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Differential Effects of Hookah vs. Cigarette Smoking on Endothelial Function
Author(s) -
RezkHanna Mary,
Doering Lynn,
Robbins Wendie,
Mason O'Neil,
Choung Jennifer,
Benowitz Neal L,
Elashoff Robert M,
Sarna Linda,
Victor Ronald
Publication year - 2016
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.30.1_supplement.954.11
Subject(s) - medicine , smoke , brachial artery , nicotine , environmental health , physiology , endothelium , chemistry , organic chemistry , blood pressure
Hookah (water pipe) smoking is a major new understudied epidemic of tobacco abuse particularly affecting youth. Hookah's rapidly growing popularity is due to unregulated expansion of hookah cafes near college campuses and social media marketing to young adults as a safer avant‐garde alternative to cigarettes. Whereas multiple studies have shown that smoking even a single cigarette acutely impairs endothelial function, the acute effect of hookah smoking on endothelial function is unknown. Because burning charcoal briquettes are used to heat the hookah tobacco product, hookah smoke differs from cigarette smoke by delivering a large acute exposure to carbon monoxide and other charcoal combustion products including fine and ultrafine particles that have been suggested by the air pollution and tobacco literature to constitute putative endothelial toxins. To determine if hookah smoking acutely impairs endothelial function, in 21 healthy young adult hookah smokers who do not smoke cigarettes (age 25±1 years, mean±SE; 6 women, 15 men; body mass index, BMI 23.6±0.6 kg·m 2 ), we measured endothelium‐dependent flow‐mediated dilation (FMD) by brachial artery ultrasound before and immediately after 30 minutes of ad lib hookah smoking in a custom‐built smoking chamber. In contrast to what we had hypothesized, brachial artery FMD did not decrease with hookah smoking but, surprisingly, increased from 6.7±0.5% to 9.7±0.6%, P<0.001: a 53.1±9.5% relative increase. In contrast, in five cigarette smokers (matched with the hookah smokers by age, gender, and BMI), FMD decreased acutely by 28.7±3.4% (p=0.006) after smoking one cigarette, thus confirming previous reports. Shear rate (the stimulus to FMD) was unaffected by either form of smoking. Furthermore, the increases in systolic blood pressure (SBP) and heart rate (HR) were more than 50% smaller with hookah than with a cigarette (ΔSBP: +7±1 vs. +17±9 mmHg, p<0.05; ΔHR: +15±2 vs. 28±5 beats.min −1 , p<0.05) but the exhaled carbon monoxide level was almost 3‐fold greater after smoking hookah than after smoking a cigarette: 29±2 vs. 11±1 ppm, p<0.01). Thus, whereas brachial artery flow‐mediated dilation is acutely impaired by cigarette smoking, it is acutely augmented by hookah smoking. Further studies are indicated to determine if the high carbon monoxide exposure constitutes the major mechanism underpinning the augmented flow‐mediated dilation.