Waterpipe tobacco additives and their effect on human puffing behavior, toxicant exposures, pulmonary function, and appeal

摘要 自推出以来的30年里，加糖水管（WP）烟草或“ma'阿塞尔”现已被人们吸食 在美国，有超过50万的初中和高中生以及120万的年轻人，这可能是由于 甜味添加剂，占烟草重量的70%，使吸入可湿性粉剂烟草烟雾 对首次使用者来说更有吸引力和更容易。WP烟草的独特之处在于甜味添加剂与 尼古丁明显高于任何其他烟草产品，使WP成为完美的“入门产品”， 尼古丁引发。人们在很大程度上误解了用可湿性粉剂或水烟抽烟草是一种危害较小的吸烟形式。 烟草使用。事实上，高水平的甜味添加剂有效地转移尼古丁，并产生有害的， 烟雾中的潜在有害成分，导致用户遭受直接和间接伤害。 为了确定可湿性粉剂烟草的主要化学添加剂对甜味感、吸引力、 有毒物质暴露，成瘾，伤害和健康风险的看法，以及WP用户的肺功能，WP 必须使用仅在感兴趣的添加剂方面不同的烟草。没有一套商业上可用的 烟草品牌，这是真的，因此，我们的研究将操纵商业产品， 找出重要的变量。关于可湿性粉剂烟草的影响， 主要添加剂，所有这些都是甜味化合物，对成瘾性，毒性，风味感知， 可湿性粉剂吸烟的吸引力和感知危害。这项研究使用了一项交叉单盲人体试验， dyads，一种经过操纵的可湿性粉剂烟草产品，一种经过验证的双管研究级可湿性粉剂，尖端 社会心理学仪器和分析化学技术，以评估人类接触系统 研究甜味添加剂对可湿性粉剂卷烟的吸引力、膨化行为和毒性的影响。 目前还没有管理WP添加剂的法规。这项研究的目的是获得 健全的科学数据，为制定循证产品标准或食品添加剂限制提供信息， 可湿性粉剂烟草，不得超过，以便该产品在美国销售和分销。 拟议的研究将解决RFA-OD-19-028的科学兴趣领域：化学和工程， 毒性，行为和成瘾，因为它将确定特定的可湿性粉剂烟草添加剂如何影响用户 吸烟行为，喜好，伤害感知，吸入和吸收的有毒物质的数量，以及 急性肺部感染的可湿性粉剂烟草吸烟。

Abstract In the 30 years since its introduction, sweetened waterpipe (WP) tobacco, or “ma’assel”, is now smoked by over half a million middle and high school children and 1.2M young adults in the U.S. This may be due to the sweet additives that comprise up to 70% of the weight of the tobacco and make inhaling WP tobacco smoke more appealing and easier for first-time users. WP tobacco is unique in that the ratio of sweet additives to nicotine is significantly higher than for any other tobacco product, making WP the perfect “starter product” for nicotine initiation. It is largely misperceived that smoking tobacco with a WP or hookah is a less harmful form of tobacco use. In fact, the high levels of sweet additives transfer nicotine efficiently and produce harmful and potentially harmful constituents in the smoke, contributing to the direct and indirect harm experienced by users. To define the effects of WP tobacco’s primary chemical additives with respect to sweet perception, appeal, toxicant exposure, addictiveness, harm and health risk perceptions, and lung function among WP users, WP tobacco that differs only in the additives of interest must be used. There is no set of commercially available tobacco brands for which this is true, and thus our study will manipulate commercial products to properly isolate the important variables. There is an existing data gap surrounding the influence of WP tobacco’s primary additives, all of which are sweet tasting compounds, on the addictiveness, toxicity, flavor perceptions, appeal and perceived harm of WP smoking. The proposed study uses a crossover single-blind human trial of dyads, a manipulated WP tobacco product, a validated dual-hose research-grade WP, cutting edge psychosocial instruments and analytical chemistry techniques to assess human exposure to systematically investigate the effects of sweet additives on the appeal, puffing behavior, and toxicity of WP tobacco smoking. Currently there are no regulations governing WP additives. The purpose of the proposed study is to acquire sound scientific data to inform the development of evidenced-based product standards, or limits to additives in WP tobacco that must not be exceeded in order for the product to be sold and distributed in the U.S. The proposed study will address RFA-OD-19-028’s Scientific Interest Areas of: Chemistry and Engineering, Toxicity, and Behavior and Addiction, in that it will determine how specific WP tobacco additives affect users puffing behavior, liking, harm perceptions, the quantities of toxicants they inhale and take up in the body, and acute pulmonary affects from WP tobacco smoking.