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Waterpipe tobacco smoking and gene variants of CYP1A1-Ile462Val and -MspI polymorphisms are possibly associated with the risk of lung cancer in the Iraqi population. Meta Gene 2020. [DOI: 10.1016/j.mgene.2019.100623] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
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2
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Qasim H, Alarabi AB, Alzoubi KH, Karim ZA, Alshbool FZ, Khasawneh FT. The effects of hookah/waterpipe smoking on general health and the cardiovascular system. Environ Health Prev Med 2019; 24:58. [PMID: 31521105 PMCID: PMC6745078 DOI: 10.1186/s12199-019-0811-y] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 08/22/2019] [Indexed: 12/13/2022] Open
Abstract
Hookah or waterpipe smoking or use is an emerging trend in the US population, especially among the youth. The misperception of hookah being less harmful than cigarettes and the availability of different but "appealing" flavors are considered among the main reasons for this trend. Hookah users however are exposed to many of the same toxic compounds/by-products as cigarette users, but at dramatically higher levels, which might lead to more severe negative health effects. In fact, hookah users are at risks of infections, cancers, lung disease, and other medical conditions. Moreover, because of the overlapping toxicant/chemical profile to conventional cigarettes, hookah smoke effects on the cardiovascular system are thought to be comparable to those of conventional cigarettes. A major source of tobacco addiction is nicotine, whose levels in hookah are extremely variable as they depend on the type of tobacco used. Taken together, in this review of literature, we will provide insights on the negative health effects of hookah in general, with a focus on what is known regarding its impact on the cardiovascular system.
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Affiliation(s)
- Hanan Qasim
- Department of Pharmaceutical Sciences, School of Pharmacy, The University of Texas at El Paso, El Paso, Texas, 79902, USA
| | - Ahmed B Alarabi
- Department of Pharmaceutical Sciences, School of Pharmacy, The University of Texas at El Paso, El Paso, Texas, 79902, USA
| | - Karem H Alzoubi
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Zubair A Karim
- Department of Pharmaceutical Sciences, School of Pharmacy, The University of Texas at El Paso, El Paso, Texas, 79902, USA
| | - Fatima Z Alshbool
- Department of Pharmaceutical Sciences, School of Pharmacy, The University of Texas at El Paso, El Paso, Texas, 79902, USA.
| | - Fadi T Khasawneh
- Department of Pharmaceutical Sciences, School of Pharmacy, The University of Texas at El Paso, El Paso, Texas, 79902, USA.
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Patil S, Patel K, Advani J, Subbannayya T, Rajagopalan P, Babu N, Solanki H, Bhandi S, Sidransky D, Chatterjee A, Gowda H, Ferrari M. Multiomic analysis of oral keratinocytes chronically exposed to shisha. J Oral Pathol Med 2019; 48:284-289. [PMID: 30659648 DOI: 10.1111/jop.12828] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 01/14/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Tobacco is smoked in different form including cigarettes and water pipes. One popular form of water pipe smoking especially in Middle Eastern countries is shisha smoking. Shisha has been associated with various diseases including oral cancer. However, genomic alterations and gene expression changes associated with chronic shisha exposure have not been previously investigated. OBJECTIVES Whole-exome sequencing and gene expression profiling of immortalized human oral keratinocytes (OKF6/TERT1) cells chronically treated with 0.5% shisha extract for a period of 8 months was undertaken to characterize molecular alterations associated with shisha exposure. METHODS Genomic DNA and RNA were extracted and preprocessed as per manufacturer's instruction and subjected to whole-exome and transcriptome sequencing using Illumina HiSeq2500 platform. Exome was analyzed using GATK pipeline whereas RNA-Seq data was analyzed using HiSat2 and HTSeq along with DESeq to elucidate differentially expressed genes. RESULTS Whole-exome sequence analysis led to identification of 521 somatic missense variants corresponding to 389 genes RNA-Seq data revealed 247 differentially expressed genes (≥2-fold, P-value<0.01) in shisha treated cells compared to parental cells. Pathway analysis of differentially expressed genes revealed that interferon-signaling pathway was significantly affected. We predict activation of MAPK1 pathway which is known to play a key role in oral cancer. We also observed allele specific expression of mutant LIMA1 based on RNA-Seq dataset. CONCLUSION Our findings provide insights into genomic alterations and gene expression pattern associated with oral keratinocytes chronically exposed to shisha.
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Affiliation(s)
- Shankargouda Patil
- Department of Medical Biotechnologies, School of Dental Medicine, University of Siena, Siena, Italy
- Division of Oral Pathology, College of Dentistry, Department of Maxillofacial Surgery and Diagnostic Sciences, Jazan University, Jazan, Saudi Arabia
| | - Krishna Patel
- Institute of Bioinformatics, International Technology Park, Bangalore, India
| | - Jayshree Advani
- Institute of Bioinformatics, International Technology Park, Bangalore, India
| | | | | | - Niraj Babu
- Institute of Bioinformatics, International Technology Park, Bangalore, India
- Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | - Hitendra Solanki
- Institute of Bioinformatics, International Technology Park, Bangalore, India
| | - Shilpa Bhandi
- Division of Operative Dentistry, College of Dentistry, Department of Restorative Dental Sciences, Jazan University, Jazan, Saudi Arabia
| | - David Sidransky
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Aditi Chatterjee
- Institute of Bioinformatics, International Technology Park, Bangalore, India
- Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | - Harsha Gowda
- Institute of Bioinformatics, International Technology Park, Bangalore, India
- Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | - Marco Ferrari
- Department of Medical Biotechnologies, School of Dental Medicine, University of Siena, Siena, Italy
- Department of Restorative Dentistry, School of Dentistry, University of Leeds, Leeds, UK
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Soule EK, Ramôa C, Eissenberg T, Cobb CO. Differences in puff topography, toxicant exposure, and subjective response between waterpipe tobacco smoking men and women. Exp Clin Psychopharmacol 2018; 26:440-447. [PMID: 30102062 PMCID: PMC6162145 DOI: 10.1037/pha0000207] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Waterpipe tobacco smoking (WTS) exposes users to toxicants in much greater amounts than a cigarette. Little is known about how gender affects WTS toxicant exposure and subjective response. Data from three WTS clinical laboratory studies were combined for analysis. Participants (N = 99; 38 women) completed a 45-min WTS session where they smoked a waterpipe ad libitum. Puff topography was measured throughout, and plasma nicotine concentration, expired air carbon monoxide (CO), and subjective responses were measured pre- and post-WTS. There was a gender effect for total puff volume with men inhaling a greater smoke volume, on average (M = 59.9 L, SD = 40.7), compared with women (M = 38.8 L, SD = 27.8; p < .01). Men had greater post-WTS mean plasma nicotine concentrations (M = 10.0 ng/ml, SD = 7.1) compared with women (M = 6.9 ng/ml, SD = 5.2; p < .05). Post-WTS expired air CO was not associated with gender (men M = 27.6 ppm, SD = 18.9; women M = 22.7 ppm, SD = 17.0, ns). Relative to men, women had higher post-WTS scores for subjective measures of "nauseous," "dizzy," "nervous," "headache," and "heart pounding." Men and women are exposed to toxicants during WTS, and men may achieve higher nicotine exposure than women, likely resulting from differences in smoke inhaled. However, similar post-WTS expired air CO between men and women and higher ratings of negative subjective responses among women may indicate that factors beyond puff topography may impact toxicant exposure and subjective response to WTS. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Javed F, ALHarthi SS, BinShabaib MS, Gajendra S, Romanos GE, Rahman I. Toxicological impact of waterpipe smoking and flavorings in the oral cavity and respiratory system. Inhal Toxicol 2017; 29:389-396. [PMID: 29039225 PMCID: PMC5927775 DOI: 10.1080/08958378.2017.1384084] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Waterpipe smoking (WS), an emerging trend has major health concerns. It is prevalent worldwide as a recreational activity both indoors and outdoors. The aim of this review was to assess the impact of waterpipe smoke on the oral and respiratory system (oral cavity and pulmonary tissues). A number of studies have shown that periodontal health status is compromised in waterpipe smokers when compared with nonsmokers. Some studies have associated WS with oral premalignant and malignant lesions; however, due to the poor quality of these studies, the presented outcomes should be interpreted with caution. Although cigarette smoking has been considered as a potential risk factor for dental caries; there are no studies in indexed literature that have shown an association to exist between dental caries and WS. Inhaled waterpipe smoke imposes oxidative stress and inflammatory responses and compromises the ventilatory capacity of the lungs and may lead to an increased risk of decline in lung function. WS may cause oral and pulmonary diseases, such as periodontal disease and chronic obstructive airway disease, respectively. The association between WS and development of dental caries and oral pre-cancer and their relationships with chronic airways disease requires investigations. This review discusses the current evidence of waterpipe smoke effects on the oral health and respiratory system based on basic and clinical science and provides future directions for research and regulatory science on how WS can affect the oral cavity and the respiratory/pulmonary system.
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Affiliation(s)
- Fawad Javed
- Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, NY, USA
| | - Shatha Subhi ALHarthi
- Department of Periodontology, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia
| | - Munerah Saleh BinShabaib
- Department of Periodontology, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia
| | - Sangeeta Gajendra
- Department of Community Dentistry, Eastman Institute for Oral Health, University of Rochester, NY, USA
| | - Georgios E. Romanos
- Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Irfan Rahman
- Department of Environmental Medicine, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA
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Cohn AM, Ehlke SJ, Cobb CO, Soule EK. Hookah tobacco smoking in a large urban sample of adult cigarette smokers: Links with alcohol and poly-tobacco use. Addict Behav 2017; 68:1-5. [PMID: 28086138 PMCID: PMC5293175 DOI: 10.1016/j.addbeh.2016.12.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 12/15/2016] [Accepted: 12/23/2016] [Indexed: 10/20/2022]
Abstract
Hookah tobacco smoking (HTS) has been increasing, particularly among young adults and has similar health effects compared to cigarette smoking. The link between HTS and poly-tobacco use is well documented, but fewer show an association between HTS and alcohol use. It is essential to identify factors that increase the risk for or addictiveness and consequences of HTS, given its growing prevalence. This study examined whether the association between HTS and poly-tobacco use differed as a function of age and alcohol consumption within in a sample of 1223 adult cigarette smokers. Approximately 20% of participants reported HTS. Compared to non-users, hookah users were more likely to be male, highly educated, and to report drug and alcohol use, binge drinking, and poly-tobacco use but were less likely to be heavy smokers (≥10 cigarettes per day). Regression analyses predicting number of tobacco products used (excluding cigarettes and HTS) indicated a three-way interaction of HTS, frequency of alcohol use, and age such that the association between HTS and number of tobacco products used was strongest for younger respondents who consumed alcohol more frequently. As observed in previous studies, alcohol is an important risk factor in the relationship between HTS and poly-tobacco use, particularly among younger cigarette smokers. The links between alcohol, HTS, and poly-tobacco use should be considered when developing HTS education and prevention materials directed toward younger cigarette smokers. Findings provide information relevant to FDA's interest in the addiction potential of HTS and its link to poly-tobacco use.
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Affiliation(s)
- Amy M Cohn
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, 900 G Street NW, 4th Floor, Washington, DC, USA; Department of Oncology, Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, 3970 Reservoir Road NW, Washington, DC, USA.
| | - Sarah J Ehlke
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, 900 G Street NW, 4th Floor, Washington, DC, USA
| | - Caroline O Cobb
- Department of Psychology and Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
| | - Eric K Soule
- Department of Psychology and Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
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Ali M, Jawad M. Health Effects of Waterpipe Tobacco Use: Getting the Public Health Message Just Right. Tob Use Insights 2017; 10:1179173X17696055. [PMID: 28579844 PMCID: PMC5428225 DOI: 10.1177/1179173x17696055] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 02/06/2017] [Indexed: 12/22/2022] Open
Abstract
Many public health messages benchmark the harms of waterpipe tobacco against those of cigarettes, usually using numerical magnitudes of risk. This approach, although well intentioned, could be perceived as alarmist, damaging scientific credibility, and giving an unintended impression that one tobacco product is less harmful than the other. This commentary makes clear the harm waterpipe tobacco smoking poses to public health by describing its mechanism of use, consumption uptake, toxicologic profile, and documented health outcomes, as well as challenge existing thinking that toxicologic assessments are the most appropriate way to frame waterpipe tobacco health promotion messages. How can we describe the health effects of waterpipe tobacco without undermining its toxicity nor falling into the temptation of alarmist messaging? Several recommendations are provided.
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Affiliation(s)
| | - Mohammed Jawad
- Department of Primary Care and Public Health, Imperial College London, London, UK
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Ramôa CP, Eissenberg T, Sahingur SE. Increasing popularity of waterpipe tobacco smoking and electronic cigarette use: Implications for oral healthcare. J Periodontal Res 2017; 52:813-823. [PMID: 28393367 DOI: 10.1111/jre.12458] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2017] [Indexed: 01/02/2023]
Abstract
Cigarette smoking increases the risk of developing several systemic conditions including cancer, cardiovascular and pulmonary diseases. Cigarette smoking is also detrimental to oral health as it increases the incidence and severity of oral cancer, periodontal diseases and peri-implantitis, as well as impacting negatively on the dental patients' response to therapy. Therefore, consideration of smoking behavior and recommendation of smoking cessation are important parts of dental treatment planning. However, cigarettes are no longer the most popular form of tobacco use among adolescents in the United States and globally. In recent years, tobacco smoking using a waterpipe ("hookah," "shisha") and use of electronic cigarettes (ECIGs) has increased significantly. Thus, dental clinicians likely will treat more patients who are waterpipe and/or ECIG users. Yet, the literature on the health effects of waterpipe and ECIGs use is sparse. Both waterpipe and ECIGs deliver the dependence-producing drug nicotine. Waterpipe tobacco smoking has been associated with periodontitis, dry socket, premalignant lesions, and oral and esophageal cancer. The health effects of long-term ECIG use are unknown. The purpose of this review is to inform healthcare professionals about waterpipes and ECIGs, highlight emerging evidence on the biological effects of these increasingly popular tobacco products, and introduce perspectives for dental patient management and future research.
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Affiliation(s)
- C P Ramôa
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - T Eissenberg
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - S E Sahingur
- Department of Periodontics, Virginia Commonwealth University, Richmond, VA, USA.,Philips Institute for Oral Health Research, Virginia Commonwealth University, Richmond, VA, USA
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Awan KH, Siddiqi K, Patil S, Hussain QA. Assessing the Effect of Waterpipe Smoking on Cancer Outcome - a Systematic Review of Current Evidence. Asian Pac J Cancer Prev 2017; 18:495-502. [PMID: 28345836 PMCID: PMC5454749 DOI: 10.22034/apjcp.2017.18.2.495] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Background: Waterpipe smoking (WPS) is widely believed to be a safe and hazard-free tobacco habit. However,
a number of studies have indicated that exposure to several toxicants and carcinogens through WPS is strongly related
to serious health hazards. The current paper presents a narrative review on the effects of WPS on cancer outcome.
Methods: The addressed focused question was “Is there an association between waterpipe smoking and cancer outcome?”
PubMed, Medline, EMBASE, ISI Web of Science and the Cochrane databases were searched until June 2015 using the
key words “Waterpipe”, “Hookah”, “Narghileh”, “Shisha”, “Hubbly Bubbly” “cancer” in various combinations. Letters
to the Editor, review articles, case-reports and unpublished articles were excluded. Results: A total of 16 studies were
included: six on lung cancer, three on oesophageal cancer, two on gastric cancer, two on bladder cancer, and one each
on nasopharyngeal, pancreatic and prostate cancers. Our search did not yield any study that evaluated the risk of oral
cancer in WPS users. The available evidence showed a significant association of WPS with lung cancer (UOR 6.0, 95%
CI 1.78–20.26); however, no association was observed with bladder, nasopharyngeal, pancreatic and prostate cancers.
Gastric (OR 3.4, 95% CI 1.7-7.1) and oesophageal cancers (OR 1.85, 95% CI 1.41-2.44) were observed to have weak
associations with WPS. Conclusion: Regardless of the limitations, there is sufficient evidence to suggest associations
of WPS with cancer, particularly in the lung. Future well-designed studies are required to identify and quantify with
confidence all the health effects of this form of smoking.
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Affiliation(s)
- Kamran Habib Awan
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, Utah 84095, United States.
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Kim KH, Kabir E, Jahan SA. Waterpipe tobacco smoking and its human health impacts. JOURNAL OF HAZARDOUS MATERIALS 2016; 317:229-236. [PMID: 27285594 DOI: 10.1016/j.jhazmat.2016.05.075] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 01/23/2016] [Accepted: 05/25/2016] [Indexed: 05/12/2023]
Abstract
Waterpipe tobacco smoking (WTS, also known as hookah, shisha, narghile, and many other names) involves passing tobacco smoke through water prior to inhalation by the consumer. As the number of waterpipe smokers is rising rapidly, there is growing concern over the use of WTS, particularly as there has been a widely held misconception that WTS is free from health hazards. In reality, it is associated with a variety of adverse health outcomes on both a short- and long-term basis. Hence, it is desirable to develop advanced techniques for surveillance, intervention, and regulatory/policy frameworks specific to the production and use of waterpipe tobacco. This review is written to survey the types and extent of pollutants released from its use and their potential health risks. A review of the present regulation guidelines is also included.
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Affiliation(s)
- Ki-Hyun Kim
- Department of Civil and Environmental Engineering, Hanyang University, Seoul 04763, Republic of Korea.
| | - Ehsanul Kabir
- Department of Farm, Power, and Machinery, Bangladesh Agricultural University, Mymensingh, Bangladesh
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Die Wasserpfeife (Shisha) – Innenraumluftqualität, Human-Biomonitoring und Gesundheitseffekte. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2016; 59:1593-1604. [DOI: 10.1007/s00103-016-2462-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Cancer risk in waterpipe smokers: a meta-analysis. Int J Public Health 2016; 62:73-83. [PMID: 27421466 PMCID: PMC5288449 DOI: 10.1007/s00038-016-0856-2] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 05/16/2016] [Accepted: 07/08/2016] [Indexed: 01/08/2023] Open
Abstract
Objectives To quantify by meta-analysis the relationship between waterpipe smoking and cancer, including cancer of the head and neck, esophagus, stomach, lung and bladder. Methods We performed a systematic literature search to identify relevant studies, scored their quality, used fixed and random-effect models to estimate summary relative risks (SRR), evaluated heterogeneity and publication bias. Results We retrieved information from 28 published reports. Considering only highquality studies, waterpipe smoking was associated with increased risk of head and neck cancer (SRR 2.97; 95 % CI 2.26–3.90), esophageal cancer (1.84; 1.42–2.38) and lung cancer (2.22; 1.24–3.97), with no evidence of heterogeneity or publication bias. Increased risk was also observed for stomach and bladder cancer but based mainly on poor-quality studies. For colorectum, liver and for all sites combined risk estimates were elevated, but there were insufficient reports to perform a meta-analysis. Conclusions Contrary to the perception of the relative safety of waterpipe smoking, this meta-analysis provides quantitative estimates of its association with cancers of the head and neck, esophagus and lung. The scarcity and limited quality of available reports point out the need for larger carefully designed studies in well-defined populations.
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Haddad L, Kelly DL, Weglicki LS, Barnett TE, Ferrell AV, Ghadban R. A Systematic Review of Effects of Waterpipe Smoking on Cardiovascular and Respiratory Health Outcomes. Tob Use Insights 2016; 9:13-28. [PMID: 27398028 PMCID: PMC4934173 DOI: 10.4137/tui.s39873] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 06/01/2016] [Accepted: 06/03/2016] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Waterpipe smoking (WPS) is a social custom common in many Middle Eastern, North African, and Asian countries and has become increasingly popular in the US, especially among youth; however, WPS smoking may be increasing in the US adult population as well. There is a common belief among waterpipe (WP) smokers that WPS is less harmful than smoking cigarettes. Thus, this review aims to systematically explore the literature on the effects of WP tobacco smoking with a particular focus on cardiovascular and respiratory health outcomes as well as on oxidative stress, immunity, and cell cycle interference health outcomes. METHODOLOGY We conducted a systematic review, guided by the criteria of The Preferred Reporting Items for Systematic Reviews and Meta-Analyses, using the following online databases MEDLINE, CINAHL, ScienceDirect, PMC, and Cochrane Library. Results were summarized qualitatively. RESULTS Forty studies met the inclusion criteria established for this review. Based on the existing evidence, several cardiovascular and respiratory physiologic health indicators and conditions have been shown to be negatively affected by WPS. In addition to the effects of nicotine and chemical toxicant exposures, WPS was significantly associated with an increase in heart rate, blood pressure, and lower pulmonary function test results, as well as a number of health conditions such as lung cancer, alterations in oxidative stress, immunity, and cell cycle interference. CONCLUSION The current literature provides evidence that WPS is associated with a number of negative health indicators and outcomes. There is need for more research related to WPS and its effects on health so that appropriate campaigns and prevention interventions can be implemented to control the epidemic increase of WPS in the US.
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Affiliation(s)
- Linda Haddad
- Associate Dean for Academic Affairs, College of Nursing, University of Florida, Gainesville, FL, USA.,CORRESPONDENCE:
| | - Debra Lynch Kelly
- Assistant Professor, College of Nursing, University of Florida, Gainesville, FL, USA
| | - Linda S. Weglicki
- Professor and Schmidt Family Foundation Distinguished Professor, Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, USA
| | - Tracey E. Barnett
- Associate Professor, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | | | - Roula Ghadban
- School of Nursing, Virginia Commonwealth University, Richmond, VA, USA
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Abdo N, Khader YS, Abdelrahman M, Graboski-Bauer A, Malkawi M, Al-Sharif M, Elbetieha AM. Respiratory health outcomes and air pollution in the Eastern Mediterranean Region: a systematic review. REVIEWS ON ENVIRONMENTAL HEALTH 2016; 31:259-280. [PMID: 27101544 DOI: 10.1515/reveh-2015-0076] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 02/11/2016] [Indexed: 06/05/2023]
Abstract
Exposure to air pollution can cause detrimental health and be an economic burden. With newly developed equipment, monitoring of different air pollutants, identifying the sources, types of air pollutants and their corresponding concentrations, and applying mitigation intervention techniques became a crucial step in public health protection. Countries in the Eastern Mediterranean Region (EMR) are highly exposed to dust storms, have high levels of particulate matter (PM) concentrations, and have a unique climatic as well as topographic and socio-economic structure. This is the first study conducted to systemically and qualitatively assess the health impacts of air pollution in the EMR, identify susceptible populations, and ascertain research and knowledge gaps in the literature to better inform decisions by policy makers. We screened relevant papers and reports published between 2000 and 2014 in research databases. A total of 36 published studies met the inclusion criteria. A variety of indoor and outdoor exposures associated with various acute and chronic respiratory health outcomes were included. Respiratory health outcomes ranged in severity, from allergies and general respiratory complaints to lung cancer and mortality. Several adverse health outcomes were positively associated with various indoor/outdoor air pollutants throughout the EMR. However, epidemiological literature concerning the EMR is limited to a few studies in a few countries. More research is needed to elucidate the health outcomes of air pollution. Standardized reliable assessments on the national level for various air pollutants in different regions should be implemented and made publically available for researchers to utilize in their research. Moreover, advancing and utilizing more sound epidemiological designs and studies on the effect of air pollution on the respiratory health outcomes is needed to portray the actual situation in the region.
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Montazeri Z, Nyiraneza C, El-Katerji H, Little J. Waterpipe smoking and cancer: systematic review and meta-analysis. Tob Control 2016; 26:92-97. [PMID: 27165994 DOI: 10.1136/tobaccocontrol-2015-052758] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 04/19/2016] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Although accumulating evidence suggests harmful effects of waterpipe smoking, there is limited information about its direct association with chronic diseases, notably cancer. We provide an up-to-date systematic review and meta-analysis of the association between waterpipe smoking and cancer. DATA SOURCES Systematic search of articles indexed in main biomedical databases: Pubmed, EmBase, Google Scholar and Web of Science, published between 1962 and September 2014. Search keywords included a combination of waterpipe or hookah, sheesha, nargile, hubble-bubble, goza or gaylan, and cancer. STUDY SELECTION Focus on observational studies (cohort, case-control, cross-sectional) that evaluated the association between waterpipe smoking and cancer. Studies with mixed exposures excluded. DATA EXTRACTION Two investigators independently extracted data and reached consensus on all items. DATA SYNTHESIS 13 case-control studies met the inclusion criteria and were considered for meta-analysis. The methodological quality of included studies was assessed using the Newcastle-Ottawa Scale (NOS). Meta-analysis revealed a positive association between waterpipe smoking and lung cancer (OR=4.58 (2.61 to 8.03); I2=44.67%), and oesophageal cancer (OR=3.63 (1.39 to 9.44); I2 =94.49%). The majority of studies had a NOS score of 5-6 or 7, indicating 'fair' or 'good' quality, respectively. CONCLUSIONS Our findings support a positive association between waterpipe smoking and cancer risk. However, high-quality studies with standardised exposure measurements are needed to clarify the contribution of waterpipe smoking to chronic diseases. More investments in initiatives for surveillance, intervention and regulatory policy for waterpipe smoking are urgently warranted.
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Affiliation(s)
- Zahra Montazeri
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Christine Nyiraneza
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Hoda El-Katerji
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Julian Little
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
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16
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Soule EK, Lipato T, Eissenberg T. Waterpipe tobacco smoking: A new smoking epidemic among the young? CURRENT PULMONOLOGY REPORTS 2015; 4:163-172. [PMID: 26756025 PMCID: PMC4706079 DOI: 10.1007/s13665-015-0124-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Waterpipe (hookah, narghile) tobacco smoking (WTS) is becoming prevalent worldwide and is one of the most popular forms of tobacco use among youth. WTS prevalence has increased dramatically among youth in the United States within the past decade. Misperceived as less harmful than cigarette smoking, WTS is associated with many of the same chronic health effects such as lung cancer, chronic obstructive pulmonary disease, cardiovascular disease, bronchitis, and asthma. Much of this risk is due to the fact that a single WTS session exposes users to large volumes of smoke that contain toxic chemicals such as carbon monoxide, cancer-causing polycyclic aromatic hydrocarbons, and volatile aldehydes. Unlike cigarette smoking, WTS poses unique risks of acute negative health outcomes including carbon monoxide poisoning and the spread of communicable diseases such as herpes and tuberculosis. Because waterpipe tobacco smoke contains the addictive chemical nicotine, youth who smoke tobacco from a waterpipe may be at risk for dependence. As a result, many youth may initiate WTS and continue to use despite negative health effects. Considering many of the potential negative health effects associated with WTS affect the pulmonary system, pulmonologists and primary care providers may treat patients who are waterpipe tobacco smokers and should be aware of the risk associated with WTS. The purpose of this review is to describe a waterpipe, the prevalence and correlates of WTS, the toxicants found in waterpipe tobacco smoke, the health effects of WTS, and implications for pulmonologists and other clinicians.
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Affiliation(s)
- Eric K. Soule
- Virginia Commonwealth University, Department of Psychology, Center for the Study of Tobacco Products, PO Box 980205, Richmond, VA 23298, USA, Phone: 804-827-3562
| | - Thokozeni Lipato
- Virginia Commonwealth University, School of Medicine, PO Box 980102, Richmond, VA 23298, USA, Phone: 804-628-3626
| | - Thomas Eissenberg
- Virginia Commonwealth University, Department of Psychology, Center for the Study of Tobacco Products, PO Box 980205, Richmond, VA 23298, Phone: 804-827-4617, Fax: 804-828-7862
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17
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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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18
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Masadeh MM, Hussein EI, Alzoubi KH, Khabour O, Shakhatreh MAK, Gharaibeh M. Identification, characterization and antibiotic resistance of bacterial isolates obtained from waterpipe device hoses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:5108-15. [PMID: 25985311 PMCID: PMC4454957 DOI: 10.3390/ijerph120505108] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 05/05/2015] [Accepted: 05/08/2015] [Indexed: 12/23/2022]
Abstract
The general lack of knowledge about the health effects of waterpipe smoking is among the reasons for its global spread. In this study, bacterial contamination of waterpipe hoses was investigated. Twenty hoses were collected from waterpipe cafés and screened for bacterial pathogens using standard culture and isolation techniques. Additionally, resistance of isolated bacteria to common antibiotics was determined by identifying the minimum inhibitory concentration (MIC) of each isolate. Forty eight bacterial isolates were detected. Isolates included both Gram-positive and Gram-negative pathogens from species that included Micrococcus (12), Corynebacterium (13) and Bacillus (9). In addition, some of the detected pathogens were found to be resistant to aztreonam (79%), cefixime (79%), norfloxacin, amoxicillin (47%), clarithromycin (46%) and enrofloxacin (38%). In conclusion, the hose of the waterpipe device is a good environment for the growth of bacterial pathogens, which can then be transmitted to users.
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Affiliation(s)
- Majed M Masadeh
- Department of Pharmaceutical Technology, Jordan University of Science and Technology, Irbid 22110, Jordan.
| | - Emad I Hussein
- Department of Biology, Yarmouk University, Irbid 22110, Jordan.
| | - Karem H Alzoubi
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid 22110, Jordan.
| | - Omar Khabour
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan:.
- Department of Biology, Faculty of Science, Taibah University, Medina 41411, Saudi Arabia.
| | - Muhamad Ali K Shakhatreh
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan:.
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El-Zaatari ZM, Chami HA, Zaatari GS. Health effects associated with waterpipe smoking. Tob Control 2015; 24 Suppl 1:i31-i43. [PMID: 25661414 PMCID: PMC4345795 DOI: 10.1136/tobaccocontrol-2014-051908] [Citation(s) in RCA: 239] [Impact Index Per Article: 26.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 12/23/2014] [Accepted: 01/15/2015] [Indexed: 01/07/2023]
Abstract
OBJECTIVE It is widely held that waterpipe smoking (WPS) is not associated with health hazards. However, several studies have documented the uptake of several toxicants and carcinogens during WPS that is strongly associated with harmful health effects. This paper reviews the literature on the health effects of WPS. DATA SOURCES Three databases-PubMed, MEDLINE and EMBASE-were searched until August 2014 for the acute and long-term health effects of WPS using the terms 'waterpipe' and its synonyms (hookah, shisha, goza, narghileh, arghileh and hubble-bubble) in various spellings. STUDY SELECTION We included original clinical studies, case reports and systematic reviews and focused on clinical human studies. ∼10% of the identified studies met the selection criteria. DATA EXTRACTION Data were abstracted by all three authors and summarised into tables. Abstracted data included study type, results and methodological limitations and were analysed jointly by all three authors. DATA SYNTHESIS WPS acutely leads to increased heart rate, blood pressure, impaired pulmonary function and carbon monoxide intoxication. Chronic bronchitis, emphysema and coronary artery disease are serious complications of long-term use. Lung, gastric and oesophageal cancer are associated with WPS as well as periodontal disease, obstetrical complications, osteoporosis and mental health problems. CONCLUSIONS Contrary to the widely held misconception, WPS is associated with a variety of adverse short-term and long-term health effects that should reinforce the need for stronger regulation. In addition, this review highlights the limitations of the published work, which is mostly cross-sectional or retrospective. Prospective studies should be undertaken to assess the full spectrum of health effects of WPS, particularly in view of its growing popularity and attractiveness to youth.
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Affiliation(s)
- Ziad M El-Zaatari
- Department of Pathology and Laboratory Medicine, American University of Beirut, Beirut, Lebanon
| | - Hassan A Chami
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon Boston University School of Medicine, Boston, Massachusetts, USA
| | - Ghazi S Zaatari
- Department of Pathology and Laboratory Medicine, American University of Beirut, Beirut, Lebanon
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