Sponsor
MLG received a research grant from Pfizer and served as a member of a scientific advisory board to Johnson&Johnson; all other authors declare no conflict of interest.
Published In
Toxicological Sciences : an Official Journal of the Society of Toxicology
Document Type
Article
Publication Date
7-22-2024
Subjects
Waterpipe tobacco -- toxicity
Abstract
Waterpipe tobacco (WPT) smoking is a public health concern, particularly among youth and young adults. The global spread of WPT use has surged since the introduction of pre-packaged flavored and sweetened WPT, which is widely marketed as a safer tobacco alternative. Besides flavorants and sugars, WPT additives include humectants, which enhance the moisture and sweetness of WPT, act as solvents for flavors, and impart smoothness to the smoke, thus increasing appeal to users. In the United States (U.S.), unlike cigarette tobacco flavoring (with the exception of menthol), there is no FDA product standard or policy in place prohibiting sales of flavored WPT. Research has shown that the numerous fruit, candy, and alcohol flavors added to WPT entice individuals to experience those flavors, putting them at an increased risk of exposure to WPT smoke-related toxicants. Additionally, burning charcoal briquettes-used as a heating source for WPT-contributes to the harmful health effects of WPT smoking. This review presents existing evidence on the potential toxicity resulting from humectants, sugars, and flavorants in WPT, and from the charcoal used to heat WPT. The review discusses relevant studies of inhalation toxicity in animal models and of biomarkers of exposure in humans. Current evidence suggests that more data are needed on toxicant emissions in WPT smoke to inform effective tobacco regulation to mitigate the adverse impact of WPT use on human health.
Rights
Copyright (c) 2024 The Authors
This work is licensed under a Creative Commons Attribution 4.0 International License.
Locate the Document
DOI
10.1093/toxsci/kfae095
Persistent Identifier
https://archives.pdx.edu/ds/psu/42366
Citation Details
Kassem, N. O. F., Strongin, R. M., Stroup, A. M., Brinkman, M. C., El-Hellani, A., Erythropel, H. C., Etemadi, A., Goniewicz, M. L., Hansen, E. G., Kassem, N. O., Li, D., Liles, S., Noël, A., Rezk-Hanna, M., Wang, Q., & Rahman, I. (2024). Toxicity of Waterpipe Tobacco Smoking: The Role of Flavors, Sweeteners, Humectants, and Charcoal. Toxicological Sciences.