In a repeated measures design, 50 adult male and female exclusive WP smokers will smoke WP tobacco weekly over a 3-week study period with 3 WP smoking practices.

A total of 25 adult make and female nonsmokers will be recruited as a control.

Waterpipe Smoking

In a repeated measures design, 50 adult male and female exclusive WP tobacco smokers will smoke WP tobacco weekly over a 3-week study period with 3 WP smoking practices as follows: 1) using room temperature water in the WP jar, 2) adding ice cubes to the water in the WP jar, and 3) using a charcoal-free electronic WP head to heat the tobacco. Six Spot first morning urine samples will be provided by participants. Two urine samples per each of the 3 smoking sessions. Urine samples will be provided on the day of the WP tobacco smoking session and the following day. Physiological measures will be taken at Baseline during the office visit and before and after each of the 3 WP tobacco smoking sessions.

Waterpipe smoking

Center for Behavioral Epidemiology and Community Health

Assessing Toxicity of Waterpipe Tobacco Smoking

Assessing Toxicity of Waterpipe Tobacco Smoking in Laboratory and Naturalistic Settings

The investigators will assess change in urinary levels of cotinine in ng/ml and ng/mg creatinine, which is the metabolite of the addictive drug nicotine, post each of three waterpipe tobacco smoking sessions. For each of the three smoking sessions, smokers will provide two first morning spot urine samples, the day of the smoking session and the following morning. The three waterpipe tobacco smoking sessions are as follows: 1) using room temperature water in the waterpipe jar, 2) adding ice cubes to the water in the waterpipe jar, and 3) using a charcoal-free electronic waterpipe head to heat the tobacco instead of charcoal.

The investigators will assess change in urinary levels of NNAL in pg/ml and ng/mg creatinine, which is the metabolite of NNK, a tobacco specific pulmonary carcinogen, post each of three waterpipe tobacco smoking sessions. For each of the three smoking sessions, smokers will provide two first morning spot urine samples, the day of the smoking session and the following morning. The three waterpipe tobacco smoking sessions are as follows: 1) using room temperature water in the waterpipe jar, 2) adding ice cubes to the water in the waterpipe jar, and 3) using a charcoal-free electronic waterpipe head to heat the tobacco instead of charcoal.

The investigators will assess change in urinary levels of SPMA in pmol/ml and pmol/mg creatinine, which is the metabolite of benzene, the human hematotoxicant and leukemogen, post each of three waterpipe tobacco smoking sessions. For each of the three smoking sessions, smokers will provide two first morning spot urine samples, the day of the smoking session and the following morning. The three waterpipe tobacco smoking sessions are as follows: 1) using room temperature water in the waterpipe jar, 2) adding ice cubes to the water in the waterpipe jar, and 3) using a charcoal-free electronic waterpipe head to heat the tobacco instead of charcoal.

The investigators will assess change in urinary levels of 1-HOP in pmol/ml and pmol/mg creatinine, which is the metabolite of pyrene, a genotoxic carcinogen, post each of three waterpipe tobacco smoking sessions. For each of the three smoking sessions, smokers will provide two first morning spot urine samples, the day of the smoking session and the following morning. The three waterpipe tobacco smoking sessions are as follows: 1) using room temperature water in the waterpipe jar, 2) adding ice cubes to the water in the waterpipe jar, and 3) using a charcoal-free electronic waterpipe head to heat the tobacco instead of charcoal.

The investigators will determine the differential effects of 3 waterpipe smoking practices on carbon monoxide (CO) exposure. We will measure breath CO using a Micro+ Smokerlyzer® CO monitor for exhaled CO before and after each of the 3 WP smoking sessions as follows: 1) using room temperature water in the WP jar, 2) adding ice cubes to the water in the WP jar, and 3) using a charcoal-free electronic WP head to heat the tobacco.

The investigators will investigate the differential effects of WP smoking practices on pulmonary function tests and respiratory symptoms by measuring blood oxygen saturation (SO2), and conducting pulmonary functions (PF) testing using a portable spirometer/oximeter to determine the change in forced expiratory volume (FEV1), forced vital capacity (FVC), FEV1/FVC and Forced Expiratory Flow (FEF25-75%) post each of the 3 waterpipe tobacco smoking sessions as follows: 1) using room temperature water in the WP jar, 2) adding ice cubes to the water in the WP jar, and 3) using a charcoal-free electronic WP head to heat the tobacco.

The investigators will investigate the differential effects of WP smoking practices on the cardiovascular system by measuring the change in blood pressure in mm/Hg, heart rate in beats/minute, and respiratory rate in number of breaths/minute, after each of the 3 WP smoking sessions as follows: 1) using room temperature water in the WP jar, 2) adding ice cubes to the water in the WP jar, and 3) using a charcoal-free electronic WP head to heat the tobacco.

The investigators will assess change in urinary levels of Furan-BDA-NAL in pmol/ml and pmol/mg creatinine, which is the metabolite of furan, a liver toxicant and carcinogen, post the first waterpipe tobacco smoking session. Furan-BDA-NAL will be assessed in the provide two first morning spot urine samples, the day of the first smoking session and the day following the first smoking session.

Nada Kassem

San Diego State University

The investigators will employ a repeated measures design. A sample of 50 adult male and female exclusive WP smokers and a control sample of 25 male and female non-smokers will be recruited. Over a 3-week study, WP smokers will smoke one WP tobacco head during each of 3 separate WP smoking sessions with a 7-day washout period before each session. Session 1, WP smokers will smoke using 1 quick-light charcoal and room temperature water in the WP jar; Session 2, WP smokers will smoke using 1 quick-light charcoal but adding ice cubes to the water in the WP jar; Session 3, WP smokers will smoke WP tobacco without charcoal using an electric WP head and room temperature water. Physiological effects, carbon monoxide exposure and biomarkers of toxicants and carcinogens related to WP tobacco smoking practices will be compared.

The E-cigarette arm will be asked to use e-cigarettes in place of regular tobacco products. The group will be assessed at baseline, 2 weeks, 4 weeks, 6 weeks, 8 weeks, 13 weeks, and 26 weeks.

The Assessment only group will be asked to refrain from use of e-cigarettes during participation. The group will be assessed at baseline, 2 weeks, 4 weeks, 6 weeks, 8 weeks, 13 weeks, and 26 weeks.

Tobacco Dependence

Schizophrenia

Bipolar Disorder

Schizoaffective Disorder

The e-cigarette arm will be provided with 8 weeks of free e-cigarettes based on self-report of regular tobacco use. Participants assigned in this arm will be asked to switch combustible tobacco with e-cigarettes. The appeal of e-cigarettes and health impacts will be measured, but we are not targeting quitting combustible tobacco or reducing craving.

E-cigarette

Centerstone Kentucky

Vinfen Corp

The Appeal and Impact of E-cigarettes in Smokers With SMI

The Appeal and Impact of E-cigarettes in Smokers With Serious Mental Illness

Sarah Pratt

Scientist, Psych Research

Dartmouth-Hitchcock Medical Center

Vinfen Corporation

This is a study to learn about the appeal and health impacts of using e-cigarettes in people with serious mental illness who are not currently thinking about qutting smoking. Reduction of craving or quitting are not targets

All follow-up assessments will be conducted by the masked outcome assessor with the exception of the tobacco use and e-cigarette use self report and the satisfaction with e-cigarettes scale administered to the intervention group.

Enrolled participants using the e-cigarette.

Ecigarette Use

Sex: Female, Male

Race (NIH/OMB)

Region of Enrollment

Participants report of daily cigarette and e-cigarette use for the previous 7 days at each study time-point (baseline and 3, 6, 9, and 12 weeks post-baseline) will be averaged to create usual daily cigarette. Mixed-effects linear regression with a random effect at the participant level will be used to assess the association between usual cigarette use (dependent variable) and usually e-cigarette use (independent predictor) over the study period while accounting for the repeated measures within subject. The model will be fit using restricted maximum likelihood. Time will be included in the model as continuous and categorical, separately, and we assess for stability of the association between cigarette use and e-cigarette over time by including an interaction term between e-cigarette use and time in the model.

Change in Daily Cigarette Smoking Given 10 or More E-cigarette Sessions in a Day

Average number of e-cigarettes used per day over the 12 week period

Average Number of E-cigarettes Used Per Day

Overall Study

Dr James Sargent

Nicotine Dependence, Other Tobacco Product

Bladder Cancer

Lung Cancer

Cancer of Head and Neck

HALO manufactures e-cigarettes which will be distributed to patients. Two products, the G6 and tank model will be used.

HALO

Dartmouth Hitchcock Medical Center

Evaluation of Appeal and Impact of E-Cigarettes Among Chronic Smokers With Smoking-Related Cancers

James D. Sargent

Professor of Pediatric Oncology

Subjects will be classified as African American if they report themselves, biological parents and both sets of biological grandparents as African American or African descent.

Subjects will be classified as European American if they report themselves, biological parents and both sets of biological grandparents as European American or European descent.

Venous blood sample (approximately 40 ml) will be drawn from each study participant at the baseline visit. Approximately 33 ml will be used immediately for the study, and the remaining two 3-ml volumes will be reserved for future use. The various components of the blood including buffy coat (white blood cells), red blood cells, plasma, and serum will be separated immediately after their collection, labelled using a unique subject number, and stored in a -80C freezer. Urine samples and oral cells will be collected from study subjects at various time points. All these samples will be labelled using a unique subject number, and stored at a -80C freezer.

Tobacco Research Programs University of Minnesota

Metabolism of NNK Among African Americans

Mechanisms of Ethnic/Racial Differences in Lung Cancer Due to Cigarette Smoking: Project 5: Metabolism of NNK Among African Americans

We will recruit smokers to smoke specially prepared cigarettes containing [pyridine-D4]NNK, and measure deuterium-labeled NNK metabolites in the urine of these subjects. The rationale for the use of deuterium-labeled NNK is that we need to specifically identify NNK-derived metabolites, because these biomarkers are also formed as a result of nicotine metabolism. Our overall hypothesis is that the relative contribution of the biomarkers of NNK metabolic activation to the total amount of NNK metabolites will be higher in African Americans as compared to European Americans.

We will collect exfoliated oral mucosa cell samples from the recruited subjects. DNA isolated from these samples will be analyzed for [pyridine-D4]NNK-derived adducts. Our overall hypothesis in this Specific Aim is that African Americans will have in the DNA of their oral mucosa cells higher levels of NNK-derived DNA adducts as compared to European Americans.

We will investigate the relationship between the levels of NNK-derived DNA adducts measured in the oral mucosa cells and the rates of repair of these adducts in cultured lymphocytes from our subjects. Our overall hypothesis for this Specific Aim is that African Americans will have lower capacity to repair NNK-induced DNA damage as compared to European Americans, and this will correlate with higher levels of [pyridine-D4]NNK-derived buccal DNA adducts.

1 butanol/kanker

Assessing Toxicity of Waterpipe Tobacco Smoking

The Appeal and Impact of E-cigarettes in Smokers With SMI

Evaluation of Appeal and Impact of E-Cigarettes Among Chronic Smokers With Smoking-Related Cancers

Metabolism of NNK Among African Americans

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