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Higgins ST, Kurti AN, Redner R, White TJ, Gaalema DE, Roberts ME, Doogan NJ, Tidey JW, Miller ME, Stanton CA, Henningfield JE, Atwood GS. A literature review on prevalence of gender differences and intersections with other vulnerabilities to tobacco use in the United States, 2004-2014. Prev Med 2015; 80:89-100. [PMID: 26123717 PMCID: PMC4592404 DOI: 10.1016/j.ypmed.2015.06.009] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 06/19/2015] [Accepted: 06/21/2015] [Indexed: 01/27/2023]
Abstract
This report describes results from a systematic literature review examining gender differences in U.S. prevalence rates of current use of tobacco and nicotine delivery products and how they intersect with other vulnerabilities to tobacco use. We searched PubMed on gender differences in tobacco use across the years 2004-2014. For inclusion, reports had to be in English, in a peer-reviewed journal or federal government report, report prevalence rates for current use of a tobacco product in males and females, and use a U.S. nationally representative sample. Prevalence rates were generally higher in males than in females across all products. This pattern remained stable despite changes over time in overall prevalence rates. Gender differences generally were robust when intersecting with other vulnerabilities, although decreases in the magnitude of gender differences were noted among younger and older users, and among educational levels and race/ethnic groups associated with the highest or lowest prevalence rates. Overall, these results document a pervasive association of gender with vulnerability to tobacco use that acts additively with other vulnerabilities. These vulnerabilities should be considered whenever formulating tobacco control and regulatory policies.
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Affiliation(s)
- Stephen T Higgins
- Vermont Center on Tobacco Regulatory Science, University of Vermont, USA.
| | - Allison N Kurti
- Vermont Center on Tobacco Regulatory Science, University of Vermont, USA
| | - Ryan Redner
- Vermont Center on Tobacco Regulatory Science, University of Vermont, USA
| | - Thomas J White
- Vermont Center on Tobacco Regulatory Science, University of Vermont, USA
| | - Diann E Gaalema
- Vermont Center on Tobacco Regulatory Science, University of Vermont, USA
| | - Megan E Roberts
- Center of Excellence in Regulatory Tobacco Science, The Ohio State University, USA
| | - Nathan J Doogan
- Center of Excellence in Regulatory Tobacco Science, The Ohio State University, USA
| | - Jennifer W Tidey
- Vermont Center on Tobacco Regulatory Science, University of Vermont, USA; Department of Psychiatry and Human Behavior, Brown University, USA
| | - Mollie E Miller
- Vermont Center on Tobacco Regulatory Science, University of Vermont, USA; Department of Psychiatry and Human Behavior, Brown University, USA
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Rolle IV, Kennedy SM, Agaku I, Jones SE, Bunnell R, Caraballo R, Xu X, Schauer G, McAfee T. Cigarette, Cigar, and Marijuana Use Among High School Students — United States, 1997–2013. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2015; 64:1136-41. [DOI: 10.15585/mmwr.mm6440a2] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Brinkman MC, Kim H, Gordon SM, Kroeger RR, Reyes IL, Deojay DM, Chitwood C, Lane TE, Clark PI. Design and Validation of a Research-Grade Waterpipe Equipped With Puff Topography Analyzer. Nicotine Tob Res 2015; 18:785-93. [PMID: 26377514 DOI: 10.1093/ntr/ntv180] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 08/07/2015] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Worldwide, commercially available waterpipes vary widely in design and durability, including differences in fabrication materials, degree of leak-tight fit, and flow path diameter. Little is known about how the components of the waterpipe may influence puffing behavior and user's exposure to toxins. To systematically evaluate exposure, it is necessary to use a standardized research-grade waterpipe (RWP) when conducting clinical and laboratory-based trials. METHODS We developed a RWP that is configured with an in-line topography system which allows real-time measurement and recording of the smoke volume drawn through the RWP. The RWP was calibrated across the flow rate range expected for waterpipe tobacco smoking and the calibration was verified for known puff volumes using a smoking machine. Operation of the RWP was qualified in a cohort of experienced waterpipe smokers, each smoker using the RWP ad libitum in a laboratory setting while smoker topography and subjective effects data were collected. RESULTS RWP machine smoking was highly reproducible and yielded puff volumes that agreed well with true values. User acceptance was comparable, and puffing behavior was similar in pattern, with more frequent puffing in the beginning of the session, but significantly different in intensity from that used to estimate the majority of toxicant exposure reported in the literature. CONCLUSIONS The RWP operates with known precision and accuracy and is well accepted by experienced smokers. This tool can be used to determine the extent to which puffing behaviors are affected by the waterpipe design, components, and/or accessories, tobacco nicotine content, sweet flavorings and/or additives known to increase addictiveness. IMPLICATIONS This study describes a standardized RWP, equipped with a puffing topography analyzer, which can operate with known precision and accuracy, and is well-accepted by experienced smokers in terms of satisfaction and reward. The RWP is an important tool for determining if puffing behaviors, and thus estimated toxin exposures, are affected by the waterpipe design, components, and/or accessories, tobacco nicotine content, sweet flavorings, and/or additives that are known to increase addictiveness.
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Affiliation(s)
- Marielle C Brinkman
- Public Health Center for Tobacco Research, Battelle, Columbus, OH; Health and Analytics, Battelle, Columbus, OH;
| | - Hyoshin Kim
- Public Health Center for Tobacco Research, Battelle, Columbus, OH; Health and Analytics, Battelle, Seattle, WA
| | - Sydney M Gordon
- Public Health Center for Tobacco Research, Battelle, Columbus, OH; Health and Analytics, Battelle, Columbus, OH
| | - Robyn R Kroeger
- Public Health Center for Tobacco Research, Battelle, Columbus, OH; Health and Analytics, Battelle, Columbus, OH
| | - Iza L Reyes
- Public Health Center for Tobacco Research, Battelle, Columbus, OH
| | | | - Caleb Chitwood
- Public Health Center for Tobacco Research, Battelle, Columbus, OH
| | - Timothy E Lane
- Applied Biology and Aerosol Technology, Battelle, Columbus, OH
| | - Pamela I Clark
- School of Public Health, University of Maryland, College Park, MD
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Soule EK, Barnett TE, Curbow BA, Moorhouse MD, Weiler RM. Hookah and Alcohol Use among Young Adult Hookah Smokers: A Mixed Methods Study. Am J Health Behav 2015; 39:665-73. [PMID: 26248176 DOI: 10.5993/ajhb.39.5.8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES Hookah tobacco smoking has grown steadily in popularity among young adults in the United States. Little attention has been given to the relationship between hookah smoking and another behavior that is common among young adults - alcohol use. The purpose of this study was to examine hookah and alcohol use among young adults. METHODS Forty young adult hookah smokers (55% female) participated in focus group sessions on hookah use beliefs and a brief survey examining hookah and alcohol use including drinking alcohol before, during, or after smoking hookah. RESULTS Quotes from the focus groups indicated that alcohol use may promote hookah use among individuals who have little or no hookah smoking experience. Alcohol use, binge drinking, and alcohol use before, during, and after hookah use were common among the participants regardless of legal drinking age status. Nearly half of the participants preferred to drink alcohol while smoking hookah due to the improved physical and social effects they associated with combining the 2 behaviors. CONCLUSIONS For some young adult hookah smokers, alcohol appears to enhance the hookah smoking experience and may play a role in hookah smoking initiation. Future research and interventions should address the association between hookah and alcohol use.
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Affiliation(s)
- Eric K Soule
- Virginia Commonwealth University, Department of Psychology, Center for the Study of Tobacco Products, Richmond, VA, USA.
| | - Tracey E Barnett
- University of Florida, Department of Behavioral Science and Community Health, Gainesville, FL, USA
| | - Barbara A Curbow
- University of Maryland, School of Public Health, College Park, MD, USA
| | - Michael D Moorhouse
- University of Florida, Department of Behavioral Science and Community Health, Gainesville, FL, USA
| | - Robert M Weiler
- George Mason University, Department of Global and Community Health, Fairfax, VA, USA
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Jaber R, Madhivanan P, Khader Y, Mzayek F, Ward K, Maziak W. Predictors of waterpipe smoking progression among youth in Irbid, Jordan: A longitudinal study (2008-2011). Drug Alcohol Depend 2015; 153:265-70. [PMID: 26024787 PMCID: PMC4510020 DOI: 10.1016/j.drugalcdep.2015.05.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 04/23/2015] [Accepted: 05/07/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND The predictors of waterpipe smoking progression are yet to be examined using a longitudinal study that is guided by a theoretical model of behavioral change. This study identifies the gender-specific predictors of waterpipe smoking progression among adolescents in Irbid, Jordan. METHODS This study uses data from a school longitudinal study of smoking behavior in Irbid, Jordan. A random sample of 19 schools was selected by probability proportionate to size. A total of 1781 seventh graders were enrolled at baseline, and completed a questionnaire annually from 2008 through 2011. Students who reported ever smoking waterpipe (N=864) at any time point were assessed for progression (escalation in the frequency of waterpipe smoking) in the subsequent follow-up. Grouped-time survival analysis was used to identify the risk of progression. RESULTS During the three years of follow-up, 29.6% of students progressed in waterpipe smoking. Predictors of waterpipe smoking progression were higher mother's education, enrollment in public school, frequent physical activity, and low refusal self-efficacy among boys, having ever smoked cigarettes, and having friends and siblings who smoke waterpipe among girls. Awareness of harms of waterpipe was protective among boys and seeing warning labels on the tobacco packs was protective among girls. CONCLUSIONS Even at this early stage, about a third of waterpipe smokers progressed in their habit during the 3 year follow up. Factors predicting progression of use differed by gender, which calls for gender-specific approaches to waterpipe interventions among Jordanian youth.
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Affiliation(s)
- Rana Jaber
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, 33199 FL, United States.
| | - Purnima Madhivanan
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, 33199 FL, United States.
| | - Yousef Khader
- Department of Community Medicine, Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan.
| | - Fawaz Mzayek
- Syrian Center for Tobacco Studies, Aleppo, Syria; Department of Epidemiology and Biostatistics, University of Memphis, Memphis, TN, United States.
| | - Kenneth Ward
- Syrian Center for Tobacco Studies, Aleppo, Syria., Department of Epidemiology and Biostatistics, University of
Memphis, Memphis, TN
| | - Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, 33199 FL, United States; Syrian Center for Tobacco Studies, Aleppo, Syria.
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Hammal F, Wild TC, Nykiforuk C, Abdullahi K, Mussie D, Finegan BA. Waterpipe (Hookah) Smoking Among Youth and Women in Canada is New, not Traditional. Nicotine Tob Res 2015; 18:757-62. [PMID: 26187392 DOI: 10.1093/ntr/ntv152] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 06/23/2015] [Indexed: 11/12/2022]
Abstract
INTRODUCTION When asserting the right of individuals to be free to smoke a hookah (waterpipe [WP]) in public places, the "cultural" importance of the practice is often cited. The purpose of this study was to explore the cultural significance of WP smoking. METHODS Qualitative methods were used to elicit the views of groups of WP smokers from different cultural backgrounds. RESULTS Sixteen group discussion sessions with a total of 75 WP smokers aged between 18 and 30 were conducted. A few participants saw culture as a factor supporting WP smoking initiation and maintenance. The vast majority indicated that WPs being perceived as "healthier" than cigarettes, and the availability of flavored shisha as important factors in their initiation and ongoing use. Most started smoking before the age of 18 calling it a "high school thing" and admitted that they had easy access to WP cafés. Many indicated that they did not know if they were smoking tobacco or a "herbal" substance. CONCLUSION Peer influence, availability of flavored products and facile access to WP cafés are major factors in WP initiation. Ethno-cultural traditions play only a minor role. The assertion that cultural traditions and practice are inherent in WP smoking as implied by media and marketing was not supported by our findings. Contemporary use of WP is spreading among new non-traditional users. Lack of knowledge about the harms of WP smoking indicates a need for education and regulation to require packaging and health warning labels and restrictions on access, especially to minors.
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Affiliation(s)
- Fadi Hammal
- Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, AB, Canada
| | - T Cameron Wild
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Candace Nykiforuk
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | | | - Dawit Mussie
- Calgary Chinese Community Services Association, Calgary, AB, Canada
| | - Barry A Finegan
- Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, AB, Canada;
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Palamar JJ, Griffin-Tomas M, Ompad DC. Illicit drug use among rave attendees in a nationally representative sample of US high school seniors. Drug Alcohol Depend 2015; 152:24-31. [PMID: 26005041 PMCID: PMC4458153 DOI: 10.1016/j.drugalcdep.2015.05.002] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 04/26/2015] [Accepted: 05/01/2015] [Indexed: 01/02/2023]
Abstract
BACKGROUND The popularity of electronic dance music and rave parties such as dance festivals has increased in recent years. Targeted samples of party-goers suggest high rates of drug use among attendees, but few nationally representative studies have examined these associations. METHODS We examined sociodemographic correlates of rave attendance and relationships between rave attendance and recent (12-month) use of various drugs in a representative sample of US high school seniors (modal age: 18) from the Monitoring the Future study (2011-2013; Weighted N=7373). RESULTS One out of five students (19.8%) reported ever attending a rave, and 7.7% reported attending at least monthly. Females and highly religious students were less likely to attend raves, and Hispanics, students residing in cities, students with higher income and those who go out for fun multiple times per week were more likely to attend. Rave attendees were more likely than non-attendees to report use of an illicit drug other than marijuana (35.5% vs. 15.6%, p<0.0001). Attendees were more likely to report use of each of the 18 drugs assessed, and attendees were more likely to report more frequent use (≥6 times) of each drug (ps<0.0001). Controlling for sociodemographic covariates, frequent attendance (monthly or more often) was associated with higher odds of use of each drug (ps<0.0001). Frequent attendees were at highest risk for use of "club drugs." DISCUSSION Findings from this study can help inform prevention and harm reduction among rave attendees at greatest risk for drug use.
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Affiliation(s)
- Joseph J. Palamar
- New York University Langone Medical Center, Department of Population Health, New York, NY, USA,Center for Drug Use and HIV Research, New York University College of Nursing, New York, NY, USA,Center for Health, Identity, Behavior, and Prevention Studies, New York University, New York, NY, USA
| | - Marybec Griffin-Tomas
- Center for Health, Identity, Behavior, and Prevention Studies, New York University, New York, NY, USA,Global Institute of Public Health, New York University, New York, NY, USA
| | - Danielle C. Ompad
- Center for Drug Use and HIV Research, New York University College of Nursing, New York, NY, USA,Center for Health, Identity, Behavior, and Prevention Studies, New York University, New York, NY, USA,Global Institute of Public Health, New York University, New York, NY, USA
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Palamar JJ, Lee L, Weitzman M. Prevalence and correlates of hashish use in a national sample of high school seniors in the United States. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2015; 41:197-205. [PMID: 25860964 DOI: 10.3109/00952990.2015.1011745] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Cannabis (marijuana) use and acceptance towards use are increasing in the US, and state-level policies are becoming more liberal. A wealth of research has been conducted to examine risk factors for use; however, studies rarely differentiate between different forms of marijuana. OBJECTIVE We sought to determine prevalence of use and delineate who is at risk for use of hashish, a more potent form of marijuana. METHODS We examined data from a nationally representative sample of high school seniors in the Monitoring the Future study (2007-2011; weighted n = 10 597). We determined how sociodemographic factors and reasons for marijuana use correlated with recent (12 month) hashish use. RESULTS Prevalence of recent hashish use was 6.5% and it was used by 18.3% of recent marijuana users. Hashish and other marijuana use tended to share many of the same correlates; however, associations were often stronger for hashish use. Females were consistently at low risk for use and users of other drugs were consistently at high risk for use. Black students tended to be at low risk for hashish use. Low risk of identifying as Hispanic or religious and high risk of higher personal income or going out more evenings per week for fun disappeared when controlling for other drug use. Using marijuana because the student felt he/she was "hooked" nearly doubled the odds for hashish use. CONCLUSIONS This was the first national study to examine prevalence and correlates of hashish use. These findings can inform prevention in a time of increasing popularity of marijuana use.
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Affiliation(s)
- Joseph J Palamar
- Department of Population Health, New York University Langone Medical Center , New York
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Palamar JJ, Acosta P. Synthetic cannabinoid use in a nationally representative sample of US high school seniors. Drug Alcohol Depend 2015; 149:194-202. [PMID: 25736618 PMCID: PMC4361370 DOI: 10.1016/j.drugalcdep.2015.01.044] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 01/06/2015] [Accepted: 01/31/2015] [Indexed: 01/05/2023]
Abstract
BACKGROUND Synthetic cannabinoids are marketed as "legal highs" and have similar effects to cannabis (marijuana). Although prevalence of synthetic cannabinoid use is now declining in the US, use has been associated with tens of thousands of poisonings and hospitalizations, particularly among teens. It is important to examine which teens are at highest risk for use of these new, potentially deleterious drugs as they are understudied and continue to emerge. METHODS Data were analyzed from a nationally representative sample of high school seniors in the Monitoring the Future study (2011-2013; Weighted N = 11,863; modal age: 18). Bivariable and multivariable models were used to delineate correlates of recent (12-month) synthetic cannabinoid use. RESULTS Ten percent reported any recent use and 3% reported more frequent use (used ≥ 6 times). Females were at low odds for use and going out 4-7 evenings per week for fun consistently increased odds of use. Black and religious students were at low odds of use until controlling for other drug use, and higher income increased odds of use until controlling for other drug use. Lifetime use of alcohol, cigarettes and other illicit drugs all robustly increased odds of use, but frequency of lifetime marijuana use was the strongest correlate with more frequent use further increasing odds of synthetic cannabinoid use. Only 0.5% of non-marijuana users reported use of synthetic cannabinoids. CONCLUSIONS This is among the first national studies to delineate correlates of synthetic cannabinoid use. Results can inform national and local efforts to prevent use and adverse consequences resulting from use.
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Affiliation(s)
- Joseph J. Palamar
- Department of Population Health, New York University (NYU) Langone Medical Center, New York, NY, USA,Center for Drug Use and HIV Research, NYU College of Nursing, New York, NY, USA
| | - Patricia Acosta
- Department of Population Health, New York University (NYU) Langone Medical Center, New York, NY, USA
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Hookah use prevalence, predictors, and perceptions among Canadian youth: findings from the 2012/2013 Youth Smoking Survey. Cancer Causes Control 2015; 26:831-8. [PMID: 25783457 PMCID: PMC4438198 DOI: 10.1007/s10552-015-0556-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 03/04/2015] [Indexed: 10/27/2022]
Abstract
PURPOSE Few national surveys currently assess hookah smoking among youth. This study describes the prevalence, patterns of use, and perceptions about hookah in a nationally representative survey of Canadian grades 9-12 students. METHODS The Youth Smoking Survey 2012/2013 was administered to 27,404 Canadian grades 9-12 students attending schools in nine Canadian provinces representing 96 % of Canadian population. Relevant dichotomous outcomes included ever use, use in the last 30 days, and the belief that hookah use is less harmful than cigarette smoking. Covariates included smoking status, sex, grade, province of residence, race/ethnicity, and amount of weekly spending money. Logistic regression models were used to examine: covariates related to the odds of ever and last-30-day hookah use; covariates related to perceptions about the harms of hookah smoking; the extent to which perceptions were associated with odds of hookah use; and whether survey year (2010/2011 or 2012/2013) was associated with hookah use, and marginal effects were calculated. RESULTS In Canada, 5.4 % of students in grades 9-12 currently use hookah and 14.3 % report ever using hookah. In 2012/2013, students had significantly higher odds of using hookah compared to students in 2010/2011 (OR 1.5, 95 % CI 1.2, 2.1). About half of hookah users (51 %) used flavored hookah. Students who believed that hookah use was less harmful than cigarette smoking had significantly higher odds of current hookah use (OR 2.6, 95 % CI 1.9, 3.5), as did students who reported higher amounts of weekly spending money. Current smokers had an 18 % higher predicted probability of currently using hookah compared to non-smokers. CONCLUSIONS Hookah use among youth is of growing concern in Canada. Findings can be used to inform policy development related to youth hookah smoking.
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Hamilton HA, Ferrence R, Boak A, O'Connor S, Mann RE, Schwartz R, Adlaf EM. Waterpipe use among high school students in Ontario: Demographic and substance use correlates. Canadian Journal of Public Health 2015; 106:e121-6. [PMID: 26125237 DOI: 10.17269/cjph.106.4764] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Revised: 03/13/2015] [Accepted: 01/24/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To examine waterpipe use and its association with demographic factors, tobacco cigarette smoking, ever use of electronic cigarettes (e-cigarettes) and alcohol use among high school students. METHODS Data were derived from the 2013 Ontario Student Drug Use and Health Survey, a school-based survey of 7th to 12th grade students. This province-wide survey was based on a stratified two-stage cluster design. Analyses were based on a subsample of 2,873 high school students and included adjustments for the complex sample design. RESULTS Overall, 12.5% of high school students (grades 9-12) had used a waterpipe in the previous year. Awareness of waterpipes was high - 68.4% of students reported that they were aware of waterpipes but had not used one in the past year; 19.1% had never heard of waterpipes or hookah. The percentage of high school students reporting waterpipe use in the past year was similar to reports of tobacco cigarette use (12.5% and 11% respectively). Waterpipe use was highly associated with past-year tobacco cigarette and regular alcohol use as well as ever use of e-cigarettes. In multivariate analyses, males and females had similar odds of waterpipe use, and non-White students and those in higher grades had greater odds of use after controlling for other substance use. CONCLUSION These findings suggest that waterpipe use among high school students should be of some concern and suggest the need for policy measures to address potential risks associated with use.
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Cavazos-Rehg PA, Krauss MJ, Kim Y, Emery SL. Risk Factors Associated With Hookah Use. Nicotine Tob Res 2015; 17:1482-90. [PMID: 25646349 DOI: 10.1093/ntr/ntv029] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Accepted: 01/24/2015] [Indexed: 01/19/2023]
Abstract
BACKGROUND Potential harms associated with hookah smoking are largely unrecognized and it is emerging as a trendy behavior. To help inform policy and preventive interventions, we used responses from a population survey of US adults to examine risk factors associated with hookah involvement. METHOD An online survey of 17 522 US adults was conducted in 2013. The nationally representative sample was drawn from GfK Group's KnowledgePanel plus off-panel recruitment. Multinomial logistic regression was used to examine the relationships between tobacco use patterns across multiple products (cigarettes, cigars, and dissolvables), perceived harms towards regular pipe/hookah use, and demographic characteristics with hookah involvement (never used, ever used with/without reusing intent). RESULT Nearly one in five (16%) of the respondents had smoked hookah at least once in their life ("ever users"). Ever users of hookah were at higher risk of having used cigarettes, cigars, and dissolvable tobacco products (all P < .01). Odds for hookah use were greater for those who perceived regular pipe/hookah use as less dangerous (P < .05). Odds for hookah involvement were higher among young adults (P < .001), individuals with higher educational attainment (P < .01), and Hispanics/Latinos (P < .05). CONCLUSIONS Information about the public health harms associated with hookah smoking should be delivered to individuals at-risk for hookah smoking. It is likely that misconceptions about the safety of hookah smoking could be driving, at least in-part, its increase in popularity.
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Affiliation(s)
| | - Melissa J Krauss
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Yoonsang Kim
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL
| | - Sherry L Emery
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL
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63
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Soneji S, Sargent JD, Tanski SE, Primack BA. Associations between initial water pipe tobacco smoking and snus use and subsequent cigarette smoking: results from a longitudinal study of US adolescents and young adults. JAMA Pediatr 2015; 169:129-36. [PMID: 25485959 PMCID: PMC4388043 DOI: 10.1001/jamapediatrics.2014.2697] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Many adolescents and young adults use alternative tobacco products, such as water pipes and snus, instead of cigarettes. OBJECTIVE To assess whether prior water pipe tobacco smoking and snus use among never smokers are risk factors for subsequent cigarette smoking. DESIGN, SETTING, AND PARTICIPANTS We conducted a 2-wave national longitudinal study in the United States among 2541 individuals aged 15 to 23 years old. At baseline (October 25, 2010, through June 11, 2011), we ascertained whether respondents had smoked cigarettes, smoked water pipe tobacco, or used snus. At the 2-year follow-up (October 27, 2012, through March 31, 2013), we determined whether baseline non-cigarette smokers had subsequently tried cigarette smoking, were current (past 30 days) cigarette smokers, or were high-intensity cigarette smokers. We fit multivariable logistic regression models among baseline non-cigarette smokers to assess whether baseline water pipe tobacco smoking and baseline snus use were associated with subsequent cigarette smoking initiation and current cigarette smoking, accounting for established sociodemographic and behavioral risk factors. We fit similarly specified multivariable ordinal logistic regression models to assess whether baseline water pipe tobacco smoking and baseline snus use were associated with high-intensity cigarette smoking at follow-up. EXPOSURES Water pipe tobacco smoking and the use of snus at baseline. MAIN OUTCOMES AND MEASURES Among baseline non-cigarette smokers, cigarette smoking initiation, current (past 30 days) cigarette smoking at follow-up, and the intensity of cigarette smoking at follow-up. RESULTS Among 1596 respondents, 1048 had never smoked cigarettes at baseline, of whom 71 had smoked water pipe tobacco and 20 had used snus at baseline. At follow-up, accounting for behavioral and sociodemographic risk factors, baseline water pipe tobacco smoking and snus use were independently associated with cigarette smoking initiation (adjusted odds ratios: 2.56; 95% CI, 1.46-4.47 and 3.73; 95% CI, 1.43-9.76, respectively), current cigarette smoking (adjusted odds ratios: 2.48; 95% CI, 1.01-6.06 and 6.19; 95% CI, 1.86-20.56, respectively), and higher intensity of cigarette smoking (adjusted proportional odds ratios: 2.55; 95% CI, 1.48-4.38 and 4.45; 95% CI, 1.75-11.27, respectively). CONCLUSIONS AND RELEVANCE Water pipe tobacco smoking and the use of snus independently predicted the onset of cigarette smoking and current cigarette smoking at follow-up. Comprehensive Food and Drug Administration regulation of these tobacco products may limit their appeal to youth and curb the onset of cigarette smoking.
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Affiliation(s)
- Samir Soneji
- Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire2Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - James D. Sargent
- Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire2Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Susanne E. Tanski
- Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Brian A. Primack
- Division of General Internal Medicine, Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
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Kumar SR, Davies S, Weitzman M, Sherman S. A review of air quality, biological indicators and health effects of second-hand waterpipe smoke exposure. Tob Control 2014; 24 Suppl 1:i54-i59. [PMID: 25480544 PMCID: PMC4345792 DOI: 10.1136/tobaccocontrol-2014-052038] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Objective There has been a rapid increase in the use of waterpipe tobacco and non-tobacco based shisha in many countries. Understanding the impact and effects of second-hand smoke (SHS) from cigarette was a crucial factor in reducing cigarette use, leading to clean indoor air laws and smoking bans. This article reviews what is known about the effects of SHS exposure from waterpipes. Data sources We used PubMed and EMBASE to review the literature. Articles were grouped into quantitative measures of air quality and biological markers, health effects, exposure across different settings, different types of shisha and use in different countries. Study selection Criteria for study selection were based on the key words related to SHS: waterpipe, hookah, shisha and third-hand smoke. Data extraction Independent extraction with two reviewers was performed with inclusion criteria applied to articles on SHS and waterpipe/hookah/shisha. We excluded articles related to pregnancy or prenatal exposure to SHS, animal studies, and non-specific source of exposure as well as articles not written in English. Data synthesis A primary literature search yielded 54 articles, of which only 11 were included based on relevance to SHS from a waterpipe/hookah/shisha. Conclusions The negative health consequences of second-hand waterpipe exposure have major implications for clean indoor air laws and for occupational safety. There exists an urgent need for public health campaigns about the effects on children and household members from smoking waterpipe at home, and for further development and implementation of regulations to protect the health of the public from this rapidly emerging threat.
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Affiliation(s)
- Sumit R Kumar
- New York University School of Medicine, New York, New York, USA
| | - Shelby Davies
- New York University School of Medicine, New York, New York, USA
| | - Michael Weitzman
- Departments of Pediatrics and Environmental Medicine, New York University School of Medicine, New York University, New York, New York, USA
| | - Scott Sherman
- Departments of Population Health, Medicine and Psychiatry, New York University School of Medicine, New York University, New York, New York, USA
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Suter MA, Mastrobattista J, Sachs M, Aagaard K. Is there evidence for potential harm of electronic cigarette use in pregnancy? ACTA ACUST UNITED AC 2014; 103:186-95. [PMID: 25366492 DOI: 10.1002/bdra.23333] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Use of electronic cigarettes (e-cigarettes) and other nicotine containing products is increasing among women of reproductive age. The short- and long-term effects of these products on both mother and fetus are unknown. METHODS Because e-cigarettes are nicotine delivery systems, we sought to conduct a comprehensive review of the effects of nicotine on the fetus. RESULTS In utero nicotine exposure in animal models is associated with adverse effects for the offspring lung, cardiovascular system and brain. In the lung, this included reduced surface area, weight, and volume, as well as emphysema-like lesions. In adulthood, exposed offspring demonstrate elevated blood pressure and increased perivascular adipose tissue. In the brain, exposure alters offspring serotonergic, dopaminergic, and norepinephrine networks, which in turn are associated with behavioral and cognitive impairments. We also review current data on the lack of efficacy of nicotine replacement therapy in pregnant women, and highlight different nicotine containing products such as snuff, snus, and hookah. CONCLUSION We conclude that no amount of nicotine is known to be safe during pregnancy, and studies specifically addressing this risk are crucial and an imminent public health issue.
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Affiliation(s)
- Melissa A Suter
- Baylor College of Medicine, Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Houston, Texas
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Maziak W, Taleb ZB, Bahelah R, Islam F, Jaber R, Auf R, Salloum RG. The global epidemiology of waterpipe smoking. Tob Control 2014; 24 Suppl 1:i3-i12. [PMID: 25298368 PMCID: PMC4345835 DOI: 10.1136/tobaccocontrol-2014-051903] [Citation(s) in RCA: 357] [Impact Index Per Article: 35.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVES In the past decade, waterpipe smoking (a.k.a. hookah, shisha, narghile) has become a global phenomenon. In this review, we provide an updated picture of the main epidemiological trends in waterpipe smoking globally. DATA SOURCES Peer-reviewed publications indexed in major biomedical databases between 2004 and 2014. Search keywords included a combination of: waterpipe, hookah, shisha along with epidemiology, patterns, prevalence and predictors. We also used different spellings of waterpipe terms commonly used. STUDY SELECTION The focus was on studies with large representative samples, national data or high-quality reports that illuminated aspects of the epidemiology and trends in waterpipe smoking. DATA EXTRACTION Multiple researchers extracted the data independently and collectively decided on the most important and pertinent studies to include in the review. DATA SYNTHESIS Waterpipe smoking has become a global phenomenon among youth. The global waterpipe epidemic is likely driven by (1) the introduction of manufactured flavoured tobacco (Maassel); (2) the intersection between waterpipe's social dimension and thriving café culture; (3) the evolution of mass communication media; (4) the lack of regulatory/policy framework specific to the waterpipe. Waterpipe smoking is becoming the most popular tobacco use method among youth in the Middle East, and is quickly gaining popularity elsewhere. Important patterns of waterpipe smoking include the predominance among younger, male, high socioeconomic, and urban groups. Intermittent and social use are also noted patterns. CONCLUSIONS Waterpipe smoking has become a global public health problem. Developing surveillance, intervention and regulatory/policy frameworks specific to the waterpipe has become a public health priority.
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Affiliation(s)
- Wasim Maziak
- Department of Epidemiology, Florida International University, Miami, Florida, USA Syrian Center for Tobacco Studies, Aleppo, Syria
| | - Ziyad Ben Taleb
- Department of Epidemiology, Florida International University, Miami, Florida, USA
| | - Raed Bahelah
- Department of Epidemiology, Florida International University, Miami, Florida, USA Faculty of Medicine and Health Sciences, University of Aden, Aden, Yemen
| | - Farahnaz Islam
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Rana Jaber
- Department of Epidemiology, Florida International University, Miami, Florida, USA
| | - Rehab Auf
- Department of Epidemiology, Florida International University, Miami, Florida, USA
| | - Ramzi G Salloum
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
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Duncan DT, Palamar JJ, Williams JH. Perceived neighborhood illicit drug selling, peer illicit drug disapproval and illicit drug use among U.S. high school seniors. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2014; 9:35. [PMID: 25182042 PMCID: PMC4163623 DOI: 10.1186/1747-597x-9-35] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 08/28/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND This study examined associations between perceived neighborhood illicit drug selling, peer illicit drug disapproval and illicit drug use among a large nationally representative sample of U.S. high school seniors. METHODS Data come from Monitoring the Future (2007-2011), an annual cross-sectional survey of U.S. high school seniors. Students reported neighborhood illicit drug selling, friend drug disapproval towards marijuana and cocaine use, and past 12-month and past 30-day illicit drug use (N = 10,050). Multinomial logistic regression models were fit to explain use of 1) just marijuana, 2) one illicit drug other than marijuana, and 3) more than one illicit drug other than marijuana, compared to "no use". RESULTS Report of neighborhood illicit drug selling was associated with lower friend disapproval of marijuana and cocaine; e.g., those who reported seeing neighborhood sales "almost every day" were less likely to report their friends strongly disapproved of marijuana (adjusted odds ratio [AOR] = 0.38, 95% CI: 0.29, 0.49) compared to those who reported never seeing neighborhood drug selling and reported no disapproval. Perception of neighborhood illicit drug selling was also associated with past-year drug use and past-month drug use; e.g., those who reported seeing neighborhood sales "almost every day" were more likely to report 30-day use of more than one illicit drug (AOR = 11.11, 95% CI: 7.47, 16.52) compared to those who reported never seeing neighborhood drug selling and reported no 30-day use of illicit drugs. CONCLUSIONS Perceived neighborhood drug selling was associated with lower peer disapproval and more illicit drug use among a population-based nationally representative sample of U.S. high school seniors. Policy interventions to reduce "open" (visible) neighborhood drug selling (e.g., problem-oriented policing and modifications to the physical environment such as installing and monitoring surveillance cameras) may reduce illicit drug use and peer disapproval of illicit drugs.
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Affiliation(s)
- Dustin T Duncan
- Department of Population Health, New York University School of Medicine, 227 East 30th Street, 6th Floor, Room 621, New York, NY 10016, USA.
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