Quantification of Trace Elements in Different Dokha and Shisha Tobacco Products using EDXRF

A literature review addressing midwakh and e-cigarette use in the Gulf region

A notable decrease in conventional cigarette smoking has been witnessed on a global scale. However, this decrease has been accompanied by an equally striking global increase in the consumption of alternative tobacco products (ATPs), namely e-cigarettes and midwakh in the Arabian Gulf region. A literature review was used to outline the chemical composition of these two ATPs and review their impacts on health. The study was conducted using databases like PubMed, Google Scholar, MDPI, and WorldCat. The literature search included terms such as "e-cigarettes," "midwakh," "dokha," "heath impacts," "psychological effects," "social influences," and "cigarette smoking" with emphasis on literature from the Arabian Gulf region. Data shows that midwakh contains markedly high levels of tar, nicotine, and various compounds of notable effects on the human body. Similarly, it was found that e-cigarettes contain non-negligible amounts of nicotine and other chemical compounds that may not have been extensively investigated. Alarming reports of system-specific effects brought about by midwakh, and e-cigarette consumption, have been reported, although further research is needed to deduce the mechanism. We also discussed some of the social and psychological factors leading to their consumption within this population. Hence, this review raises questions around the safety of these two types of ATPs and encourages comprehensive studies globally and regionally.

Nondestructive characterization of diseased Chinese chive leaves using X-ray intensity ratios with microbeam synchrotron radiation X-ray fluorescence spectrometry

The Chinese chive (Allium tuberosum) is a core crop grown in Kochi Prefecture, Japan. However, withering symptoms occur during greenhouse growing, which have a negative impact on crop management Chinese chive leaves with physiological disorders (PD) or necrotic streak disease (ND) present with withering as typical blight symptoms. Excess or deficiency of elements may cause such withering in Chinese chive leaves with PD. Therefore, visualizing the elemental distribution in plant bodies may help clarify the cause of this withering. In this study, using synchrotron radiation X-ray fluorescence (SR-XRF) imaging, we examined the elemental distribution conditions in healthy Chinese chive leaves without withering, those that withered due to PD, and those that withered due to ND. Segmentation analysis of inductively coupled plasma-optical emission spectroscopy (ICP-OES) was performed on the SR-XRF imaged Chinese chive leaves and the data from the two analytical methods were compared. SR-XRF imaging provided more detailed data on elemental distribution compared with segmentation analysis using ICP-OES. Based on the SR-XRF imaging results, the X-ray intensity ratios for Ca/K, Fe/Mn, and Zn/Cu were calculated. These findings support that the Ca/K, Fe/Mn, and Zn/Cu X-ray intensity ratios can be used in the early detection of withered leaves and to predict the factors causing withering.

Dokha brand differentiation by elemental analysis measured by inductively coupled plasma-mass spectrometry

Dokha is a tobacco product commonly used in Middle Eastern and Northern African regions. It is available in three blends purportedly corresponding to the degree of "buzz" experienced by the user. The "buzz" has been linked in part to nicotine levels, which are higher than those found in cigarettes and is believed to be the reason dokha is abused as a "legal high." There have been reports of seizure activity from dokha users, and elevated concentrations of toxic metals have been measured in dokha tobacco. The purpose of this work was to determine whether we could use dokha's elemental content, measured by inductively coupled plasma-mass spectrometry, to link dokha back to its brand. This could aid investigators in identifying brands and/or distribution routes in the case of adverse effects resulting from dokha use. We measured the concentrations of Mg, K, Mn, Ni, Cu, Rb, Sr, and Ba in Medwakh, Nirvana, Scorpion, Enjoy, Kingdom, and Iconic dokha brands. Analysis of variance revealed statistical differences in concentrations of elements among groups. Discriminant function analysis (using leave-one-out classification) was 58.3% successful at differentiating brands. Enjoy dokha was the most, and Kingdom dokha the least, correctly classified among groups. Attempts to further link dokha blends back to light, medium, and heavy blends were less successful. These results indicate potential for using elemental content to discriminate among dokha brands. Our data may also help to understand the degree of additional processing and/or adulteration of dokha products available to users in the United States.

Patterns of Tobacco Smoking and Nicotine Vaping among University Students in the United Arab Emirates: A Cross-Sectional Study

Various forms of tobacco smoking and nicotine vaping tools are available on the market. This study quantified the prevalence of and identified factors associated with patterns of smoking and nicotine vaping among university students in the United Arab Emirates (UAE). A cross-sectional sample of students enrolled in three public universities was surveyed. Self-reported current smoking and nicotine vaping were recorded. Of 1123 students, 81.7% completed the online survey (mean age, 20.7 ± 3.4 (SD) years; 70.7% females). The prevalence of current smoking was 15.1% while the prevalence of current nicotine vaping was nearly 4.0%. Among current smokers, 54.7% reported conventional smoking only, 15.1% reported nicotine vaping only, and 28.8% were poly-users. Conventional midwakh (47.5%), followed by conventional shisha/waterpipe (36.7%), conventional cigarettes (36.7%), electronic shisha/waterpipe (25.2%), and electronic cigarettes (24.5%), were most commonly reported by students. Students aged 20–25 years (adjusted odds ratios (aOR): 2.08, 95% confidence interval (CI): 1.18–3.67) or >25 years (aOR: 4.24, 95% CI: 1.41–12.80) had higher odds of being current smokers compared to those aged 17–19 years. The male gender was also independently associated with higher odds of being a current smoker (aOR: 5.45, 95% CI: 3.31–8.97) as well as higher odds of smoking cigarettes, shisha, and midwakh, or nicotine vaping compared to being female. Of nicotine vaping users, 36.1% reported using nicotine vaping because they enjoyed the flavor and vaporizing experience and 34.4% used it to help them to quit smoking. A relatively high prevalence of self-reported smoking was reported among university students in the UAE. The findings also suggest that nicotine vaping use is relatively widespread, but still less common than traditional smoking. Vigilant and tailored university-based smoking control and preventive measures are warranted.

Options for waterpipe product regulation: A systematic review on product characteristics that affect attractiveness, addictiveness and toxicity of waterpipe use

INTRODUCTION

Despite its known adverse effects on human health, waterpipe smoking is increasing in popularity worldwide. However, compared to cigarettes, regulation of waterpipe product smoking lags behind and presents unique challenges. In search for regulatory options, this systematic review analyzes 36 studies on the differential effects on human health of the waterpipe characteristics including smoking products, heating sources, device components, and packages.

METHODS

A systematic review was performed according to PRISMA guidelines, revealing 443 unique citations. After screening, 36 studies were included in the results. Research articles were selected to inform on differential effects caused by product characteristics on adverse health effects, attractiveness, addictiveness and prevalence of waterpipe use.

RESULTS

Flavors are the key aspect that defines attractiveness of waterpipe product smoking. All waterpipe products, with or without nicotine, produce toxicants in similar quantities as cigarettes. Heating sources for waterpipe tobacco include charcoals and electrical heating. Both heating sources increase toxicant emissions in different ways. Hoses and mouth tips are device components that are often shared in waterpipe smoking. Sharing influences attractiveness by enriching the social experience. At the same time, it influences the transfer of infectious diseases by bacteria and viruses from one smoker to another. Studies showed that more generic and less attractive packages with health warnings are effective in reducing the attractiveness of waterpipe smoking.

CONCLUSIONS

Based on our findings, we advise to include all waterpipe products, tobacco and non-tobacco, with or without nicotine, in tobacco product regulations and smoking bans in order to: ban waterpipe molasses with characterizing flavors or ban the use of flavorings at any level; mandate dissemination of information on all waterpipe tobacco elements to the national regulator; prescribe testing to regulate contents of waterpipe smoking products and heating sources. Moreover, we advise to stimulate research on emissions of waterpipes.

Method validation for a multi-element panel in serum by inductively coupled plasma mass spectrometry (ICP-MS)

BACKGROUND

Laboratory testing for trace and toxic elements is important to diagnose metal toxicity and nutritional deficiency. There are several essential elements that are necessary for biological function and non-essential elements that can pose risk from exposure. Both essential and nonessential elements can be toxic if concentrations exceed a certain threshold.

METHODS

An aliquot of serum was diluted in a diluent solution, which contained iridium (Ir) as the internal standard, gold (Au), 0.05% Triton X-100, and 1% nitric acid (HNO3). The diluted specimen was aspirated into an inductively coupled plasma-mass spectrometer for quantitative elemental analysis of chromium (Cr), cobalt (Co), copper (Cu), manganese (Mn), nickel (Ni), selenium (Se) and zinc (Zn). The sample was introduced into the instrument spray chamber to form aerosol droplets, then atomized and ionized in argon plasma. The ions exited the plasma, passed through the interface of the instrument, then arrived at the entrance of the collision cell where helium gas was introduced to remove polyatomic interferences by kinetic energy discrimination (KED). After exiting the collision cell, the ions were filtered by a quadrupole mass spectrometer.

RESULTS

The analytical measurement range was determined specifically for each element. Imprecision was <20% CV for the lowest limit of quantification for each element and accuracy was within ±15%.

CONCLUSIONS

This method was validated for the quantification of seven elements in serum to assess nutritional deficiency and toxicity. The multi-element panel by ICP-MS met the validation criteria for biological monitoring of trace and toxic elements in patient specimens.