Impact of Flavors and Design Features on Patterns of Waterpipe Use and Toxicity in Pregnant Mothers

项目总结/摘要 本提案是对RFA-OD-15-005《关于WA的化学、毒理学和成瘾研究》的响应。 terpipe烟草（R 01），通过提出研究来解决研究目标#4，水管的影响 烟草特性对使用行为的影响，以及研究目标#3，水烟的影响 水烟烟气的毒性特征水烟使用是一种日益严重的公共健康问题 在美国的问题，严重的健康风险与吸烟相似。增加使用水- 生育年龄妇女的烟斗烟草问题尤其严重，因为国际研究强调， 不孕症、产科并发症、低出生体重和产后呼吸问题的风险增加， 怀孕期间使用一次性水管。然而，没有关于发病率和模式的公开数据。 美国孕妇使用水管烟草的初步数据来自我们正在进行的产前检查 队列研究显示，低收入孕妇使用水烟的比例很高，20%的人赞同 在围产期吸水烟。甜味调味的水烟（Maassel）和新颖的 设计特征促成了水烟筒吸烟的广泛使用。然而， 烟草使用模式和尼古丁和有毒物质的生物标志物， 怀孕母亲的情况不详。烟用香料和设计特征对水烟的影响 孕妇中的使用和生物标志物尤其重要，因为孕妇可能 和胎儿毒性以及增加暴露于尼古丁和燃烧产物。 这项拟议中的研究将是第一个调查口味和设计特征对使用模式的影响， 依赖性，以及孕妇水管使用者有毒物质暴露的生物标志物， 垂直设计怀孕的水烟使用者（N = 100）将完成关于（a）使用， 感知和偏好的水管风味和设计特征，以及（B）水管和杜模式， 在3个评估点（妊娠早期和妊娠晚期， 产后）。设计特点也将通过水管和水管的个人照片进行调查 烟草使用（例如，在整个怀孕期间， 产后将采集尿液、呼吸和唾液样本，以评估母体/胎儿的尼古丁暴露， 一氧化碳和最先进的挥发性有机化合物（VOC）标记物。我们建议的研究将 提供关键的科学数据的影响，水烟烟草口味和设计特点对帕特， 在弱势群体中使用。结果将为FDA提供关键数据，以告知开发人员- 以保护健康为目标的水管烟草装置和成分的产品标准的修订 妇女和儿童。

Project Summary/Abstract This proposal is responsive to RFA-OD-15-005, Chemistry, Toxicology, and Addiction Research on Wa- terpipe Tobacco (R01), by proposing research to address Research Objective #4, the impact of waterpipe tobacco characteristics on use behaviors, and Research Objective #3, impact of waterpipe tobacco characteristics on toxicity of waterpipe tobacco smoke. Waterpipe tobacco use is a growing public health problem in the U.S., with serious health risks similar to those found in cigarette smoking. Increased use of wa- terpipe tobacco in reproductive-age women is especially problematic as international studies highlight the in- creased risk of infertility, obstetrical complications, low birth weight, and respiratory problems following mater- nal waterpipe use during pregnancy. However, there are no published data regarding rates and patterns of use of waterpipe tobacco use in pregnant women in the U.S. Preliminary data from our ongoing prenatal cohorts reveal high rates of waterpipe tobacco use among low income pregnant women, with 20% endorsing waterpipe tobacco smoking in the perinatal period. Sweetened flavored waterpipe tobacco (maassel) and novel design features have contributed to the widespread use of waterpipe tobacco smoking. However, the impact of flavors and design features on patterns of waterpipe tobacco use and biomarkers of nicotine and toxicant ex- posure in pregnant mothers is unknown. The impact of flavors and design features on waterpipe tobacco use and biomarkers among pregnant women is especially important due to the potential for maternal and fetal toxicity from flavors as well as the increased exposure to nicotine and combustion products. The proposed study will be the first to investigate the impact of flavors and design features on patterns of use, dependence, and biomarkers of toxicant exposure in pregnant waterpipe users utilizing a prospective, longitu- dinal design. Pregnant waterpipe tobacco users (N = 100) will complete detailed interviews regarding (a) use, perceptions, and preferences for waterpipe flavors and design features, and (b) patterns of waterpipe and du- al/poly waterpipe tobacco use and dependence at 3 assessment points (1st and 3rd trimesters, 3-months post- partum). Design features will also be investigated through personal photographs of waterpipes and waterpipe tobacco use (e.g., owned waterpipes, waterpipe smoking in lounge/bar settings) throughout pregnancy and postpartum. Urine, breath, and saliva samples will be collected to assess maternal/fetal exposure to nicotine, carbon monoxide, and state-of-the-art markers of volatile organic compounds (VOCs). Our proposed study will provide critical scientific data on the impact of waterpipe tobacco flavors and design features on pat- terns of use in vulnerable populations. Results will provide critical data to the FDA to inform the develop- ment of product standards for waterpipe tobacco devices and constituents with the goal of protecting the health of women and children.