Young adult waterpipe smokers: Smoking behaviors and associated subjective and physiological effects

Addict Behav. 2014 Jun;39(6):1113-9. doi: 10.1016/j.addbeh.2014.03.010. Epub 2014 Mar 12.


Introduction: The purpose of this pilot study was to investigate smoking behaviors and subjective and physiological effects of nicotine on young adult occasional waterpipe smokers.

Methods: This study utilized a repeated-measures design that included one repeated factor for condition (nicotine and non-nicotine). For each participant, the sequencing of the repeated factor was assigned using random allocation. The two nicotine conditions were nicotine (0.75 g) and non-nicotine (0 g placebo) tobacco. Over the course of two weeks, twenty-two participants completed subjective (Acute Subjective Effects of Nicotine) and physiological (blood pressure, heart rate, and CO level) measures. Additional measures (QSU and MNWS-R) were used to assess for withdrawal symptoms.

Sample: The participants (n=22) were young adults (23 ± 3.1years); 71% smoked waterpipe once a month in the past year and 29% smoked waterpipe 1-2 times per week. In addition, 60% reported sharing their waterpipe with friends while smoking. None of the participants reported using any other forms of tobacco products.

Results: Under the nicotine condition, participants tended to smoke longer (i.e. smoking duration, p=0.004), take more puffs (p=0.03), take shorter puffs (p=0.03), and inhale less volume with each puff (p=0.02). The repeated measures analysis of the factor headrush revealed an effect of the nicotine condition (F=9.69, p<0.001, partial η(2)=0.31) and time (F=8.17, p=0.02, partial η(2)=0.30). Heart rate increased significantly across the nicotine condition (F=7.92, p=0.01, partial η(2)=0.31) and over time (F=12.64, p=0.01, partial η(2)=0.41).

Conclusions: This study demonstrates how differences between nicotine and non-nicotine waterpipe smoking are associated with changes in smoking behaviors, experiencing a headrush and an increase in heart rate.

Keywords: Headrush; Nicotine; Self-regulation; Waterpipe; Young.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Affect / drug effects
  • Blood Pressure / drug effects
  • Carbon Monoxide / analysis*
  • Dizziness / chemically induced
  • Dizziness / physiopathology*
  • Fatigue / chemically induced
  • Fatigue / physiopathology
  • Female
  • Follow-Up Studies
  • Heart Rate / drug effects
  • Hemodynamics / drug effects*
  • Humans
  • Male
  • Nicotine / pharmacology*
  • Personal Satisfaction
  • Pilot Projects
  • Smoking / physiopathology*
  • Social Behavior*
  • Substance Withdrawal Syndrome / physiopathology
  • Surveys and Questionnaires
  • Young Adult


  • Nicotine
  • Carbon Monoxide