Evaluation of the effects of PAKDAM, an invented water pipe shape device, to get Nitrous Oxide and Oxygen only instead of tobacco smoke - Tehran 2023

<bold>Background:</bold> Finding an alternative for water pipe smoking is challenging on tobacco control program worldwide. About a decade the device, which was called PAKDAM (means clean inspiration) was invented in Iran and has been used in some cafe to prepare Nitrous Oxide and Oxygen as a new instrument instead of water pipe with no tobacco. The goal of this study was to evaluate the effects of PAKDAM and investigating its short and midterm side effects in users. <bold>Methods:</bold> In a case-control study which was done early 2023, 152 individuals were selected and divided into two groups: 76 PAKDAM consumers (case) and 76 non- consumers (control). In terms of smoking status, both groups were divided into two groups of 36 smokers and 36 nonsmokers. Participants in this study have read and signed the participation form and filled out the questionnaire then their vital signs, O2 saturation, CO expiratory and respiratory tests were done. <bold>Findings:</bold> No significant difference was observed between case and control groups in demographic indicators. The subjects who used the device had a mean blood pressure of 123.7116.11, oxygen saturation of 97.21.9, exhaled carbon monoxide of 9.85.5, and an FVC / FEV1 ratio of 88.57.9. These figures in people who did not use the device were (137.7918.15) - (94.14.2) - (14.3  9.3) and (83.9  10.4), respectively. In addition to the effects on the respiratory system, consumers had lower heart rates and lower systolic and diastolic blood pressures. <bold>Conclusion:</bold> The blood oxygen level and FEV1 / FVC ratio were higher in people using PAKDAM and the amount of exhaled carbon monoxide and blood pressure were lower.