Cobb Caroline O, Blank Melissa D, Morlett Alejandra, Shihadeh Alan, Jaroudi Ezzat, Karaoghlanian Nareg, Kilgalen Barbara, Austin Janet, Weaver Michael F, Eissenberg Thomas
Schroeder Institute for Tobacco Research and Policy Studies, Legacy, Washington, DC;
Department of Psychology, West Virginia University, Morgantown, WV;
Nicotine Tob Res. 2015 Jun;17(6):667-74. doi: 10.1093/ntr/ntu196. Epub 2014 Sep 25.
Clinical laboratory work among intermittent and daily waterpipe tobacco smokers has revealed significant risks for tobacco dependence and disease associated with waterpipe tobacco smoking (WTS). No studies have compared these groups directly. This study examined whether WTS frequency was associated with differential puff topography, toxicant exposure, and subjective response using a placebo-control design.
Eighty participants reporting WTS of 2-5 episodes (LOW; n = 63) or ≥20 episodes (HIGH; n = 17) per month for ≥6 months completed 2 double-blind, counterbalanced 2-hr sessions that were preceded by ≥12hr of tobacco abstinence. Sessions differed by product smoked ad libitum for 45+ min: preferred brand/flavor of waterpipe tobacco (active) or a flavor-matched tobacco-free waterpipe product (placebo). Outcomes included puff topography, plasma nicotine, carboxyhemoglobin (COHb), and subjective response.
HIGH users had more puffs, shorter inter-puff-intervals, and a higher total puff volume for placebo relative to active, as well as relative to LOW users during placebo. Plasma nicotine concentrations increased when smoking active (but not placebo) with no significant differences between groups at 25min post-product administration. COHb increased significantly during all conditions; the largest increase was for HIGH users when smoking placebo. There was some evidence of higher baseline scores for nicotine/tobacco nicotine abstinence symptomology.
Higher frequency waterpipe users may be more sensitive to the effects of waterpipe smoke nicotine content. Among HIGH users, higher baseline nicotine/tobacco abstinence symptoms may indicate greater nicotine dependence. These data support continued surveillance of WTS and development of dependence measures specific to this product.
针对间歇性和每日吸食水烟的吸烟者开展的临床实验室研究表明，吸食水烟存在烟草依赖及相关疾病的重大风险。尚无研究直接比较过这些群体。本研究采用安慰剂对照设计，考察了水烟吸食频率与不同的抽吸特征、毒物暴露及主观反应之间是否存在关联。
80名参与者报告称，他们每月吸食水烟2 - 5次（低频率组；n = 63）或≥20次（高频率组；n = 17），且持续≥6个月，他们完成了2次双盲、平衡的2小时试验，试验前需戒烟≥12小时。两次试验的区别在于，参与者可随意吸食产品45分钟以上：他们偏爱的水烟品牌/口味（活性产品）或口味匹配的无烟水烟产品（安慰剂）。观察指标包括抽吸特征、血浆尼古丁、碳氧血红蛋白（COHb）和主观反应。
高频率使用者在吸食安慰剂时，相对于活性产品，以及相对于低频率使用者在吸食安慰剂时，有更多的抽吸次数、更短的抽吸间隔时间和更高的总抽吸量。吸食活性产品（而非安慰剂）时，血浆尼古丁浓度升高，产品给药后25分钟时，各组之间无显著差异。在所有情况下，COHb均显著升高；高频率使用者在吸食安慰剂时升高幅度最大。有证据表明，尼古丁/烟草尼古丁戒断症状的基线分数较高。
较高频率的水烟使用者可能对水烟烟雾中的尼古丁含量影响更为敏感。在高频率使用者中，较高的基线尼古丁/烟草戒断症状可能表明其尼古丁依赖程度更高。这些数据支持对水烟吸食持续进行监测，并制定针对该产品的依赖测量方法。
