TY - JOUR T1 - Impact of flavors and humectants on waterpipe tobacco smoking topography, subjective effects, toxicant exposure and intentions for continued use JF - Tobacco Control JO - Tob Control SP - 366 LP - 372 DO - 10.1136/tobaccocontrol-2019-055509 VL - 30 IS - 4 AU - Theodore L Wagener AU - Eleanor L S Leavens AU - Toral Mehta AU - Jessica Hale AU - Alan Shihadeh AU - Thomas Eissenberg AU - Matthew Halquist AU - Marielle C Brinkman AU - Amanda L Johnson AU - Evan L Floyd AU - Kai Ding AU - Rachel El Hage AU - Rola Salman Y1 - 2021/07/01 UR - http://tobaccocontrol.bmj.com/content/30/4/366.abstract N2 - Introduction The present study examined how the lack of characterising flavours and low levels of humectants may affect users’ waterpipe tobacco (WT) smoking topography, subjective effects, toxicant exposure and intentions for continued use.Methods 89 WT smokers completed four ad libitum smoking sessions (characterising flavor/high humectant (+F+H); characterising flavor/low humectant (+F-H); no characterising flavor/high humectant (-F+H); no characterising flavor/low humectant (-F-H)) in a randomised cross-over design. WT was commercially available; same brand but nicotine levels were not held constant. A subsample (n=50) completed a standardised, 10-puff session preceding ad libitum smoking. Participants completed questionnaires, exhaled carbon monoxide (eCO) testing and provided blood samples for plasma nicotine. Smoking topography was measured throughout the session. Post hoc analyses showed that -F+H and -F-H did not differ significantly in humectant levels. Therefore, these groups were collapsed in analyses (-F-H).Results WT smokers reported significantly greater satisfaction, liking, enjoyment and greater intentions for continued use when smoking +F+H compared with other WT products, with -F-H receiving the lowest ratings. Significant differences in topography were observed during standardised and ad libitum sessions, with the -F-H preparation leading to greater total inhaled volume and eCO boost, but lower nicotine boost compared with +F+H (all p<0.05).Discussion The findings demonstrate the importance of flavours and humectants on improving WT smoking experience and increasing the likelihood that users will want to initiate and continue smoking. Moreover, it demonstrates that flavours and humectants influence smoking behaviour and toxicant exposure in some unexpected ways that are important for regulatory efforts.No data are available. ER -