Acute effects of midwakh smoking on plasma nicotine levels and cardiopulmonary function

BACKGROUND: Midwakh smoking is the second most widely used form of smoking in the United Arab Emirates predominantly among adults. Despite high prevalence, there is a lack of scientific data on plasma nicotine after a single midwakh session and its effect on cardiopulmonary function. This study assessed the acute effects of midwakh smoking on plasma nicotine levels and cardiopulmonary function after a single session. METHODS: Among 211 midwakh smokers who visited the Sleep Disorders Specialized Clinic, 9 (nine) agreed to participate in the study. Blood samples were collected before and after smoking (5 min) to determine the nicotine and cotinine levels using mass spectroscopy. Anthropometric data, smoking details, physiological parameters, heart rate variability (HRV), spirometry, and forced oscillation technique were measured pre‑ and post‑smoking. RESULTS: The mean age of the participants was 35.2 (10.2) years, and they started midwakh smoking at 20.33 (8.5) years. Plasma nicotine levels significantly increased from 14.67 (9.73) to 28.18 (12.92) ng/ml from baseline to postsmoking (P = 0.004). Plasma cotinine levels significantly decreased from 303.06 (141.87) to 281.16 (119.37) ng/ml (P < 0.001). Significant changes were observed in all physiological parameters (P < 0.001) pre‑vs. postsmoking. HRV parameters including parasympathetic and sympathetic indices, showed pre‑ and post‑smoking (P < 0.001). There were also significant changes in FVC, FEV1, and FEF _(25‑75); P < 0.001, parameters pre‑ and postsmoking. CONCLUSION: This study involving a small sample demonstrates changes in blood nicotine and cotinine levels and differences in cardiopulmonary function among midwakh smokers; however, findings should be interpreted with caution due to limited generalizability.