Puff count

Puff count is the number of self-reported inhalations taken during a smoking or vaping session, used in surveys (TLFB, DFAQ-CU, unit-preference grids) to estimate cannabis exposure. It is attractive because it accommodates variable joint/bowl sizes and shared use, but is notoriously variable: Azorlosa et al. (1995 J Pharmacol Exp Ther) demonstrated that delivered THC varies substantially with puff volume (mL), breath-hold duration, and device airflow; Prince, Conner & Pearson (2018 Psychol Addict Behav) found regular users are poor at estimating their own consumption by weight and by hits. Recent work operationalizes "grams-per-hit ratios" (GPHRs) customized by self-rated hit size (small/medium/large) to improve mg-THC estimation (Borodovsky et al. 2024). ⚠️ Poor reliability as a standalone exposure measure; researchers recommend combining puff count with potency (%THC) and device/product information. Citations: Azorlosa JL et al. J Pharmacol Exp Ther. 1995;272:560-569; Prince MA, Conner BT, Pearson MR. Psychol Addict Behav. 2018;32:426-433; Borodovsky JT et al. 2024 (PMC12406232).