Credit: Florida International University

Flavored tobacco is one of the major factors behind the popularity of waterpipe smoking in the United States and internationally, a recent FIU study found.

Researchers at Stempel College examined the impact of tobacco flavor manipulation on satisfaction, puffing behavior and toxicant exposure among and low-frequency users.

"We wanted to better understand how flavored tobacco—which is extremely popular among young waterpipe smokers—was really affecting waterpipe smoking at different stages of their use trajectory," said Wasim Maziak, principal investigator on the project and chair of the Epidemiology Department at Stempel College.

This cross-over study was conducted among 144 current waterpipe smokers, who reported waterpipe smoking less than once a week or at least once a week in the past 6 months. Participants attended two counterbalanced 45 -minute smoking sessions that differed by flavor, offering either their preferred flavored tobacco or unflavored tobacco. The researchers measured puff topography, expired , plasma nicotine and subjective measures to understand if the smoker found the experience more or less satisfying, depending on the tobacco used.

"We suspected, based on the popularity of flavored tobacco, that the flavors would enhance waterpipe users' experience, while the unflavored [tobacco flavored] variant would do the reverse," Maziak said.

Results of the study showed the both high-frequency and low-frequency waterpipe users reported an enhanced smoking experience and greater interest in future use after smoking the flavored compared with unflavored tobacco. High-frequency users, however, were more keen on the flavored in the future and had higher puffing parameters in general, compared with low-frequency users.

"Our results indicate that removing flavors will likely negatively affect waterpipe satisfaction and future use and thus limiting waterpipe flavors represents a promising regulatory strategy to curb waterpipe use among young people in the U.S.," Maziak concluded.

More information: Wasim Maziak et al. Effect of flavour manipulation on low and high-frequency waterpipe users' puff topography, toxicant exposures and subjective experiences, Tobacco Control (2019). DOI: 10.1136/tobaccocontrol-2019-055040

Journal information: Tobacco Control