Understanding tobacco flavor effects on waterpipe smokers’ experiences and exposures

了解烟味对水烟吸烟者体验和暴露的影响 摘要： 水烟斗(WP)吸烟(又名水烟、水烟、大麻)在中国迅速增长 在美国，特别是在年轻人中。青少年吸烟可湿性粉尘的时间趋势 在美国，研究表明，在高收入人群中，吸食可湿性粉剂已经可以与吸烟相媲美。 2014年，这是有史以来第一次出现在学校的学生。有证据表明，吸烟可湿性粉剂会导致 依赖、其他烟草使用，以及许多已知的与吸烟有关的疾病，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了 食品和药物管理局(FDA)在2014年提议将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的传播 在美国。鉴于加香烟草在塑造“可湿性粉剂体验”中的突出作用，规范可湿性粉剂 烟草香精代表了FDA遏制美国年轻人使用可湿性粉剂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进行这些努力 与通过风味调节可湿性粉剂的潜力有关。这些包括：-味道如何 操控对不同阶段可湿性粉剂使用者吸烟体验和满意度的影响 他们的吸烟轨迹-如何吸烟非首选香料或无香料可湿性粉剂烟草 反映吸烟者对尼古丁的暴露和依赖；以及-如何调味 可湿性粉尘对工人膨化行为和一氧化碳等有毒物质暴露的影响 吸烟者。这些问题的答案将有助于FDA预测香料监管对 可湿性粉剂试验和继续使用。在这项研究中，我们将使用临床实验室方法来 回答这些问题，我们将招募两组可湿性粉剂吸烟者基于他们的使用 吸烟频率：低吸烟者(初学者)与高吸烟者(有经验的吸烟者)(72人/组；总计144岁；年龄 18-30)。每个参与者将经历3次可湿性粉剂吸烟，不同的味道(首选味道； 非首选风味；无风味)，同时测量可湿性粉剂的满意度、依赖性、危害 将进行感知，以及接触尼古丁和毒物。可湿性粉剂的反应 处于可湿性粉剂吸烟轨迹不同阶段的吸烟者(初学者与有经验的吸烟者)到味道 操控，将使我们能够预测限制口味对广泛的可湿性粉剂吸烟者的影响。 这个项目承诺提供第一个证据来指导FDA在潜在的 调节美国可湿性粉料烟草对可湿性粉剂的吸收和使用。

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.