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

摘要： 在美国，水烟正在上升，并开始超过香烟，成为最受欢迎的吸烟方法。 年轻人吸烟。不幸的是，水烟是与许多相同的 吸烟对健康的负面影响，如癌症、肺病、呼吸道疾病，以及 心血管疾病水烟吸引人的一个潜在原因是它几乎完全是 用甜味剂和额外的水果、糖果、咸味和甜点调味料调味。家庭吸烟 该法案禁止香烟中除了薄荷醇以外的香料， 有证据表明，口味增加青年启蒙和维持使用的成年人，目前还没有 适用于水烟。因此，水烟目前不受管制， 口味.为了有效地监管水烟，FDA需要明确的科学证据来支持 规定到目前为止，还没有研究通过实验和系统地研究水管的影响， 烟草香料对水烟开始、吸烟行为、滥用倾向或由此导致的烟草暴露的影响- 相关毒物这项研究将提供所需的科学证据。采用随机 交叉设计，60个目前的水管吸烟者（30个低依赖，30个高依赖）将完成三个 用三种不同口味的烟草（优选的口味， 甜的、无香料的-甜的、无香料的-非常低的甜的），在此之前12小时， 烟草/尼古丁戒断。会议将由一个标准的48小时冲洗期，水管 烟草尼古丁水平将保持不变。吸烟行为的测量（抽吸地形图） 除了自我报告外，还将收集急性毒物暴露（CO升压和血浆尼古丁） 滥用责任的措施，继续使用的意图，以及使用水管的味道的重要性。如果 调味品决心影响用户最初尝试水管，增加他们继续 使用该产品，和/或使其更可口，更频繁地抽吸或更长/更深地抽吸，然后调味 将有助于启动和维持水管依赖。这项创新的研究在其 对水管味道影响的系统检查，将为FDA和 其他机构需要为生产、分销和营销制定有效的监管策略 水烟斗烟草

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.