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Comparison of Toxicant Load from Waterpipe and Cigarette Tobacco Smoking among Young Adults in the United States

Primack, BA and Shensa, A and Sidani, JE and Tulikangas, MC and Roberts, MS and Colditz, JB and Mor, MK and James, A. Everette (2018) Comparison of Toxicant Load from Waterpipe and Cigarette Tobacco Smoking among Young Adults in the United States. Tobacco Control. (In Press)

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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 18–30 year old smokers and non-smokers.

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 to 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 to 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.


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Item Type: Article
Status: In Press
CreatorsEmailPitt UsernameORCID
Primack, BAbprimack@pitt.eduBPRIMACK
Shensa, Aars146@pitt.eduARS146
Sidani, JEjes107@pitt.eduJES107
Colditz, JBjbc28@pitt.eduJBC28
Mor, MKmariamor@pitt.eduMARIAMOR
James, A.
Centers: Other Centers, Institutes, Offices, or Units > Center for Research on Media, Technology, and Health
Date: March 2018
Date Type: Acceptance
Journal or Publication Title: Tobacco Control
Schools and Programs: School of Medicine > Medicine
Refereed: Yes
Funders: National Cancer Institute
Article Type: Research Article
Date Deposited: 30 Apr 2018 13:40
Last Modified: 14 May 2018 05:15


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