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The Effects of Electronic Hookah on Endothelial Cell Function: The Role of Nicotine

Institution: University of California, Los Angeles
Investigator(s): Mary Rezk-Hanna,
Award Cycle: 2019 (Cycle 30) Grant #: T30IP1013 Award: $498,419
Subject Area: Cardiovascular and Cerebrovascular Disease
Award Type: High Impact Pilot Award

Initial Award Abstract
Electronic nicotine delivery systems (ENDS) are growing quickly in the United States and around the world. Recently, electronic (e-) hookahs are becoming more popular, particularly among young females, who belief that these products are safer than traditional flavored hookah tobacco smoking. Unlike other ENDS such as e-cigarettes, e-hookah bowls are used through traditional water-pipes, allowing the smoke-containing nicotine, propylene glycol, glycerin, and flavorings-to pass through a water-filled base, possibly modifying the smoke, before it is inhaled through the user's mouth. Contributing to e-hookah bowls' popularity is the belief that e-hookah flavored smoke is filtered as it passes through the water, claiming e-hookah a safer tobacco alternative. However, an e-hookah bowl exposes the user to flavored nicotine by producing smoke containing a complex mixture of extremely small particles carrying toxins inside that could result in vascular toxicity. The goal of this grant proposal is to study the effects of e-hookah bowl inhalation on humans' blood vessel function and biological vascular markers; and underlying process by which e-hookah lead to damage to the protective functions of endothelial cells, which line the inside of blood vessels and the heart. In a cross-over study design, we will first study blood vessel function by ultrasound imaging measurements of the main artery of the upper arm and collect biological markers of oxidants and inflammation in 18 young healthy hookah smokers 21-39 years old, before and after two separate 30-minute e-hookah bowl inhalation sessions using one brand of nicotine-containing and nicotine-free e-hookah liquid and, for control comparison, before and after sham hookah smoking. Then, in freshly collected endothelial cells before and after the sessions we will study production of nitric oxide and markers of inflammation and oxidative stress. To compare exposures across sessions, we will measure levels of nicotine, and toxic chemicals: acrolein and benzene. Findings from this study will help provide important data on the effects of e-hookah inhalation on vascular health and underlying causes of how e-hookah exposure may impact vascular health. Our findings will provide important information to the FDA and policymakers to create stricter laws specific to hookah.