The Effect of a 30-Min Water-Pipe Smoking Session on Cognitive Measures and Cardio-Pulmonary Parameters

Abstract

Introduction One session of water-pipe tobacco smoking (WPS) can increase carboxyhemoglobin (COHb) to levels comparable to those reported in carbon monoxide poisoning, which may cause memory impairment and confusion. Methods A prospective study evaluating healthy volunteers pre- and post-30 min of WPS session. Primary outcome parameters were executive cognitive measures [digit span test and Paced Auditory Serial Addition Test (PASAT)]. The effect of repeated cognitive testing 30 min apart without WPS was evaluated in age- and sex-matched healthy volunteers. Secondary outcome parameters included cardio-pulmonary, COHb, serum nicotine, and cytokine changes. Results Thirty-five subjects aged 25.6 ± 4.5 years smoked water-pipe for a 30-min session. Control group included 20 subjects aged 25.2 ± 5.1 years. Digit span test median score decreased after WPS (16 and 15, respectively, p = .003), insignificant decrease in controls. Median PASAT score increased after WPS (49 and 52, respectively, p = .009); however, a much larger significant increase was observed in controls (p ≤ .001). One WPS session resulted in significant increases in heart and respiratory rates and significant decrease in FEF25–75%. Post WPS, median COHb levels increased (from 2.2% to 10.7%, p < .0001) as did median serum nicotine levels (from 1.2 to 26.8 ng/mL, p < .0001). Serum cytokines levels: IL-2 and IL-6 increased (p < .0001 for each), and IL-10 and IL-5 decreased (p < .0001 and p = .04, respectively). Conclusions One session of WPS resulted in significant negative effects on cognitive executive measures, significant increases in COHb and serum nicotine levels, and significant changes in serum cytokines. Our findings call for increasing awareness towards the possible consequences of cognitive alterations following a 30-min session of WPS. Implications One 30-min session of water-pipe smoking resulted in negative effects on executive cognitive measures, increased carboxyhemoglobin and serum nicotine, and significant changes in serum cytokine levels. This study adds to the accumulating evidence on the harmful effects of water-pipe smoking, a growing epidemic, and calls for awareness of its possible consequences of acute cognitive alterations.

Acute and long-term effects of water pipe smoking on the respiratory system: A narrative review

“…[40] Hakim et al, in a prospective study of 45 volunteers who were subjected to 30-min session of water pipe smoking, also reported a significant increase in the respiratory rate postsmoking (from 14.36 to 16.68 breaths/ min; P = 0.001). [46] Similar effects have also been reported by Shaikh et al [47] and Toukan et al [48]…”

Waterpipe Use among Adolescents in Germany: Prevalence, Associated Consumer Characteristics, and Trends (German Health Interview and Examination Survey for Children and Adolescents, KiGGS)

“…Furthermore, the consumption of WP is associated with other harmful health effects similar to those associated with cigarette smoking [ 21 ]. In addition to the increased risk of carbon monoxide poisoning, which can result from combustion of the WP charcoal [ 22 ], smoking WP can cause acute to chronic impairment [ 23 ], negative impacts on executive brain function, or carcinogenic changes in various organs including the lungs and cardiovascular system [ 24 , 25 , 26 ]. Sharing a WP among different people can also increase the risk of transmission and infection with bacterial or viral diseases [ 27 ], which is particularly relevant during times of acute pandemic such as the present global novel coronavirus disease (COVID-19) pandemic.…”

Comparative Study on Pulmonary Toxicity in Mice Induced by Exposure to Unflavoured and Apple- and Strawberry-Flavoured Tobacco Waterpipe Smoke

“…To further clarify the mechanisms by which the plain and the flavoured WPS exert their pulmonary pathophysiological effects, two markers of inflammation, viz., IL-6 and TNFα, and three markers of oxidative stress, viz., total NO, catalase, and GSH, were measured. The proinflammatory cytokines IL-6 and TNFα have been reported to increase, following Oxidative Medicine and Cellular Longevity exposure to cigarette smoke and WPS, and to play a significant role in the acute smoke-induced inflammatory reaction in the lung, occasioning connective tissue damage which ultimately leads to emphysema [10,[23][24][25][26]. The present data show that the exposure to P-WPS did not increase the concentration of IL-6 in lung homogenates.…”