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Cancer Epidemiology, Biomarkers & Prevention
Cancer Epidemiology, Biomarkers & Prevention
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Comparison of Nicotine and Carcinogen Exposure with Water Pipe and Cigarette Smoking

Peyton Jacob III, Ahmad H. Abu Raddaha, Delia Dempsey, Christopher Havel, Margaret Peng, Lisa Yu and Neal L. Benowitz
Peyton Jacob III
1Division of Clinical Pharmacology and Experimental Therapeutics, Medical Service, San Francisco General Hospital Medical Center, the Departments of Medicine and Bioengineering & Therapeutic Sciences and 2Department of Physiological Nursing, School of Nursing, University of California, San Francisco
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Ahmad H. Abu Raddaha
1Division of Clinical Pharmacology and Experimental Therapeutics, Medical Service, San Francisco General Hospital Medical Center, the Departments of Medicine and Bioengineering & Therapeutic Sciences and 2Department of Physiological Nursing, School of Nursing, University of California, San Francisco
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Delia Dempsey
1Division of Clinical Pharmacology and Experimental Therapeutics, Medical Service, San Francisco General Hospital Medical Center, the Departments of Medicine and Bioengineering & Therapeutic Sciences and 2Department of Physiological Nursing, School of Nursing, University of California, San Francisco
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Christopher Havel
1Division of Clinical Pharmacology and Experimental Therapeutics, Medical Service, San Francisco General Hospital Medical Center, the Departments of Medicine and Bioengineering & Therapeutic Sciences and 2Department of Physiological Nursing, School of Nursing, University of California, San Francisco
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Margaret Peng
1Division of Clinical Pharmacology and Experimental Therapeutics, Medical Service, San Francisco General Hospital Medical Center, the Departments of Medicine and Bioengineering & Therapeutic Sciences and 2Department of Physiological Nursing, School of Nursing, University of California, San Francisco
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Lisa Yu
1Division of Clinical Pharmacology and Experimental Therapeutics, Medical Service, San Francisco General Hospital Medical Center, the Departments of Medicine and Bioengineering & Therapeutic Sciences and 2Department of Physiological Nursing, School of Nursing, University of California, San Francisco
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Neal L. Benowitz
1Division of Clinical Pharmacology and Experimental Therapeutics, Medical Service, San Francisco General Hospital Medical Center, the Departments of Medicine and Bioengineering & Therapeutic Sciences and 2Department of Physiological Nursing, School of Nursing, University of California, San Francisco
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DOI: 10.1158/1055-9965.EPI-12-1422 Published May 2013
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Abstract

Background: Smoking tobacco preparations in a water pipe (hookah) is widespread in many places of the world and is perceived by many as relatively safe. We investigated biomarkers of toxicant exposure with water pipe compared with cigarette smoking.

Methods: We conducted a crossover study to assess daily nicotine and carcinogen exposure with water pipe and cigarette smoking in 13 people who were experienced in using both products.

Results: When smoking an average of 3 water pipe sessions compared with smoking 11 cigarettes per day (cpd), water pipe use was associated with a significantly lower intake of nicotine, greater exposure to carbon monoxide (CO), and a different pattern of carcinogen exposure compared with cigarette smoking, with greater exposure to benzene, and high molecular weight polycyclic aromatic hydrocarbon (PAH), but less exposure to tobacco-specific nitrosamines, 1,3-butadiene, acrolein, acrylonitrile, propylene oxide, ethylene oxide, and low molecular weight PAHs.

Conclusions: A different pattern of carcinogen exposure might result in a different cancer risk profile between cigarette and water pipe smoking. Of particular concern is the risk of leukemia related to high levels of benzene exposure with water pipe use.

Impact: Smoking tobacco in water pipes has gained popularity in the United States and around the world. Many believe that water pipe smoking is not addictive and less harmful than cigarette smoking. We provide data on toxicant exposure that will help guide regulation and public education regarding water pipe health risk. Cancer Epidemiol Biomarkers Prev; 22(5); 765–72. ©2013 AACR.

Footnotes

  • Note: Supplementary data for this article are available at Cancer Epidemiology, Biomarkers & Prevention Online (http://cebp.aacrjournals.org/).

  • Received December 19, 2012.
  • Revision received January 30, 2013.
  • Accepted February 6, 2013.
  • ©2013 American Association for Cancer Research.
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Cancer Epidemiology Biomarkers & Prevention: 22 (5)
May 2013
Volume 22, Issue 5
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Comparison of Nicotine and Carcinogen Exposure with Water Pipe and Cigarette Smoking
Peyton Jacob III, Ahmad H. Abu Raddaha, Delia Dempsey, Christopher Havel, Margaret Peng, Lisa Yu and Neal L. Benowitz
Cancer Epidemiol Biomarkers Prev May 1 2013 (22) (5) 765-772; DOI: 10.1158/1055-9965.EPI-12-1422

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Comparison of Nicotine and Carcinogen Exposure with Water Pipe and Cigarette Smoking
Peyton Jacob III, Ahmad H. Abu Raddaha, Delia Dempsey, Christopher Havel, Margaret Peng, Lisa Yu and Neal L. Benowitz
Cancer Epidemiol Biomarkers Prev May 1 2013 (22) (5) 765-772; DOI: 10.1158/1055-9965.EPI-12-1422
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