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

摘要 自引入以来的30年里，加糖水烟斗(WP)烟草，或称“ma‘assel”，现在由 在美国，超过50万初中生和高中生以及120万年轻人。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产生烟雾 对新用户来说更有吸引力，也更容易。WP烟草的独特之处在于，甜味添加剂与可湿性烟草的比例 尼古丁含量明显高于任何其他烟草产品，这使可湿性粉剂成为 尼古丁启蒙。人们在很大程度上错误地认为，吸食带有可湿性粉剂或水烟的烟草是一种危害较小的 烟草使用。事实上，高水平的甜味添加剂可以有效地转移尼古丁，并产生有害的 烟雾中的潜在有害成分，对使用者造成直接和间接伤害。 为了确定可湿性粉剂烟草的主要化学添加剂对甜味、吸引力、 可湿性粉剂使用者的毒物暴露、成瘾性、危害和健康风险认知以及肺功能 必须使用仅在感兴趣的添加剂方面不同的烟草。目前还没有一套商业上可用的 烟草品牌，因此我们的研究将操纵商业产品以适当地 分离出重要的变量。围绕可湿性粉剂烟草的影响存在一个现有的数据缺口 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危害性。拟议的研究使用了交叉单盲人体试验 DYADS，一种经过处理的可湿性粉剂烟草产品，经过验证的双软管研究级可湿性粉剂，尖端 有系统地评估人类接触辐射的心理社会仪器和分析化学技术 研究甜味添加剂对可湿性粉性烟草吸烟的吸引力、吸胀行为和毒性的影响。 目前还没有关于可湿性粉剂添加剂的规定。拟议研究的目的是获得 可靠的科学数据，为制定以证据为基础的产品标准或限制添加剂提供信息 可湿性粉剂烟草不得超过该产品才能在美国销售和分销。 拟议的研究将涉及RFA-OD-19-028‘S的科学兴趣领域：化学和工程， 毒性、行为和成瘾，因为它将决定特定的可湿性粉剂烟草添加剂如何影响使用者 吞云吐雾的行为、喜好、有害的感觉、他们吸入的毒物的数量和在体内的摄取量，以及 吸烟可湿性粉剂引起的急性肺部影响。

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.