Understanding tobacco flavor effects on waterpipe smokers’ experiences and exposures

了解烟草风味对水烟吸烟者的体验和暴露的影响 摘要： 水烟（WP）吸烟（又名水烟，水烟，narghile）正在迅速增加， 美国，尤其是年轻人。青少年可湿性粉剂吸烟的时间趋势 在美国，表明WP吸烟已成为吸烟的高， 2014年，学校首次举办。有证据表明，可湿性粉剂吸烟可导致 依赖，其他烟草使用，以及许多已知的吸烟相关疾病，包括 癌症、心血管疾病和不良妊娠结局。这些令人担忧的趋势导致 2014年，美国食品药品监督管理局（FDA）提议将WP纳入其监管范围。 授权，允许FDA应用基于证据的监管方法来控制WP传播 在美国.鉴于香料烟草在塑造“WP体验”方面的突出作用， 烟草香精代表了FDA遏制美国青少年使用WP的一种有希望的方法。 该项目旨在通过提供具体问题的答案来协助FDA开展这些工作 与通过风味调节WP的潜力有关。这些包括：-如何将风味 操作影响WP使用者在不同阶段的吸烟体验和满意度， 他们的吸烟轨迹-如何将吸烟非首选口味或无味WP烟草 反映了吸烟者对尼古丁的接触和依赖;以及-如何将口味操纵 影响膨化行为和暴露于有毒物质，如一氧化碳（CO）之间WP 吸烟者。这些问题的答案将有助于FDA预测风味法规对食品安全的影响。 WP实验和继续使用。在这项研究中，我们将使用临床实验室方法， 回答这些问题，我们将根据他们的使用情况招募两组WP吸烟者 频率：低频率（初学者）vs.高频率（有经验的）吸烟者（72/组;共144人;年龄 18-30）。每个参与者将经历3个不同口味的WP吸烟会议（首选口味; 非首选风味;无味），而WP的满意度，依赖性，危害 感知，以及暴露于尼古丁和有毒物质。WP的回应 吸烟者在其WP吸烟轨迹的不同阶段（初学者与有经验的人） 操纵，将使我们能够预测限制口味对广泛的WP吸烟者的影响。 该项目有望提供第一个证据，以指导FDA的潜力， 在美国对可湿性粉剂的吸收和使用进行管制。

Understanding tobacco flavor effects on waterpipe smokers' experiences and exposures Abstract: Waterpipe (WP) tobacco smoking (a.k.a. hookah, shisha, narghile) is increasing rapidly in the United States (US), particularly among young people. Time trends of WP smoking among youth in the US, show that WP smoking has become comparable to cigarette smoking among high- school students for the first time ever in 2014. Evidence suggests that WP smoking can lead to dependence, other tobacco use, and many of the known smoking-related diseases including cancer, cardiovascular disease and adverse pregnancy outcomes. These alarming trends led the Food and Drug Administration (FDA) in 2014 to propose including the WP under its regulatory authority, allowing the FDA to apply evidence-based regulatory approaches to control WP spread in the US. Given the salience of flavored tobacco in shaping the “WP experience”, regulating WP tobacco flavor represents a promising approach for the FDA to curb WP use among US youth. This project aims to assist the FDA in these efforts by providing answers to specific questions pertinent to the potential of WP regulation through flavor. These include: - How would flavor manipulation affect the smoking experience and satisfaction of WP users at different stages of their smoking trajectory - How would smoking non-preferred flavor or unflavored WP tobacco reflects on smokers' exposure to nicotine, and dependence; and - How would flavor manipulation influence puffing behavior and exposure to toxicants such as carbon monoxide (CO) among WP smokers. Answers to these questions will help the FDA predict the impact of flavor regulation on WP experimentation and continued use. In this study, we will use clinical laboratory methods to answer these questions, where we will recruit two groups of WP smokers based on their use frequency: low (Beginners) vs. high frequency (Experienced) smokers (72/group; total 144; age 18-30). Each participant will undergo 3 WP smoking sessions that differ by flavor (preferred flavor; non-preferred flavor; unflavored), while measurement of WP satisfaction, dependence, harm perception, and exposure to nicotine and toxicants will be conducted. The response of WP smokers at different stages of their WP smoking trajectory (Beginners vs. Experienced) to flavor manipulation, will allow us to predict the effect of limiting flavors on a wide range of WP smokers. This project promises to provide the first evidence to guide the FDA in terms of the potential of regulating WP flavored tobacco on WP uptake and use in the US.