Comparison of Nicotine and Carcinogen Exposure with Water Pipe and Cigarette Smoking

Abstract

Background Smoking tobacco preparations in a water pipe (hookah) is widespread in many places of the world and is perceived by many as relatively safe. We investigated biomarkers of toxicant exposure with water pipe compared to cigarette smoking. Methods We conducted a cross-over study to assess daily nicotine and carcinogen exposure with water pipe and cigarette smoking in 13 people who were experienced in using both products. Results While smoking an average of 3 water pipe sessions compared to smoking 11 cigarettes per day, water pipe use was associated with a significantly lower intake of nicotine, greater exposure to carbon monoxide and a different pattern of carcinogen exposure compared to cigarette smoking, with greater exposure to benzene and high molecular weight PAHs, but less exposure to tobacco-specific nitrosamines, 1,3-butadiene and acrolein, acrylonitrile, propylene oxide, ethylene oxide, and low molecular weight PAHs. Conclusions A different pattern of carcinogen exposure might result in a different cancer risk profile between cigarette and water pipe smoking. Of particular concern is the risk of leukemia related to high levels of benzene exposure with water pipe use. Impact Smoking tobacco in water pipes has gained popularity in the United States and around the world. Many believe that water pipe smoking is not addictive and less harmful than cigarette smoking. We provide data on toxicant exposure that will help guide regulation and public education regarding water pipe health risk.

Exposure to Nicotine and Selected Toxicants in Cigarette Smokers Who Switched to Electronic Cigarettes: A Longitudinal Within-Subjects Observational Study

“…28 Urine concentrations of total NNAL were measured by LC-MS/ MS. 30 The following metabolites of volatile toxicants (derivates of mercapturic acid, MA) were determined using an LC-MS/MS method: 2-hydroxyethylmercapturic acid (HEMA), 2-hydroxy-3-buten-1-ylmercapturic acid and isomers (MHBMA), 3-hydroxy-1-methyl propylmercapturic acid (HPMMA), 3-hydroxypropylmercapturic acid (3HPMA), S-phenylmercapturic acid (SPMA), 2-carbamoylethylmercapturic acid (acrylamide mercapturic acid (AAMA), 2-cyanoethylmercapturic acid (CNEMA), and 2-hydroxypropylmercapturic acid (2HPMA). 31 The following metabolites of polycyclic aromatic hydrocarbons (PAHs) (free plus conjugated) were determined using LC-MS/MS: 2-naphthol, 1-hydroxyfluorene, 2-hydroxyfluorene, 3-hydroxyfluorene, 1-hydroxyphenanthrene, 2-hydroxyphenanthrene, 3+4-hydroxyphenanthrene (sum); and 1-hydroxypyrene. 32 Methods and analytical runs were validated using established procedures.…”

“…33,34 Lower limits of quantitation are provided in Supplementary Table 2, and the details on quality control measures for the various assays are listed elsewhere. [30][31][32]35 Urine creatinine was measured in the San Francisco General Hospital clinical laboratory using a standard colorimetric assay.…”

Children’s Exposure to Secondhand and Thirdhand Smoke Carcinogens and Toxicants in Homes of Hookah Smokers

“…Studies have identified carcinogens and toxicants such as polyaromatic hydrocarbons and volatile aldehydes in hookah tobacco smoke and biomarkers of these toxicants in the urine of hookah smokers (Al Rashidi, Shihadeh, & Saliba, 2008;Daher et al, 2010;Jacob et al, 2011Jacob et al, , 2013.…”

Tobacco smoking among nursing students in Saudi Arabia: A descriptive correlational study

“…Smoking cessation programs and anti-smoking campaigns should emphasize that recent evidence on the health hazards of first-, second-and third-hand tobacco smoking. [36][37][38][39][40][41] The findings showed that former smokers less agreed than never smokers to ban smoking in restaurants. The dependency on nicotine that was experienced by former smokers may have contributed to that lenient attitude toward enforcing smoking banning.…”