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Karaca Y, Eryigit U, Aksut N, Turkmen S. Syncope associated with water pipe smoking. BMJ Case Rep 2013; 2013:bcr-2013-009526. [PMID: 23606397 DOI: 10.1136/bcr-2013-009526] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The water pipe (narghile) in particular is widely used in the Arabian Peninsula and the Turkish world, and has also recently become an increasingly popular way of consuming tobacco in Europe. Contrary to popular belief, it contains more tar, carbon monoxide (CO) and toxic gases than cigarettes. This report describes a patient presenting to the emergency department with syncope as a result of water pipe use, with tests revealing toxically high CO levels.
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Affiliation(s)
- Yunus Karaca
- Department of Emergency Medicine, Medicine Faculty, Karadeniz Technical University, Trabzon, Turkey.
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52
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Abughosh S, Wu IH, Hawari F, Peters RJ, Yang M, Crutchley R, Essien EJ. Cigarette smoking among Jordanian adults. J Ethn Subst Abuse 2012; 11:101-12. [PMID: 22679892 DOI: 10.1080/15332640.2012.674888] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The objectives were to determine the rate of cigarette smoking and correlates of its use among a sample of Jordanian adults (N = 600). A survey-based, cross-sectional study was conducted with a convenient sample. Logistic regression was used to determine predictors of being a cigarette smoker. Approximately half of the population (45%) had smoked a cigarette in the past month, 40% in the past week, and 36% in past 24 hours. These findings underscore the magnitude of the smoking problem in the Jordanian population and the urgent need for effective interventions. Future research should focus on developing interventions that incorporate the predictors identified.
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Affiliation(s)
- Susan Abughosh
- College of Pharmacy, Institute of Community Health, University of Houston, 1441 Movsund St., Texas Medical Center, Houston, TX 77030, USA.
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La Fauci G, Weiser G, Steiner IP, Shavit I. Carbon monoxide poisoning in narghile (water pipe) tobacco smokers. CAN J EMERG MED 2012; 14:57-9. [PMID: 22417961 DOI: 10.2310/8000.2011.110431] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Narghile (water pipe, hookah, shisha, goza, hubble bubble, argeela) is a traditional method of tobacco use. In recent years, its use has increased worldwide, especially among young people. Narghile smoking, compared to cigarette smoking, can result in more smoke exposure and greater levels of carbon monoxide (CO). We present an acutely confused adolescent patient who had CO poisoning after narghile tobacco smoking. She presented with syncope and a carboxyhemoglobin level of 24% and was treated with hyperbaric oxygen. Five additional cases of CO poisoning after narghile smoking were identified during a literature search, with carboxyhemoglobin levels of 20 to 30%. Each patient was treated with oxygen supplementation and did well clinically. In light of the increasing popularity of narghile smoking, young patients presenting with unexplained confusion or nonspecific neurologic symptoms should be asked specifically about this exposure, followed by carboxyhemoglobin measurement.
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Affiliation(s)
- Giovanna La Fauci
- Pediatric Department, Arcispedale S. Anna Hospital, Ferrara University, Italy
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54
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Rammah M, Dandachi F, Salman R, Shihadeh A, El-Sabban M. In vitro cytotoxicity and mutagenicity of mainstream waterpipe smoke and its functional consequences on alveolar type II derived cells. Toxicol Lett 2012; 211:220-31. [PMID: 22516759 PMCID: PMC3407546 DOI: 10.1016/j.toxlet.2012.04.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2012] [Revised: 03/31/2012] [Accepted: 04/02/2012] [Indexed: 01/31/2023]
Abstract
INTRODUCTION While waterpipe tobacco smoking has become a global phenomenon, its potential health consequences are poorly understood. In this manuscript, we report the in vitro mutagenicity of waterpipe smoke condensate (WSC), the alteration in cellular parameters of lung alveolar cells in response to WSC exposure and discuss the implication of cellular responses in the pathophysiology of chronic obstructive pulmonary disease (COPD). METHODS The mainstream WSC was generated using a standard laboratory machine protocol. We assessed its mutagenicity using Ames test. In addition, we studied the effect of WSC on the proliferation and cell cycle of alveolar type II cells and vascular endothelial cells. We also assessed the effect of WSC on the expression of genes involved in cell cycle arrest and inflammation. RESULTS Within the range of tested doses, WSC did not elicit sufficient response to be considered mutagenic in any of the strains tested (TA98, TA100, TA102, and TA97a) but were found to be toxic for strains TA97a and TA102 at the highest tested doses. However, WSC induced cell cycle arrest and cellular senescence mediated by the p53-p21 pathway. Also our study indicated that WSC induced an increase in the transcriptional expression of matrix metalloproteinases, MMP-2 and MMP-9 and an immune response regulator, Toll Like Receptor-4. CONCLUSION The data reported here represent the first in vitro demonstration of the effect of waterpipe smoke on cellular parameters providing evidence of the potential involvement of WPS in the pathogenesis of COPD through impairing cellular growth and inducing inflammation.
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Affiliation(s)
- Mayyasa Rammah
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut 1107 2020.
| | - Farah Dandachi
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut 1107 2020.
| | - Rola Salman
- Department of Mechanical Engineering, American University of Beirut, Beirut 1107 2020.
| | - Alan Shihadeh
- Department of Mechanical Engineering, American University of Beirut, Beirut 1107 2020.
| | - Marwan El-Sabban
- corresponding author: Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Bliss Street, P.O.Box: 11-0236, Riad El-Solh 1107 2020, Beirut-Lebanon, , Tel: +961-1-350000, FAX: +961-1-3500004913
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Khabour OF, Alzoubi KH, Eissenberg T, Mehrotra P, Azab M, Carroll MV, Afifi RA, Primack BA. Waterpipe tobacco and cigarette smoking among university students in Jordan. Int J Tuberc Lung Dis 2012; 16:986-92. [PMID: 22525279 DOI: 10.5588/ijtld.11.0764] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING While waterpipe and cigarette smoking have been well studied in Syria and Lebanon, data from Jordan are limited. OBJECTIVES To characterize the relative prevalence of waterpipe tobacco and cigarette smoking among university students in Jordan, and to compare the demographic and environmental factors associated with each form of tobacco use. DESIGN We surveyed 1845 students randomly recruited from four universities in Jordan. We used multivariable logistic regression controlling for clustering of individuals within universities to determine associations between demographic and environmental covariates and waterpipe tobacco and cigarette use. RESULTS Waterpipe tobacco smoking rates were 30% in the past 30 days and 56% ever, while cigarette smoking rates were 29% in the past 30 days and 57% ever. Past 30-day waterpipe tobacco smoking rates were 59% for males and 13% for females. Females had substantially lower odds than males of being current waterpipe (OR 0.12, 95%CI 0.10-0.15) or cigarette (OR 0.08, 95%CI 0.05-0.14) smokers. Current cigarette smoking was more significantly associated with markers of high socio-economic status (SES) than waterpipe tobacco smoking. CONCLUSION Waterpipe tobacco smoking is as common as cigarette smoking among Jordanian university students. While cigarette smoking is consistently associated with high SES, waterpipe tobacco smoking is more evenly distributed across various populations.
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Affiliation(s)
- O F Khabour
- Department of Medical Laboratory Sciences, Jordan University for Science and Technology, Irbid, Jordan
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Baheiraei A, Mirghafourvand M, Nedjat S, Mohammadi E, Mohammad-Alizadeh Charandabi S. Prevalence of water pipe use and its correlates in Iranian women of reproductive age in Tehran: a population-based study. Med Princ Pract 2012; 21:340-4. [PMID: 22414554 DOI: 10.1159/000336583] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2011] [Accepted: 12/19/2011] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The objective of this study was to determine the prevalence of water pipe smoking and its associated sociodemographic factors among Iranian women of reproductive age in Tehran. SUBJECTS AND METHODS This was a population-based cross-sectional study of 1,359 Iranian women aged 15-49 years. The multistage random cluster technique was used to obtain the sample. Questionnaire-based interviews with questions relating to water pipe smoking and sociodemographic variables were used to collect the data. The multivariate logistic regression model was used to analyse the relationships between the dependent variable (water pipe smoking) and the independent variables (sociodemographic characteristics). RESULTS The prevalence of water pipe smoking was 6.3% among Iranian women. Water pipe smoking was more likely in the age range of 15-24 years [odds ratio (OR) = 4.8, 95% confidence interval (95% CI) = 2.7-8.6] compared to the age range of 35 years or older, in women with a university education (OR = 1.9, 95% CI = 1.3-3.0) compared to women with a high-school diploma or lower, and in women with an average crowding index score (OR = 4.7, 95% CI = 2.1-10.6) compared to women living in small families. CONCLUSION The findings of this study show that Iranian women with a university education and the younger age group (15-24 years) were at most risk of water pipe smoking. The findings of this study about associated factors may contribute to the development of efficient health promotion programmes for the prevention and cessation of water pipe smoking.
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Affiliation(s)
- Azam Baheiraei
- Department of Reproductive Health, Tehran University of Medical Sciences, Tehran, Iran.
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57
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Abughosh S, Wu IH, Rajan S, Peters RJ, Essien EJ. Waterpipe smoking among students in one US university: predictors of an intention to quit. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2012; 60:528-535. [PMID: 23002801 DOI: 10.1080/07448481.2012.718018] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To examine the intention to quit waterpipe smoking among college students. PARTICIPANTS A total of 276 University of Houston students identified through an online survey administered in February 2011. Participants indicated they had smoked a waterpipe in the month prior to the survey. METHODS Cross-sectional study. Questions included demographics, tobacco use, perceived risk of waterpipe smoking, and social acceptability. Multivariate logistic regression was used to determine predictors of an intention to quit. RESULTS Most of the sample participants (n = 227; 83%) reported that they had no intention to quit. Students believing that waterpipe smoking was harmful were more likely to have an intention to quit (odd ratio [OR] = 2.38, 95% confidence interval [CI; 1.05, 5.36]). Those who smoked for more than 60 minutes were less likely to have a desire to quit (OR = 0.29, 95% CI [0.12, 0.73]). CONCLUSIONS The low level of a desire to quit demonstrated underscores the urgent need to develop interventions that educate users about expected harms of continued use.
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Affiliation(s)
- Susan Abughosh
- Institute of Community Health, College of Pharmacy, University of Houston, Houston, TX 77030, USA.
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Maatouk F, Barkallah M, May W. Prevalence of cigarette smoking among Tunisian dental students. Prev Med 2011; 53:435-6. [PMID: 21996549 DOI: 10.1016/j.ypmed.2011.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2011] [Revised: 09/20/2011] [Accepted: 09/21/2011] [Indexed: 10/17/2022]
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Ghafouri N, Hirsch JD, Heydari G, Morello CM, Kuo GM, Singh RF. Waterpipe smoking among health sciences university students in Iran: perceptions, practices and patterns of use. BMC Res Notes 2011; 4:496. [PMID: 22087840 PMCID: PMC3279519 DOI: 10.1186/1756-0500-4-496] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2011] [Accepted: 11/16/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In recent years waterpipe smoking has become a popular practice amongst young adults in eastern Mediterranean countries, including Iran. The aim of this study was to assess waterpipe smoking perceptions and practices among first-year health sciences university students in Iran and to identify factors associated with the initiation and maintenance of waterpipe use in this population. RESULTS Out of 371 first-year health sciences students surveyed, 358 eight students completed a self-administered questionnaire in the classrooms describing their use and perceptions towards waterpipe smoking. Two hundred and ninety six responders met study inclusion criteria. Waterpipe smoking was common among first-year health sciences university students, with 51% of students indicating they were current waterpipe smokers. Women were smoking waterpipes almost as frequently as men (48% versus 52%, respectively). The majority of waterpipe smokers (75.5%) indicated that the fun and social aspect of waterpipe use was the main motivating factor for them to continue smoking. Of waterpipe smokers, 55.3% were occasional smokers, using waterpipes once a month or less, while 44.7% were frequent smokers, using waterpipes more than once a month. A large number of frequent waterpipe smokers perceived that waterpipe smoking was a healthier way to use tobacco (40.6%) while only 20.6% thought it was addictive. Compared to occasional smokers, significantly more frequent smokers reported waterpipe smoking was relaxing (62.5% vs. 26.2%, p = 0.002), energizing (48.5% vs. 11.4%, p = 0.001), a part of their culture (58.8% vs. 34.1%, p = 0.04), and the healthiest way to use tobacco (40.6% vs. 11.1%, p = 0.005). CONCLUSIONS Social and recreational use of waterpipes is widespread among first-year health sciences university students in Iran. Women and men were almost equally likely to be current waterpipe users. Public health initiatives to combat the increasing use of waterpipes among university students in Iran must consider the equal gender distribution and its perception by many waterpipe smokers as being a healthier and non-addictive way to use tobacco.
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Affiliation(s)
- Nasim Ghafouri
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, CA, USA
| | - Jan D Hirsch
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, CA, USA
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Gholamreza Heydari
- Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Tobacco Prevention and Control Research Center, National Research Institute of Tuberculosis & Lung Disease, Tehran, Iran
| | - Candis M Morello
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, CA, USA
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Grace M Kuo
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, CA, USA
- School of Medicine Department of Family and Preventive Medicine, University of California, San Diego, CA, USA
| | - Renu F Singh
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, CA, USA
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Dar-Odeh NS, Abu-Hammad OA. The changing trends in tobacco smoking for young Arab women; narghile, an old habit with a liberal attitude. Harm Reduct J 2011; 8:24. [PMID: 21878112 PMCID: PMC3176153 DOI: 10.1186/1477-7517-8-24] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2011] [Accepted: 08/30/2011] [Indexed: 01/02/2023] Open
Abstract
Narghile smoking by young females is becoming more acceptable than cigarettes in the conservative societies of Arab countries. Lack of social constraints on narghile smoking has resulted in an increased prevalence of narghile smoking among young Arab females and an earlier age of onset of this habit when compared to cigarette smoking. Documented health hazards of narghile smoking including pulmonary, cardiovascular and neoplastic ailments are consequently expected to affect this vulnerable sector of the population together with their offspring. In this commentary, we shed some light on the changing trend of tobacco use among young Arabic women as shown by an increasing number of studies investigating habits of tobacco use in young people.
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Affiliation(s)
- Najla S Dar-Odeh
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontics, Faculty of Dentistry, University of Jordan, Queen Rania Street, Amman, 11942, Jordan.
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61
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Martinasek MP, McDermott RJ, Martini L. Waterpipe (hookah) tobacco smoking among youth. Curr Probl Pediatr Adolesc Health Care 2011; 41:34-57. [PMID: 21232693 DOI: 10.1016/j.cppeds.2010.10.001] [Citation(s) in RCA: 132] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Waterpipe tobacco smoking is a centuries old practice, influenced by cultural tradition in Eastern Mediterranean countries, the Middle East, and parts of Asia. It historically has been an activity enjoyed primarily by men. In the past 2 decades, however, this method of tobacco smoking has increased in popularity in other parts of the world, including the USA. Growing interest in this form of smoking can be traced, in part, to the advent of a flavored tobacco, called maassel. The combination of flavoring agents and the paraphernalia itself used in the smoking process, along with its mystic appeal, novelty, affordability, and the social atmosphere in which smoking often occurs, has made waterpipe smoking attractive to women as well as men, cigarette smokers and nonsmokers alike, and particular groups, including persons of college age and younger adolescents. Although waterpipe smoking is perceived by its new generation of users to be less addictive and hazardous to health than cigarette smoking, researchers draw diametrically opposed conclusions. Research demonstrates that numerous toxic agents, including carcinogens, heavy metals, other particulate matter, and high levels of nicotine, are efficiently delivered through waterpipes. Moreover, sidestream smoke exposes others in the vicinity of waterpipe smokers to the risk of respiratory diseases and other conditions. In addition, persons sharing waterpipe mouthpieces may share infectious agents as well. Waterpipe tobacco smoking has been declared a public health problem by the World Health Organization and other authorities. Recognition of the deleterious effects of waterpipe smoking has led to initial attempts to expand regulatory control. Because waterpipe tobacco is not directly burned in the smoking process, many existing control measures do not apply. Public health authorities should monitor waterpipe tobacco use carefully. Finally, pediatricians and other healthcare providers should discourage experimentation and continued use among their adolescent patients.
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Affiliation(s)
- Mary P Martinasek
- Department of Community and Family Health, University of South Florida, College of Public Health (MDC 056), Tampa, FL, USA
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