RT Journal Article
SR Electronic
T1 Comparison of toxicant load from waterpipe and cigarette tobacco smoking among young adults in the USA
JF Tobacco Control
JO Tob Control
FD BMJ Publishing Group Ltd
SP 60
OP 66
DO 10.1136/tobaccocontrol-2017-054226
VO 28
IS 1
A1 Brian A Primack
A1 Ariel Shensa
A1 Jaime E Sidani
A1 Megan C Tulikangas
A1 Mark S Roberts
A1 Jason B Colditz
A1 Maria K Mor
A1 A Everette James
A1 Michael J Fine
YR 2019
UL http://tobaccocontrol.bmj.com/content/28/1/60.abstract
AB Objectives To form population-level comparisons of total smoke volume, tar, carbon monoxide and nicotine consumed from waterpipe tobacco smoking (WTS) and cigarette smoking using data from a nationally representative sample of smokers and non-smokers aged 18–30 years.Methods In March and April 2013, we surveyed a nationally representative sample of 3254 US young adults to assess the frequency and volume of WTS and cigarette smoking. We used Monte Carlo analyses with 5000 repetitions to estimate the proportions of toxicants originating from WTS and cigarette smoking. Analyses incorporated survey weights and used recent meta-analytic data to estimate toxicant exposures associated with WTS and cigarette smoking.Results Compared with the additive estimates of WTS and cigarette smoking combined, 54.9% (95% CI 37.5% to 72.2%) of smoke volume was attributed to WTS. The proportions of tar attributable to WTS was 20.8% (95% CI 6.5% to 35.2%), carbon monoxide 10.3% (95% CI 3.3% to 17.3%) and nicotine 2.4% (95% CI 0.9% to 3.8%).Conclusions WTS accounted for over half of the tobacco smoke volume consumed among young US adult waterpipe and cigarette smokers. Toxicant exposures to tar, carbon monoxide and nicotine were lower, but still substantial, for WTS alone compared with WTS and cigarette smoking. Public health and policy interventions to reduce harm from tobacco smoking in young US adults should explicitly address WTS toxicant exposures.