The Impact of Waterpipe Tobacco Flavors on Waterpipe Smoking Intentions, Perceptions, Patterns, and Toxicant Exposure

摘要： 在美国，吸水烟斗的人数正在上升，并开始取代香烟，成为最受欢迎的吸烟方式 年轻人中的烟草使用情况。不幸的是，吸食水烟与许多相同的疾病有关。 消极的健康后果，如吸烟，如癌症、肺部疾病、呼吸道疾病和 心血管疾病。水烟吸引力的一个潜在原因是，它几乎是唯一的 用甜味剂和其他水果、糖果、可口和甜点调味品调味。家庭吸烟 预防和烟草控制法案，由于科学原因，禁止香烟中除薄荷外的香料 有证据表明，香料增加了年轻人的成长，并在成年人中保持了使用，目前还没有 适用于水烟。因此，水烟目前不受监管，有数百种 味道。为了有效地监管水烟，fda需要明确的科学证据来支持。 规章制度。到目前为止，还没有对水管的影响进行实验和系统的研究。 烟草味对烟斗的启动、吸烟行为、滥用倾向或由此导致的烟草暴露-- 相关毒物。拟议的研究将提供这一所需的科学证据。使用随机化的 交叉设计，60名当前水烟吸烟者(30名低依赖者，30名高依赖者)将完成三项 用三种不同口味的烟草平衡水烟吸烟期(首选口味- 加糖、无香料-甜味、无香料-非常低甜味)，在此之前12小时 烟草/尼古丁戒断。会议将由标准的48小时冲洗期和水管隔开 烟草尼古丁水平将在各时段保持不变。吸烟行为的衡量标准(烟尘地形) 除了自我报告外，还将收集急性毒物暴露(一氧化碳增加和血浆尼古丁) 滥用责任的措施，继续使用的意图，以及使用水管的香精的重要性。如果 调味品决心影响用户最初尝试自来水，增加他们继续使用的意愿 使用该产品，和/或使其更容易接受，更频繁地泡烟或更长/更深的泡芙，然后调味 将有助于启动和维持对水管的依赖。这项在ITS中的创新研究 系统地检测水管香精的影响，将为FDA和 其他机构需要为生产、分销和营销建立有效的监管战略 水烟的味道。

Abstract: Waterpipe smoking in the US is on the rise and beginning to overtake cigarettes as the most popular method of tobacco use among young adults. Unfortunately, waterpipe smoking is associated with many of the same negative health outcomes as cigarette use such as cancer, lung disease, respiratory illness, and cardiovascular disease. A potential reason for the appeal of waterpipe tobacco is that it is almost exclusively flavored with both sweeteners and additional fruit, candy, savory and dessert flavorings. The Family Smoking Prevention and Tobacco Control Act which banned flavors, except menthol, from cigarettes due to scientific evidence indicating that flavors increased youth initiation and maintained use among adults, does not currently apply to waterpipe tobacco. As a result, waterpipe tobacco is currently unregulated and comes in hundreds of flavors. In order to regulate waterpipe tobacco effectively, the FDA requires clear scientific evidence to support regulations. To date, no study has experimentally and systematically investigated the impact of waterpipe tobacco flavors on waterpipe initiation, smoking behaviors, abuse liability, or resultant exposure to tobacco- related toxicants. The proposed study will provide this needed scientific evidence. Using a randomized crossover-design, 60 current waterpipe smokers (30 low dependent, 30 high dependent) will complete three counterbalanced waterpipe smoking sessions with three differently flavored tobacco (preferred flavor- sweetened, unflavored-sweetened, unflavored-very low sweetened) that are preceded by 12 hours of tobacco/nicotine abstinence. Sessions will be separated by a standard 48-hour washout period, and waterpipe tobacco nicotine levels will be held constant across sessions. Measures of smoking behavior (puff topography) and acute toxicant exposure (CO boost and plasma nicotine) will be collected, in addition to self-report measures of abuse liability, intentions for continued use, and importance of flavors for using waterpipe. If flavorings are determined to influence users to initially try waterpipe, increase their willingness to continue to use the product, and/or make it more palatable to puff more frequently or take longer/deeper puffs, then flavors would be contributing to the initiation and maintenance of waterpipe dependence. This innovative study in its systematic examination of the impact of waterpipe flavors, will provide the scientific foundation the FDA and other agencies need to establish effective regulatory strategies for the manufacture, distribution, and marketing of waterpipe tobacco.