Comparison of Puff Topography, Toxicant Exposure, and Subjective Effects in Low- and High-Frequency Waterpipe Users: A Double-Blind, Placebo-Control Study

Cobb, Caroline O.; Blank, Melissa D.; Paredes, Alejandra Morlett; Shihadeh, Alan; Jaroudi, Ezzat; Karaoghlanian, Nareg; Kilgalen, Barbara; Austin, Janet; Weaver, Michael F.; Eissenberg, Thomas

doi:10.1093/ntr/ntu196

Cited by 25 publications

(16 citation statements)

References 52 publications

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“…Advantages of these methods are that they are time- and cost-efficient relative to longer-term studies, and can be predictive of the results of those studies (e.g., Breland et al, 2002; Fagerström et al, 2000, 2002; Hughes and Keely, 2004). The effects reported in these studies are also reliable, as has been demonstrated previously for a “heat, not burn” product (Buchhalter and Eissenberg, 2000; Buchhalter et al, 2001; Breland et al, 2002) and for tobacco smoking using a waterpipe (Blank et al, 2011; Cobb et al, 2015, 2011) and as highlighted by comparing the ECIG effects reported here with those that were reported elsewhere using an identical device/liquid combination (Lopez et al, 2016). That is, in this study and that reported by Lopez et al (2016), cigarette-smoking participants completed two, 10-puff (30 sec interpuff interval) use bouts with an ECIG composed of a 3.3 V battery attached to a 1.5 Ohm dual-coil heating element loaded with approximately 1 ml of a 18 mg/ml nicotine liquid made of approximately 70% propylene glycol and 30% vegetable glycerin.…”

Section: Discussionsupporting

confidence: 87%

“…A fourth implication of this work is that clinical laboratory methods such as those described here and also used to evaluate other novel tobacco products (Buchhalter et al, 2001; Breland et al, 2002; Cobb et al, 2015, 2010; Gray et al, 2008; Lopez et al, 2016) are valuable for revealing important features of these products, including toxicant delivery and physiological and subjective effect profile. Advantages of these methods are that they are time- and cost-efficient relative to longer-term studies, and can be predictive of the results of those studies (e.g., Breland et al, 2002; Fagerström et al, 2000, 2002; Hughes and Keely, 2004).…”

Section: Discussionmentioning

confidence: 98%

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Expanding clinical laboratory tobacco product evaluation methods to loose-leaf tobacco vaporizers

Lopez

Hiler

Maloney

et al. 2016

Drug and Alcohol Dependence

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Background Novel tobacco products entering the US market include electronic cigarettes (ECIGs) and products advertised to “heat, not burn” tobacco. There is a growing literature regarding the acute effects of ECIGs. Less is known about “heat, not burn” products. This study’s purpose was to expand existing clinical laboratory methods to examine, in cigarette smokers, the acute effects of a “heat, not burn” “loose-leaf tobacco vaporizer” (LLTV). Methods Plasma nicotine and breath carbon monoxide (CO) concentration and tobacco abstinence symptom severity were measured before and after two 10-puff (30-sec interpuff interval) product use bouts separated by 60 minutes. LLTV effects were compared to participants’ own brand (OB) cigarettes and an ECIG (3.3 V; 1.5 Ohm; 18 mg/ml nicotine). Results Relative to OB, LLTV increased plasma nicotine concentration to a lesser degree, did not increase CO, and appeared to not reduce abstinence symptoms as effectively. Relative to ECIG, LLTV nicotine and CO delivery and abstinence symptom suppression did not differ. Participants reported that both the LLTV and ECIG were significantly less satisfying than OB. Conclusions Results demonstrate that LLTVs are capable of delivering nicotine and suppressing tobacco abstinence symptoms partially; acute effects of these products can be evaluated using existing clinical laboratory methods. Results can inform tobacco product regulation and may be predictive of the extent that these products have the potential to benefit or harm overall public health.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 98%

Expanding clinical laboratory tobacco product evaluation methods to loose-leaf tobacco vaporizers

Lopez

Hiler

Maloney

et al. 2016

Drug and Alcohol Dependence

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“…The majority of participants in this study were regular WP smokers, but did not report high levels of dependence. Existing research suggests high and low frequency WP smokers differ in terms of their attitudes and beliefs about WP smoking47 as well as in their smoking patterns and behaviours 46. For this reason, the current study may not generalise to more frequent or nicotine dependent WP smokers.…”

Section: Discussionmentioning

confidence: 85%

Comparison of a preferred versus non-preferred waterpipe tobacco flavour: subjective experience, smoking behaviour and toxicant exposure

et al. 2017

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The current study is the first to examine flavours in WP smoking by measuring preferred versus control preparations to understand the impact on subjective experience, smoking behaviour and toxicant exposure. The pattern of results suggests that even this relatively minor manipulation resulted in significant changes in subjective experience. These results indicate a possible need for regulations restricting flavours in WP tobacco as with combustible cigarettes.

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“…However, one recent study compares the effects of a 12 h abstinence period in frequent (≥20 monthly episodes, n=17) and occasional (2–5 episodes monthly; n=63) users. 104 While the relatively small sample size in the frequent user group may have influenced study sensitivity adversely, elevated scores on several withdrawal-related measures were observed in the frequent users relative to the occasional users (eg, both factors of the modified Questionnaire of Smoking Urges). Interpreting these results is made challenging by the absence of an assessment of participant dependence using a validated scale (eg, the LWDS-11).…”

Section: Does the Literature On Wts Address Key Features Of Dependencmentioning

confidence: 99%

Waterpipe tobacco smoking: what is the evidence that it supports nicotine/tobacco dependence?

2014

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ObjectiveWaterpipe 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 sourcesPUBMED search using: ((“waterpipe” or “narghile” or “arghile” or “shisha” or “goza” or “narkeela” or “hookah” or “hubble bubble”)) AND (“dependence” or “addiction”).Study selectionExcluded 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 synthesisWTS 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.ConclusionsWTS 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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Comparison of Puff Topography, Toxicant Exposure, and Subjective Effects in Low- and High-Frequency Waterpipe Users: A Double-Blind, Placebo-Control Study

Cited by 25 publications

References 52 publications

Expanding clinical laboratory tobacco product evaluation methods to loose-leaf tobacco vaporizers

Expanding clinical laboratory tobacco product evaluation methods to loose-leaf tobacco vaporizers

Comparison of a preferred versus non-preferred waterpipe tobacco flavour: subjective experience, smoking behaviour and toxicant exposure

Waterpipe tobacco smoking: what is the evidence that it supports nicotine/tobacco dependence?

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