Public Health Policy Evaluation Unit, Imperial College London, Hammersmith, UK.
Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA.
Tob Control. 2019 Mar;28(2):181-188. doi: 10.1136/tobaccocontrol-2017-054230. Epub 2018 May 28.
Studies that assess waterpipe tobacco smoking behaviour and toxicant exposure generally use controlled laboratory environments with small samples that may not fully capture real-world variability in human behaviour and waterpipe products. This study aimed to conduct real-time sampling of waterpipe tobacco use in natural environments using an in situ device.
We used the REALTIME sampling instrument: a validated, portable, self-powered device designed to sample automatically a fixed percentage of the aerosol flowing through the waterpipe mouthpiece during every puff. We recruited participants at café and home settings in Jordan and measured puffing behaviour in addition to inhalation exposure of total particulate matter (TPM), carbon monoxide (CO), nicotine, polycyclic aromatic hydrocarbons and volatile aldehydes. We correlated total inhaled volume with five selected toxicants and calculated the regression line of this relationship.
Averaged across 79 singleton sessions (52% male, mean age 27.0, 95% home sessions), sessions lasted 46.9 min and participants drew 290 puffs and inhaled 214 L per session. Mean quantities of inhaled toxicants per session were 1910 mg TPM, 259 mg CO, 5.0 mg nicotine, 117 ng benzo[a]pyrene and 198 ng formaldehyde. We found positive correlations between total inhaled volume and TPM (r=0.472; p<0.001), CO (r=0.751; p<0.001), nicotine (r=0.301, p=0.035) and formaldehyde (r=0.526; p<0.001), but a non-significant correlation for benzo[a]pyrene (r=0.289; p=0.056).
In the natural environment, waterpipe tobacco users inhale large quantities of toxicants that induce tobacco-related disease, including cancer. Toxicant content per waterpipe session is at least equal, but for many toxicants several magnitudes of order higher, than that of a cigarette. Health warnings based on early controlled laboratory studies were well founded; if anything our findings suggest a greater exposure risk.
评估水烟烟草使用行为和有毒物质暴露的研究通常使用控制实验室环境和小样本，这些可能无法充分捕捉人类行为和水烟产品的真实世界变异性。本研究旨在使用原位装置在自然环境中实时采样水烟烟草使用情况。
我们使用了 REALTIME 采样仪器：一种经过验证的、便携式、自供电的设备，旨在在每次吸烟时自动对通过水烟烟嘴的气溶胶的固定比例进行采样。我们在约旦的咖啡馆和家庭环境中招募参与者，并测量吸烟行为以及总颗粒物（TPM）、一氧化碳（CO）、尼古丁、多环芳烃和挥发性醛的吸入暴露量。我们将总吸入量与五种选定的有毒物质相关联，并计算出这种关系的回归线。
在 79 个单一会话（52%为男性，平均年龄 27.0 岁，95%为家庭会话）中，每个会话平均持续 46.9 分钟，参与者共抽吸 290 口，每次抽吸 214 升。每个会话吸入的有毒物质平均量为 1910mg TPM、259mg CO、5.0mg 尼古丁、117ng 苯并[a]芘和 198ng 甲醛。我们发现总吸入量与 TPM（r=0.472；p<0.001）、CO（r=0.751；p<0.001）、尼古丁（r=0.301，p=0.035）和甲醛（r=0.526；p<0.001）呈正相关，但与苯并[a]芘（r=0.289；p=0.056）呈非显著相关。
在自然环境中，水烟烟草使用者吸入大量有毒物质，这些物质会导致与烟草相关的疾病，包括癌症。每次水烟会话的有毒物质含量至少相等，但对于许多有毒物质，其含量要高出几个数量级。基于早期控制实验室研究的健康警告是有充分依据的；如果有什么不同的话，我们的发现表明存在更大的暴露风险。
