romanos
- Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Irfan Rahman
- Department of Environmental Medicine, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA
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22
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Walters MS, Salit J, Ju JH, Staudt MR, Kaner RJ, Rogalski AM, Sodeinde TB, Rahim R, Strulovici-Barel Y, Mezey JG, Almulla AM, Sattar H, Mahmoud M, Crystal RG. Waterpipe smoking induces epigenetic changes in the small airway epithelium. PLoS One 2017; 12:e0171112. [PMID: 28273093 PMCID: PMC5342191 DOI: 10.1371/journal.pone.0171112] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 01/16/2017] [Indexed: 01/01/2023] Open
Abstract
Waterpipe (also called hookah, shisha, or narghile) smoking is a common form of tobacco use in the Middle East. Its use is becoming more prevalent in Western societies, especially among young adults as an alternative form of tobacco use to traditional cigarettes. While the risk to cigarette smoking is well documented, the risk to waterpipe smoking is not well defined with limited information on its health impact at the epidemiologic, clinical and biologic levels with respect to lung disease. Based on the knowledge that airway epithelial cell DNA methylation is modified in response to cigarette smoke and in cigarette smoking-related lung diseases, we assessed the impact of light-use waterpipe smoking on DNA methylation of the small airway epithelium (SAE) and whether changes in methylation were linked to the transcriptional output of the cells. Small airway epithelium was obtained from 7 nonsmokers and 7 light-use (2.6 ± 1.7 sessions/wk) waterpipe-only smokers. Genome-wide comparison of SAE DNA methylation of waterpipe smokers to nonsmokers identified 727 probesets differentially methylated (fold-change >1.5, p<0.05) representing 673 unique genes. Dominant pathways associated with these epigenetic changes include those linked to G-protein coupled receptor signaling, aryl hydrocarbon receptor signaling and xenobiotic metabolism signaling, all of which have been associated with cigarette smoking and lung disease. Of the genes differentially methylated, 11.3% exhibited a corresponding significant (p<0.05) change in gene expression with enrichment in pathways related to regulation of mRNA translation and protein synthesis (eIF2 signaling and regulation of eIF4 and p70S6K signaling). Overall, these data demonstrate that light-use waterpipe smoking is associated with epigenetic changes and related transcriptional modifications in the SAE, the cell population demonstrating the earliest pathologic abnormalities associated with chronic cigarette smoking.
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Affiliation(s)
- Matthew S. Walters
- Department of Genetic Medicine, Weill Cornell Medical College, New York, New York, United States of America
| | - Jacqueline Salit
- Department of Genetic Medicine, Weill Cornell Medical College, New York, New York, United States of America
| | - Jin Hyun Ju
- Department of Genetic Medicine, Weill Cornell Medical College, New York, New York, United States of America
| | - Michelle R. Staudt
- Department of Genetic Medicine, Weill Cornell Medical College, New York, New York, United States of America
| | - Robert J. Kaner
- Department of Genetic Medicine, Weill Cornell Medical College, New York, New York, United States of America
- Department of Medicine, Weill Cornell Medical College, New York, New York, United States of America
| | - Allison M. Rogalski
- Department of Genetic Medicine, Weill Cornell Medical College, New York, New York, United States of America
| | - Teniola B. Sodeinde
- Department of Genetic Medicine, Weill Cornell Medical College, New York, New York, United States of America
| | - Riyaad Rahim
- Department of Genetic Medicine, Weill Cornell Medical College, New York, New York, United States of America
| | - Yael Strulovici-Barel
- Department of Genetic Medicine, Weill Cornell Medical College, New York, New York, United States of America
| | - Jason G. Mezey
- Department of Genetic Medicine, Weill Cornell Medical College, New York, New York, United States of America
| | | | - Hisham Sattar
- Pulmonary Section, Hamad Medical Corporation, Doha, Qatar
| | - Mai Mahmoud
- Weill Cornell Medical College-Qatar, Doha, Qatar
| | - Ronald G. Crystal
- Department of Genetic Medicine, Weill Cornell Medical College, New York, New York, United States of America
- Department of Medicine, Weill Cornell Medical College, New York, New York, United States of America
- * E-mail:
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23
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Die Wasserpfeife (Shisha) – Innenraumluftqualität, Human-Biomonitoring und Gesundheitseffekte. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2016; 59:1593-1604. [DOI: 10.1007/s00103-016-2462-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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24
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[Waterpipe (shisha) smoking among adolescents in Germany: Results of the KiGGS study: first follow-up (KiGGS Wave 1)]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2016; 58:467-73. [PMID: 25665891 DOI: 10.1007/s00103-015-2128-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND At the beginning of the 21st century, waterpipe (shisha) smoking has become a new and global youth trend in tobacco consumption. Despite the fact that this type of tobacco use can also lead to serious health problems, there are only a few studies on this topic in Germany. OBJECTIVES The aim of this study was to determine the prevalence of waterpipe smoking among 12- to 17-year-old adolescents. Age- and sex-related differences were analyzed and, for the first time in Germany, the association between parental socioeconomic status and waterpipe use was examined. MATERIALS AND METHODS Data were obtained from the first follow-up of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 1), which was conducted from 2009 to 2012. Waterpipe smoking was assessed among adolescents aged 12 to 17 years using three items (n = 4,543). We calculated prevalence rates and age-adjusted odds ratios (OR) with 95 % confidence intervals (95 % CI). RESULTS Lifetime prevalence of waterpipe use was 28.9 % (95 % CI: 26.9-31.0). Approximately one fifth (20.6 %; 95 % CI: 18.8-22.6) of the adolescents reported waterpipe use in the past 12 months, one tenth (10.0 %; 95 % CI: 8.6-11.6) reported current use (at least once during the past 30 days). In both sexes, prevalence increased with age. Waterpipe smoking rates were significantly higher among boys than girls, while no significant differences were found regarding parental socioeconomic status. CONCLUSIONS A considerable number of adolescents in Germany are at least occasional waterpipe (shisha) smokers. Because of waterpipe related health and addiction risks that are often underestimated by adolescents, specific health education and prevention measures are necessary.
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Kassem NOF, Jackson SR, Boman-Davis M, Kassem NO, Liles S, Daffa RM, Yasmin R, Madanat H, Hovell MF. Hookah Smoking and Facilitators/Barriers to Lounge Use among Students at a US University. Am J Health Behav 2015; 39:832-48. [PMID: 26450551 DOI: 10.5993/ajhb.39.6.11] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To examine hookah tobacco use, hookah lounge attendance, and facilitators and barriers to hookah lounge attendance. METHODS A cross-sectional Web-based survey of a random sample of 1332 undergraduate students (Mean Age = 21.2 years) attending a United States university. RESULTS The majority of respondents (72.8%) had ever smoked hookah tobacco, and 28% of those had ever smoked during adolescence. The majority of ever hookah smokers (81.5%) and a portion of never hookah smokers (20%) had ever been to a hookah lounge. The adjusted odds of ever visiting a hookah lounge were 2.1 times higher among participants who reported that the closest hookah lounge to the university was < 5 miles away than those who reported that the closest hookah lounge was ≥ 5 miles away. Facilitators of visiting hookah lounges included friends and close proximity of hookah lounges to campus; barriers included cost of smoking hookah, crowded lounges, and having to be 18 years old. CONCLUSION Youth are vulnerable to experimenting with hookah tobacco smoking. Hookah lounges provide patrons the opportunity to smoke hookah tobacco with smoker and non-smoker friends in entertaining settings. Our findings suggest that zoning laws and anti-hookah smoking legislation may help curb hookah uptake by prohibiting hookah lounges from opening in close proximity to universities, reducing the density of hookah lounges in cities, and raising the admission age for hookah lounges to 21 years.
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Affiliation(s)
- Nada O F Kassem
- Center for Behavioral Epidemiology and Community Health (CBEACH), San Diego State University Research Foundation, San Diego, CA, USA.
| | - Sheila R Jackson
- Center for Behavioral Epidemiology and Community Health (CBEACH), San Diego State University Research Foundation, San Diego, CA, USA
| | | | - Noura O Kassem
- Center for Behavioral Epidemiology and Community Health (CBEACH), San Diego State University Research Foundation, San Diego, CA, USA
| | - Sandy Liles
- Center for Behavioral Epidemiology and Community Health (CBEACH), San Diego State University Research Foundation, San Diego, CA, USA
| | - Reem M Daffa
- Center for Behavioral Epidemiology and Community Health (CBEACH), San Diego State University Research Foundation, San Diego, CA, USA
| | - Roxana Yasmin
- Center for Behavioral Epidemiology and Community Health (CBEACH), San Diego State University Research Foundation, San Diego, CA, USA
| | - Hala Madanat
- Graduate School of Public Health, San Diego State University, San Diego, CA, USA
| | - Melbourne F Hovell
- Center for Behavioral Epidemiology and Community Health (CBEACH), San Diego State University Research Foundation, San Diego, CA, USA
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Schubert J, Müller FD, Schmidt R, Luch A, Schulz TG. Waterpipe smoke: source of toxic and carcinogenic VOCs, phenols and heavy metals? Arch Toxicol 2015; 89:2129-39. [PMID: 25248501 DOI: 10.1007/s00204-014-1372-x] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 09/11/2014] [Indexed: 10/24/2022]
Abstract
The use of the waterpipe, a traditional aid for the consumption of tobacco, has spread worldwide and is steadily increasing especially among the youth. On the other hand, there is a lack of knowledge regarding the composition of mainstream waterpipe smoke and the toxicological risks associated with this kind of smoking habit. Using a standardized machine smoking protocol, mainstream waterpipe smoke was generated and further analyzed for twelve volatile organic compounds (VOCs) and eight phenolic compounds by applying gas chromatography-mass spectrometry and reverse-phase high-performance liquid chromatography-fluorescence detection, respectively. Additionally, seventeen elements were analyzed in waterpipe tobacco and charcoal prior to and after smoking, applying inductively coupled plasma-mass spectrometry to assess the maximum exposure of these elements. For the first time ever, we have been able to show that waterpipe mainstream smoke contains high levels of the human carcinogen benzene. Compared with cigarette smoke yields, the levels were 6.2-fold higher, thus representing a significant health hazard for the waterpipe smoker. Furthermore, we found that waterpipe mainstream smoke contains considerable amounts of catechol, hydroquinone and phenol, each of which causing some health concern at least. The analysis of waterpipe tobacco and charcoal revealed that both matrices contained considerable amounts of the toxic elements nickel, cadmium, lead and chromium. Altogether, the data on VOCs, phenols and elements presented in this study clearly point to the health hazards associated with the consumption of tobacco using waterpipes.
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Affiliation(s)
- Jens Schubert
- Department of Chemicals and Product Safety, German Federal Institute for Risk Assessment (BfR), Max-Dohrn-Straße 8-10, 10589, Berlin, Germany.
| | - Frederic D Müller
- Department of Chemicals and Product Safety, German Federal Institute for Risk Assessment (BfR), Max-Dohrn-Straße 8-10, 10589, Berlin, Germany
| | - Roman Schmidt
- Department of Chemicals and Product Safety, German Federal Institute for Risk Assessment (BfR), Max-Dohrn-Straße 8-10, 10589, Berlin, Germany
| | - Andreas Luch
- Department of Chemicals and Product Safety, German Federal Institute for Risk Assessment (BfR), Max-Dohrn-Straße 8-10, 10589, Berlin, Germany
| | - Thomas G Schulz
- Department of Chemicals and Product Safety, German Federal Institute for Risk Assessment (BfR), Max-Dohrn-Straße 8-10, 10589, Berlin, Germany
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Paschke M, Hutzler C, Henkler F, Luch A. Toward the stereochemical identification of prohibited characterizing flavors in tobacco products: the case of strawberry flavor. Arch Toxicol 2015; 89:1241-55. [PMID: 26138682 DOI: 10.1007/s00204-015-1558-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 06/18/2015] [Indexed: 10/23/2022]
Abstract
With the revision of the European Tobacco Products Directive (2014/40/EU), characterizing flavors such as strawberry, candy, vanillin or chocolate will be prohibited in cigarettes and fine-cut tobacco. Product surveillance will therefore require analytical means to define and subsequently detect selected characterizing flavors that are formed by supplemented flavors within the complex matrix tobacco. We have analyzed strawberry-flavored tobacco products as an example for characterizing fruit-like aroma. Using this approach, we looked into aroma components to find indicative patterns or features that can be used to satisfy obligatory product information as requested by the European Directive. Accordingly, a headspace solid-phase microextraction (HS-SPME) technique was developed and coupled to subsequent gas chromatography-mass spectrometry (GC/MS) to characterize different strawberry-flavored tobacco products (cigarettes, fine-cut tobacco, liquids for electronic cigarettes, snus, shisha tobacco) for their volatile additives. The results were compared with non-flavored, blend characteristic flavored and other fruity-flavored cigarettes, as well as fresh and dried strawberries. Besides different esters and aldehydes, the terpenes linalool, α-terpineol, nerolidol and limonene as well as the lactones γ-decalactone, γ-dodecalactone and γ-undecalactone could be verified as compounds sufficient to convey some sort of strawberry flavor to tobacco. Selected flavors, i.e., limonene, linalool, α-terpineol, citronellol, carvone and γ-decalactone, were analyzed further with respect to their stereoisomeric composition by using enantioselective HS-SPME-GC/MS. These experiments confirmed that individual enantiomers that differ in taste or physiological properties can be distinguished within the tobacco matrix. By comparing the enantiomeric composition of these compounds in the tobacco with that of fresh and dried strawberries, it can be concluded that non-natural strawberry aroma is usually used to produce strawberry-flavored tobacco products. Such authenticity control can become of interest particularly when manufacturers claim that natural sources were used for flavoring of products. Although the definition of characterizing flavors by analytical means remains challenging, specific compounds or features are required to be defined for routine screening of reported information. Clarifications by sensory testing might still be necessary, but could be limited to a few preselected samples.
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Affiliation(s)
- Meike Paschke
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), Max-Dohrn-Strasse 8-10, 10589, Berlin, Germany,
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Aboaziza E, Eissenberg T. Waterpipe tobacco smoking: what is the evidence that it supports nicotine/tobacco dependence? Tob Control 2015; 24 Suppl 1:i44-i53. [PMID: 25492935 PMCID: PMC4345797 DOI: 10.1136/tobaccocontrol-2014-051910] [Citation(s) in RCA: 129] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 11/20/2014] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Waterpipe tobacco smoking (WTS) involves passing tobacco smoke through water prior to inhalation, and has spread worldwide. This spread becomes a public health concern if it is associated with tobacco-caused disease and if WTS supports tobacco/nicotine dependence. A growing literature demonstrates that WTS is associated with disability, disease and death. This narrative review examines if WTS supports nicotine/tobacco dependence, and is intended to help guide tobacco control efforts worldwide. DATA SOURCES PUBMED search using: (("waterpipe" or "narghile" or "arghile" or "shisha" or "goza" or "narkeela" or "hookah" or "hubble bubble")) AND ("dependence" or "addiction"). STUDY SELECTION Excluded were articles not in English, without original data, and that were not topic-related. Thirty-two articles were included with others identified by inspecting reference lists and other sources. DATA SYNTHESIS WTS and the delivery of the dependence-producing drug nicotine were examined, and then the extent to which the articles addressed WTS-induced nicotine/dependence explicitly, as well as implicitly with reference to criteria for dependence outlined by the WHO. CONCLUSIONS WTS supports nicotine/tobacco dependence because it is associated with nicotine delivery, and because some smokers experience withdrawal when they abstain from waterpipe, alter their behaviour in order to access a waterpipe and have difficulty quitting, even when motivated to do so. There is a strong need to support research investigating measurement of WTS-induced tobacco dependence, to inform the public of the risks of WTS, which include dependence, disability, disease and death, and to include WTS in the same public health policies that address tobacco cigarettes.
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Affiliation(s)
- Eiman Aboaziza
- Center for Clinical and Translational Research and Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Thomas Eissenberg
- Department of Psychology, Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
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Shihadeh A, Schubert J, Klaiany J, El Sabban M, Luch A, Saliba NA. Toxicant content, physical properties and biological activity of waterpipe tobacco smoke and its tobacco-free alternatives. Tob Control 2015; 24 Suppl 1:i22-i30. [PMID: 25666550 PMCID: PMC4345918 DOI: 10.1136/tobaccocontrol-2014-051907] [Citation(s) in RCA: 144] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 01/14/2015] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Waterpipe smoking using sweetened, flavoured tobacco products has become a widespread global phenomenon. In this paper, we review chemical, physical and biological properties of waterpipe smoke. DATA SOURCES Peer-reviewed publications indexed in major databases between 1991 and 2014. Search keywords included a combination of: waterpipe, narghile, hookah, shisha along with names of chemical compounds and classes of compounds, in addition to terms commonly used in cellular biology and aerosol sizing. STUDY SELECTION The search was limited to articles published in English which reported novel data on waterpipe tobacco smoke (WTS) toxicant content, biological activity or particle size and which met various criteria for analytical rigour including: method specificity and selectivity, precision, accuracy and recovery, linearity, range, and stability. DATA EXTRACTION Multiple researchers reviewed the reports and collectively agreed on which data were pertinent for inclusion. DATA SYNTHESIS Waterpipe smoke contains significant concentrations of toxicants thought to cause dependence, heart disease, lung disease and cancer in cigarette smokers, and includes 27 known or suspected carcinogens. Waterpipe smoke is a respirable aerosol that induces cellular responses associated with pulmonary and arterial diseases. Except nicotine, smoke generated using tobacco-free preparations marketed for 'health conscious' users contains the same or greater doses of toxicants, with the same cellular effects as conventional products. Toxicant yield data from the analytical laboratory are consistent with studies of exposure biomarkers in waterpipe users. CONCLUSIONS A sufficient evidence base exists to support public health interventions that highlight the fact that WTS presents a serious inhalation hazard.
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Affiliation(s)
- Alan Shihadeh
- Department of Mechanical Engineering, American University of Beirut, Beirut, Lebanon
- Department of Psychology, Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Jens Schubert
- Department of Safety of Pesticides, German Federal Institute for Risk Assessment, Berlin, Germany
| | - Joanne Klaiany
- Department of Chemistry, American University of Beirut, Beirut, Lebanon
| | - Marwan El Sabban
- Department of Human Morphology, American University of Beirut, Beirut, Lebanon
| | - Andreas Luch
- Department of Chemicals and Product Safety, German Federal Institute for Risk Assessment, Berlin, Germany
| | - Najat A Saliba
- Department of Psychology, Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Chemistry, American University of Beirut, Beirut, Lebanon
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Kassem NOF, Daffa RM, Liles S, Jackson SR, Kassem NO, Younis MA, Mehta S, Chen M, Jacob P, Carmella SG, Chatfield DA, Benowitz NL, Matt GE, Hecht SS, Hovell MF. Children's exposure to secondhand and thirdhand smoke carcinogens and toxicants in homes of hookah smokers. Nicotine Tob Res 2014; 16:961-75. [PMID: 24590387 PMCID: PMC4072898 DOI: 10.1093/ntr/ntu016] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Accepted: 01/19/2014] [Indexed: 11/14/2022]
Abstract
INTRODUCTION We examined homes of hookah-only smokers and nonsmokers for levels of indoor air nicotine (a marker of secondhand smoke) and indoor surface nicotine (a marker of thirdhand smoke), child uptake of nicotine, the carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), and the toxicant acrolein by analyzing their corresponding metabolites cotinine, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) and NNAL-glucuronides (total NNAL) and 3-hydroxypropylmercapturic acid. METHODS Data were collected at 3 home visits during a 7-day study period from a convenience sample of 24 households with a child 5 years or younger. Three child urine samples and 2 air and surface samples from the living room and the child bedroom were taken in homes of nonsmokers (n = 5) and hookah-only smokers (n = 19) comprised of daily hookah smokers (n = 8) and weekly/monthly hookah smokers (n = 11). RESULTS Nicotine levels in indoor air and on surfaces in the child bedrooms in homes of daily hookah smokers were significantly higher than in homes of nonsmokers. Uptake of nicotine, NNK, and acrolein in children living in daily hookah smoker homes was significantly higher than in children living in nonsmoker homes. Uptake of nicotine and NNK in children living in weekly/monthly hookah smoker homes was significantly higher than in children living in nonsmoker homes. CONCLUSIONS Our data provide the first evidence for uptake of nicotine, the tobacco-specific lung carcinogen NNK, and the ciliatoxic and cardiotoxic agent acrolein in children living in homes of hookah smokers. Our findings suggest that daily and occasional hookah use in homes present a serious, emerging threat to children's long-term health.
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Affiliation(s)
- Nada O F Kassem
- Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, Division of Health Promotion, San Diego State University, San Diego, CA;
| | - Reem M Daffa
- Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, Division of Health Promotion, San Diego State University, San Diego, CA
| | - Sandy Liles
- Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, Division of Health Promotion, San Diego State University, San Diego, CA
| | - Sheila R Jackson
- Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, Division of Health Promotion, San Diego State University, San Diego, CA
| | - Noura O Kassem
- Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, Division of Health Promotion, San Diego State University, San Diego, CA
| | - Maram A Younis
- Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, Division of Health Promotion, San Diego State University, San Diego, CA
| | - Setoo Mehta
- Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, Division of Health Promotion, San Diego State University, San Diego, CA
| | - Menglan Chen
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN
| | - Peyton Jacob
- Departments of Medicine and Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, CA
| | | | - Dale A Chatfield
- Department of Chemistry, San Diego State University, San Diego, CA
| | - Neal L Benowitz
- Departments of Medicine and Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, CA
| | - Georg E Matt
- Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, Division of Health Promotion, San Diego State University, San Diego, CA; Department of Psychology, San Diego State University, San Diego, CA
| | - Stephen S Hecht
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN
| | - Melbourne F Hovell
- Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, Division of Health Promotion, San Diego State University, San Diego, CA
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