Comparative analysis of waterpipe and cigarette suppression of abstinence and craving symptoms

This study's objective is to examine the relative effectiveness of cigarettes and waterpipe (WP) in reducing tobacco abstinence symptoms in dual cigarette/WP smokers. Sixty-one dual cigarette/WP smokers participated (mean age ± SD 22.0 ± 2.6 year; mean cigarettes/day 22.4 ± 10.1; mean WPs/week 5.2 ± 5.6). After 12-hour abstinence participants completed two smoking sessions (WP or cigarette), while they responded to subjective measures of withdrawal, craving, and nicotine effects administered before smoking and 5, 15, 30 and 45 min thereafter. For both tobacco use methods, scores on measures of withdrawal and craving were high at the beginning of session (i.e., before smoking) and were reduced significantly and comparably during smoking. Analysis of smoking and recovery (post-smoking) phases showed similarity in the way both tobacco use methods suppressed withdrawal and craving, but the recovery of some of these symptoms can be faster with cigarette use. This study is the first to show the ability of WP to suppress abstinence effects comparably to cigarettes, and its potential to thwart cigarette cessation.

Research Highlights
► Anecdotal evidence shows that cigarette quitters can replace it with waterpipe.
► Abstinence symptoms were studied pre-post smoking for cigarettes and waterpipe.
► Both methods can comparably suppress abstinence symptoms during the smoking phase.
► After smoking, withdrawal/craving recovered faster in the cigarette condition.
► Left unaddressed, waterpipe smoking can undermine smoking cessation programs.