Tobacco use is widely regarded as the leading cause of preventable mortality around the world. While the health effects of cigarette smoke have been well-established, investigations into waterpipe smoke, which involves a charcoal-heated tobacco mixture, have only recently been reported in the literature. Waterpipe (hookah, shisha, goza, narghile, arghile, or hubble-bubble) use is rising globally, with marked increases among young adults in the United States. Benzene, an accepted cause of leukemia, is released upon combustion of the coal and tobacco mixture in the waterpipe. In this study, we recruited 105 waterpipe smokers and 103 nonsmokers from San Diego County, CA, USA who provided first-void urine samples the mornings before and after a 3-hour waterpipe-only smoking event. Subjects were divided into two groups; one group smoked waterpipe socially at a hookah lounge, and the other group smoked waterpipe socially in their home. Nonsmokers were present during the smoking event but did not actively smoke waterpipe, so they were exposed to secondhand waterpipe smoke. We quantified S-phenylmercapturic acid (SPMA), a urinary biomarker of benzene exposure, by liquid chromatography-tandem mass spectrometry. Overall, the SPMA in smokers' urine increased significantly (P < 0.001) after a social waterpipe-only smoking session. There was a 2-fold increase in smokers at home (P < 0.01) and a 3-fold increase in smokers at hookah lounges (P < 0.001). Urinary SPMA did not change in nonsmokers at home, but nonsmokers at hookah lounges exhibited a 2-fold increase in SPMA excretion (P < 0.05), although absolute levels were lower than those in smokers. These data demonstrate that waterpipe smoke is an important source of exposure to benzene and likely poses a health risk for smokers. The data also suggest that nonsmokers in hookah lounges are exposed to toxicants in secondhand waterpipe smoke.

Monitoring benzene exposure from waterpipe smoke in smokers and nonsmokers

248th National Meeting (2014)

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