An assessment into the health and environmental impacts of smoking dokha and E-cigarettes in a Young United Arab Emirates (UAE) population

Dokha and electronic cigarettes are widely used by youth in the Middle East, yet research on their physiological and environmental impacts in the United Arab Emirates remains limited. This study examined these effects in 92 young adults, including 21 nonsmokers, 14 dokha users, and 57 electronic cigarette users. Physiological measures included heart rate, blood pressure, lung function, and cotinine, while environmental monitoring captured carbon monoxide, carboxyhemoglobin, and particulate matter across particle sizes from 0.5 to 10 micrometers before and after product use. Dokha users showed significant increases in carbon monoxide (3.9 ± 2.1 to 5.9 ± 2.2 parts per million) and carboxyhemoglobin (1.3% ± 0.3% to 1.6% ± 0.4%), compared to stable levels in nonsmokers. Electronic cigarette users recorded elevated cotinine (1503.7 ± 933.3 μg/L) and post-use increases in fine and coarse particulate matter that exceeded World Health Organization limits. Lung function, measured by the ratio of forced expiratory volume in one second to forced vital capacity, was reduced in dokha (0.5 ± 0.08) and electronic cigarette users (0.6 ± 0.06) compared to nonsmokers (1.1 ± 0.4), suggesting airway obstruction. Mean heart rate also rose in both user groups following consumption. These findings provide the first United Arab Emirates-specific evidence of physiological and environmental burdens of dokha and electronic cigarette use, underscoring the need for regulation and long-term health studies.