Does switching to a tobacco-free waterpipe product reduce toxicant intake? A crossover study comparing CO, NO, PAH, volatile aldehydes, “tar” and nicotine yields

• Published in: Food and chemical toxicology Vol. 50; no. 5; pp. 1494 - 1498
• Main Authors: Shihadeh, Alan, Salman, Rola, Jaroudi, Ezzat, Saliba, Najat, Sepetdjian, Elizabeth, Blank, Melissa D., Cobb, Caroline O., Eissenberg, Thomas
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.05.2012; Elsevier
• Subjects: Aldehydes - analysis; Aldehydes - toxicity; Biological and medical sciences; Carbon monoxide; Carbon Monoxide - analysis; Carbon Monoxide - toxicity; Chemical and industrial products toxicology. Toxic occupational diseases; Cross-Over Studies; Gas, fumes; Hookah; Humans; Medical sciences; Narghile; Nicotiana; Nicotine; Nicotine - analysis; Nitric Oxide - analysis; Nitric Oxide - toxicity; Polycyclic Compounds - analysis; Polycyclic Compounds - toxicity; Shisha; Smoke; Tobacco; Tobacco, tobacco smoking; Toxicology; Tobacco; Carbon monoxide; Shisha; Narghile; Hookah; Nicotine; Toxic gas; Tar; Toxicity; Biochemical compound; Aldehyde; Polycyclic aromatic compound; Crossover study; Volatiles; Persistent organic pollutant; Alkaloid; Yield; Comparative study; Waterpipe; Organic compounds
• ISSN: 0278-6915; 1873-6351
• DOI: 10.1016/j.fct.2012.02.041

► Smoke toxicant content was compared for tobacco and non-tobacco products. ► Smoke from both categories of products contained substantial quantities of toxicants. ► Tobacco-free products did not exhibit reduced PAH, volatile aldehydes, CO, NO, or “tar” yields. ► Only the tobacco-based products produced a nicotine-containing smoke. Waterpipe (hookah, narghile, shisha) use has become a global phenomenon, with numerous product variations. One variation is a class of products marketed as “tobacco-free” alternatives for the “health conscious user”. In this study toxicant yields from waterpipes smoked using conventional tobacco-based and tobacco-free preparations were compared. A human-mimic waterpipe smoking machine was used to replicate the puffing sequences of 31 human participants who completed two double-blind ad libitum smoking sessions in a controlled clinical setting: once with a tobacco-based product of their choosing and once with a flavor-matched tobacco-free product. Outcome measures included yields of carbon monoxide, nitric oxide, volatile aldehydes, nicotine, tar, and polycyclic aromatic hydrocarbons. Smoke from both waterpipe preparations contained substantial quantities of toxicants. Nicotine yield was the only outcome that differed significantly between preparations. These findings contradict advertising messages that “herbal” waterpipe products are a healthy alternative to tobacco products.