Wagener Theodore L, Leavens Eleanor L S, Mehta Toral, Hale Jessica, Shihadeh Alan, Eissenberg Thomas, Halquist Matthew, Brinkman Marielle C, Johnson Amanda L, Floyd Evan L, Ding Kai, El Hage Rachel, Salman Rola
Department of Internal Medicine, Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, United States.
Tob Control. 2020 May 13. doi: 10.1136/tobaccocontrol-2019-055509.
The present study examined how the lack of characterising flavours and low levels of humectants may affect users' waterpipe tobacco (WT) smoking topography, subjective effects, toxicant exposure and intentions for continued use.
89 WT smokers completed four ad libitum smoking sessions (characterising flavor/high humectant (+F+H); characterising flavor/low humectant (+F-H); no characterising flavor/high humectant (-F+H); no characterising flavor/low humectant (-F-H)) in a randomised cross-over design. WT was commercially available; same brand but nicotine levels were not held constant. A subsample (n=50) completed a standardised, 10-puff session preceding ad libitum smoking. Participants completed questionnaires, exhaled carbon monoxide (eCO) testing and provided blood samples for plasma nicotine. Smoking topography was measured throughout the session. Post hoc analyses showed that -F+H and -F-H did not differ significantly in humectant levels. Therefore, these groups were collapsed in analyses (-F-H).
WT smokers reported significantly greater satisfaction, liking, enjoyment and greater intentions for continued use when smoking +F+H compared with other WT products, with -F-H receiving the lowest ratings. Significant differences in topography were observed during standardised and ad libitum sessions, with the -F-H preparation leading to greater total inhaled volume and eCO boost, but lower nicotine boost compared with +F+H (all p<0.05).
The findings demonstrate the importance of flavours and humectants on improving WT smoking experience and increasing the likelihood that users will want to initiate and continue smoking. Moreover, it demonstrates that flavours and humectants influence smoking behaviour and toxicant exposure in some unexpected ways that are important for regulatory efforts.
本研究探讨了特征风味的缺失和保湿剂含量低如何影响水烟吸食者的水烟吸食行为、主观感受、接触毒物情况以及继续使用的意愿。
89名水烟吸食者采用随机交叉设计完成了四次自由吸食环节（特征风味/高保湿剂含量（+F+H）；特征风味/低保湿剂含量（+F-H）；无特征风味/高保湿剂含量（-F+H）；无特征风味/低保湿剂含量（-F-H））。水烟为市售产品；同一品牌但尼古丁含量未保持恒定。一个子样本（n=50）在自由吸食前完成了一次标准化的10口吸食环节。参与者完成问卷调查、呼出一氧化碳（eCO）测试并提供血样以检测血浆尼古丁含量。在整个环节中测量吸食行为。事后分析表明，-F+H和-F-H在保湿剂含量上无显著差异。因此，在分析中将这两组合并（-F-H）。
与其他水烟产品相比，水烟吸食者在吸食+F+H时报告的满意度、喜爱度、享受度以及继续使用的意愿显著更高，-F-H的评分最低。在标准化和自由吸食环节中观察到了吸食行为的显著差异，与+F+H相比，-F-H制剂导致总吸入量和eCO升高幅度更大，但尼古丁升高幅度更低（所有p<0.05）。
研究结果表明风味和保湿剂对于改善水烟吸食体验以及增加使用者开始并继续吸烟的可能性具有重要意义。此外，研究表明风味和保湿剂以一些意想不到的方式影响吸烟行为和毒物接触，这对于监管工作很重要。
