Gholamreza Heydari - Tobacco Prevention and Control Research Center, National Research Institute of Tuberculosis and LungDiseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Atefeh Fakharian - Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and LungDiseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Maryam Sadat Mirenayat - Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and LungDiseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Mohsen Abedi - Physiotherapy Research Center, School of Rehabilitation Sciences, Shahid Beheshti University ofMedical Sciences, Tehran, Iran
Behzad Valizadeh - National Tobacco Control Secretariat, Ministry of Health and Medical Education, Tehran, Iran
Hamidreza Jamaati - Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and LungDiseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Background: The demand for Water pipe smoking is increasing, and even given theimplementation of tobacco control programs in many countries, this social and health problem stillexists. Therefore, it is very critical to find a solution that can be a healthy alternative behavior toreduce or eliminate hookah smoking. Many studies showed that the combination of Nitrous oxide(N۲O) and Oxygen (O۲) led to a reduction pain, greater respiration and euphoria. About a decadethe device, which was called PAKDAM (means clean inspiration) was invented in Iran and hasbeen used in some cafe to prepare N۲O and O۲ as a new instrument instead of water pipe. Thegoal of this study was to evaluate the effects of Pakdam and investigating its short and midtermside effects in users.Methods: In a case-control pilot study which was done between September ۲۰۲۱ and March ۲۰۲۲,۱۵۲ individuals were selected and divided into two groups: ۷۶ consumers (case) and ۷۶ nonconsumers(control). In terms of smoking status, both groups were divided into two groups of ۳۶smokers and ۳۶ nonsmokers. Participants in this study have read and signed the participation formand filled out the questionnaire then their vital signs, O۲ saturation, CO expiratory and spirometrytest were done.Results: No significant difference was observed between case and control groups in demographicindicators. The subjects who used the device had a mean blood pressure of ۱۲۳.۷۱±۱۶.۱۱, oxygensaturation of ۹۷.۲±۱.۹, exhaled carbon monoxide of ۹.۸±۵.۵, and an FVC / FEV۱ ratio of۸۸.۵±۷.۹. These figures in people who did not use the device were (۱۳۷.۷۹±۱۸.۱۵) - (۹۴.۱±۴.۲) -(۱۴.۳ ± ۹.۳) and (۸۳.۹ ± ۱۰.۴), respectively. In addition to the effects on the respiratory system,consumers had lower heart rates and lower systolic and diastolic blood pressures.Conclusion: The blood oxygen level and FEV۱ / FVC ratio were higher in people using Pakdamand the amount of exhaled carbon monoxide and blood pressure were lower. This condition wasmore common in smokers and less in non-smokers. It is possible to see the favorable effects ofusing Pakdam device on people especially in smokers.

Tobacco Control, Pakdam.