What is shisha pen

Shisha pens are cigarette-shaped pipes which vaporise flavoured liquids, providing a similar experience to regular cigarettes. Shisha pens appear to be much safer than their regular smoking counterparts. The way that shisha pens work is surprisingly simple. Instead, the pen heats the vaping liquid, turning it into a vapour when you inhale. Every shisha pen contains a battery and a heating element. The battery supplies energy to the heating element which, in turn, heats the liquid in the tube.

They work instead by heating to the point just where it can become an easily-inhaled gas. Most shisha pens have three main components: a battery, a chamber with the vape liquid, and the heating element. When you suck in through the shisha pen, you activate the battery which warms the heating element and heats a tiny pocket of liquid. The liquid then turns into a gas and flows through the mouth, providing the user with a pleasant and satisfying experience. Some people worry that the batteries on shisha pens will run out quickly because of the amount of energy that they have to supply.

Rarely, however, is that the case. Glycerol is widely used in many industrial and consumer products, e. The GRAS approval, however, does not apply to exposure to propylene glycol and glycerol through the shisha-pen. This is because in this scenario the substances are not ingested as in food, but inhaled, which results in exposure of the respiratory tract and lungs.

For propylene glycol, it is known that repeated, short-term exposure of eyes, skin, nose, and mouth may cause irritation [ 12 ]. The concentrations that reached the airways and lungs after using a shisha-pen were compared to data from published toxicity studies [ 13 - 15 ]. Studies were selected based on resemblance of the exposure scenario to that of shisha-pen use.

Differences between studies and the actual exposure to shisha-pen use, such as differences in duration of exposure and differences between animals and humans, were taken into account when only animal studies were available.

Hazard assessment of propylene glycol showed that there is no evidence that propylene glycol is carcinogenic to humans The Health Council of the Netherlands [ 16 ]. Effects such as nasal burning, stinging and throat irritation were attributed to exposure to propylene glycol as part of a pharmaceutical formulation inhaled by patients suffering from allergic rhinitis for 4 weeks. A few 4 out of 27 reacted with cough and slight airway obstruction [ 15 ].

Minor systemic effects were observed only in female rats which included body weight reduction and changes in leukocyte profile. For risk assessment of propylene glycol the maximum alveolar concentrations in after one puff was estimated to be to The estimated maximum alveolar concentration of propylene glycol in one puff exceeds this peak acceptable concentration. This analysis of the shisha-pen demonstrates that a risk of irritating effects on the respiratory tract epithelium due to propylene glycol exists.

Details on risk assessment of propylene glycol exposure assessment, PoD, and risk on local effects is presented in Risk assessment propylene glycol; 1-puff scenario section propylene glycol; 1-puff scenario. The MOE analysis is presented in Table 1.

For the exposure scenario, the same method as previously described [ 7 ] was utilized with a few adaptations. Puffing patterns puff frequency, strength and duration vary considerably among individuals who smoke electronic cigarettes or shisha-pens, but surveys indicate that individuals take an average of — puffs per day [ 8 , 9 ].

There is no data available on the duration of shisha-pen smoking sessions and therefore we can only assume that 1 puff has a volume of 50 mL as it is with cigarette smoke [ 5 ], or 70 mL as is found with e-cigarettes [ 6 ]. We must keep in mind that with the nicotine-free shisha-pen, the user will not adjust the volume to satisfy the nicotine craving, for this reason we used both volumes to obtain a range of exposure as an indication of the overall risk.

The average concentration per shisha-pen smoking session can be calculated by adapting the exposure scenario described previously for cigarette smoking [ 7 ] and dividing the amount in mg inhaled during a shisha-pen session D 1-puff shisha-pen by 0.

GC analysis showed that the smoke in the shisha pen was comprised of an average of 0. The estimated inhaled concentration of propylene glycol per puff was 0. One human study in which humans were exposed to an aerosol mist as part of an aviation emergency training was considered the best PoD for further risk assessment. Please refer to Table 1 for MOE calculation. The MOE for respiratory tract irritation was found to range from 0.

Considering the MOE, a risk of effects on the respiratory tract epithelium due to propylene glycol exists. Hazard assessment of glycerol showed no evidence for carcinogenic effects.

Due to lack of relevant human inhalation studies with glycerol, no MOE was calculated. Given the high inhaled concentration of glycerol in one puff, a risk of irritating effects on the respiratory tract epithelium due to glycerol exists with increased duration of shisha-pen exposure. Details on risk assessment of glycerol exposure assessment, PoD, and risk on local effects is presented in Risk assessment glycerol; 1-puff scenario section glycerol; 1-puff scenario.

Puffing patterns puff frequency, strength and duration vary considerably among individuals who smoke electronic cigarettes or shisha-pens, but surveys indicate that individuals take an average of — puffs per day [ 9 , 8 ]. There is no data available on the duration of shisha-pen smoking sessions and therefore we can only assume that 1 puff has a volume of 50 mL [ 5 ], or 70 mL [ 6 ]. The estimated inhaled concentration of glycerol per puff was 0.

Two studies with continuous exposure were found. It must be kept in mind that in the rat study, animals were exposed to glycerol for 6 h per day and that these data were compared with 1 puff of a shisha-pen.

Because a relevant study with a similar exposure pattern as that of a shisha-pen could not be found, a reliable MOE could not be calculated. Given the high inhaled concentration of glycerol in one puff, a risk of irritating effects on the respiratory tract epithelium due to glycerol exists with increased duration of exposure. For the risk assessments performed for propylene glycol and glycerol present in the vapor of the shisha-pen, it is recognised that several assumptions have been made and that the risk assessment can be refined reconsidering these assumptions.

Although such a refinement is beyond the scope of the present analysis, considering the low MOE, it remains to be seen if further refinement will alter the conclusion. The current study is the first to present a chemical analysis and subsequent assessment of the risks of inhaling nicotine-free shisha-pen vapor, focusing on the major components propylene glycol and glycerol.

For propylene glycol risk assessment could rely on a relevant human study, allowing for MOE analysis. Also, for glycerol animal data were available allowing for estimation of risks upon exposure. Some limitations include the lack of information on shisha-pen use; we can only assume that topography including puff volume is within the range of that of cigarettes and e-cigarettes. Furthermore, there were no human propylene glycol and animal propylene glycol, glycerol studies that mimicked the exposure scenario of shisha-pen smoking.

Other factors to be taken into account when performing risk assessment include less-than-lifetime exposure, interspecies extrapolation rat to humans , and inter-individual variability. Moreover, the current chemical risk assessment approach presents a single-component analysis and the combined effects of propylene glycol and glycerol need further investigation. In conclusion, upon use of a shisha-pen, consumers inhale propylene glycol and glycerol, resulting in exposure of the respiratory tract and alveolar space.

This study shows that already after one puff of the shisha-pen the inhaled concentration is sufficiently high to potentially cause irritation of the airways. New products such as the nicotine-free shisha-pen and their potential popularity among elementary school children as was reported in the Netherlands, stress the need for detection of these products and assessment of their risks to inform regulatory actions aimed at limiting potential harm that may be caused to consumers and protecting young people to take up smoking.

In addition, little information is known in regards to how young people use the shisha-pen puffs per session, sessions per day, duration of use. Further research is needed to investigate how consumers, including young people use the shisha pen puffs per session, sessions per day, duration of use.

More information to fill these data gaps is needed to better assess the long-term risks of smoking shisha-pens. Competing interests. ASK participated in the design of the study and drafted the manuscript. LGS-H performed the risk assessment analysis and drafted the risk assessment methodology of the manuscript. PMJB performed the risk assessment analysis and helped to draft the manuscript. JWJMC performed and drafted the analytical chemistry analysis.

WNK performed the analytical chemistry analysis and helped to draft the manuscript. RT conceived of the study, and participated in its design and coordination and helped to draft the manuscript. All authors read and approved the final manuscript.

Anne S Kienhuis, Email: ln. MVIR siuhneiK. Lya G Soeteman-Hernandez, Email: ln. They are easily carried in a pocket or purse. You can browse for different shisha products on our easy-to-use website. This includes components such as shisha pipes , hoses , flavours and handy accessories like mouth tips.

Save my name, email, and website in this browser for the next time I comment. This site uses Akismet to reduce spam. Learn how your comment data is processed. Here are eight great benefits of the shisha pen… 1. No nicotine Another downside to smoking tobacco is nicotine.