ArticleTobacco control2019
Toxicant inhalation among singleton waterpipe tobacco users in natural settings.
Article in Tobacco control, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Concurrent Alcohol Use and Waterpipe Tobacco Smoking: Smoking Topography, Toxicant Exposure, and Abuse Liability.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2020Trial
- Pathological findings of respiratory and reproductive organs in male rats exposed to tobacco and electronic cigarette smoke.Open veterinary journal · 2026Article
- Prevalence and associated factors of shisha smoking among students in Senegal: Global Youth Tobacco Survey 2020.Tobacco induced diseases · 2024Article
- Genotoxicity of waterpipe smoking in young adults from Sarajevo, Bosnia & Herzegovina.Heliyon · 2023Article
- Article
- Waterpipe smoking: Results from a population-based study in Qatar.Tobacco induced diseases · 2022Article
- Hookah Smoke Mediates Cancer-Associated Epigenomic and Transcriptomic Signatures in Human Respiratory Epithelial Cells.JTO clinical and research reports · 2021Article
- Waterpipe Tobacco Smoke Exposure during Lactation-Susceptibility of Reproductive Hormones and Oxidative Stress Parameters in Male Progeny Rats.Reproductive sciences (Thousand Oaks, Calif.) · 2021Article
- Changes at global and site-specific DNA methylation ofInhalation toxicology · 2020Article
- The effect of genetic variations in the choline acetyltransferase gene (ChAT) on waterpipe tobacco smoking dependence.Tobacco induced diseases · 2020Article
- A Proposed Waterpipe Emissions Topography Protocol Reflecting Natural Environment User Behaviour.International journal of environmental research and public health · 2019Article
- Chemical Characterization of Nanoparticles and Volatiles Present in Mainstream Hookah Smoke.Aerosol science and technology : the journal of the American Association for Aerosol Research · 2019Article
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
backgroundStudies that assess waterpipe tobacco smoking behaviour and toxicant exposure generally use controlled laboratory environments with small samples that may not fully capture real-world variability in human behaviour and waterpipe products. This study aimed to conduct real-time sampling of waterpipe tobacco use in natural environments using an in situ device.
methodsWe used the REALTIME sampling instrument: a validated, portable, self-powered device designed to sample automatically a fixed percentage of the aerosol flowing through the waterpipe mouthpiece during every puff. We recruited participants at café and home settings in Jordan and measured puffing behaviour in addition to inhalation exposure of total particulate matter (TPM), carbon monoxide (CO), nicotine, polycyclic aromatic hydrocarbons and volatile aldehydes. We correlated total inhaled volume with five selected toxicants and calculated the regression line of this relationship.
resultsAveraged across 79 singleton sessions (52% male, mean age 27.0, 95% home sessions), sessions lasted 46.9 min and participants drew 290 puffs and inhaled 214 L per session. Mean quantities of inhaled toxicants per session were 1910 mg TPM, 259 mg CO, 5.0 mg nicotine, 117 ng benzo[a]pyrene and 198 ng formaldehyde. We found positive correlations between total inhaled volume and TPM (r=0.472; p<0.001), CO (r=0.751; p<0.001), nicotine (r=0.301, p=0.035) and formaldehyde (r=0.526; p<0.001), but a non-significant correlation for benzo[a]pyrene (r=0.289; p=0.056).
conclusionsIn the natural environment, waterpipe tobacco users inhale large quantities of toxicants that induce tobacco-related disease, including cancer. Toxicant content per waterpipe session is at least equal, but for many toxicants several magnitudes of order higher, than that of a cigarette. Health warnings based on early controlled laboratory studies were well founded; if anything our findings suggest a greater exposure risk.
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