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Bhargava SS, Das S, Priya H, Mishra D, Shivabasappa S, Sood A, Hazarika CR, Gupta PC, Chakma JK, Swasticharan L, Sinha P, Munish VG, Gupta SR. The Burden and Correlates of Waterpipe (Hookah) Smoking among Adolescents and Youth: A Systematic Review. Subst Use Misuse 2023; 59:29-40. [PMID: 37907086 DOI: 10.1080/10826084.2023.2257320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
BACKGROUND This systematic review evaluated the available medical literature on the prevalence and trends of waterpipe tobacco smoking among adolescents and youth in jurisdictionally representative populations. METHODS PubMed, Embase, and Scopus were searched for relevant studies from inception until 31 December 2022 that reported the burden of waterpipe smoking among adolescents and youth (10-24 years of age). We extracted qualitative data on the demographic characteristics, burden, and correlates of waterpipe smoking (PROSPERO ID: CRD42022310982). RESULTS A total of 2,197 articles were screened and 62 were included in the analysis. The majority (29) of the studies was from the United States of America and there were no studies from the south-east Asian region. The prevalence of ever waterpipe smoking among the 10-24 years age group was noted to be 18.16% (95% CI, 18.03-18.29). The prevalence of current (30-day) waterpipe smoking was 6.43% (95% CI, 6.34-6.50). The age of initiation of waterpipe smoking was variable. The prevalence of waterpipe smoking was higher among males, among those who belong to the high- and middle-income groups, and among university students. The common risk factors of waterpipe smoking included cigarette smoking, alcohol, and substance use. Waterpipe smoking resulted in increased susceptibility to the use of conventional forms of tobacco (e.g. smoking) among those who were never smokers. CONCLUSION Waterpipe smoking usage was significantly high among adolescents and young adults. Developing regulatory guidelines for water-pipe smoking, surveillance of its use, intervention, and specific policy frameworks may be considered a public health priority.
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Affiliation(s)
- Stuti Sharad Bhargava
- Division of Non Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Saibal Das
- Indian Council of Medical Research - Centre for Ageing and Mental Health, Kolkata, India
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Harsh Priya
- Department of Public Health Dentistry, Centre for Dental Education and Research, All India institute of Medical Sciences, New Delhi, India
| | - Deepika Mishra
- Department of Oral Pathology and Microbiology, Centre for Dental Education and Research, All India institute of Medical Sciences, New Delhi, India
| | - Santhosh Shivabasappa
- Department of Clinical Pharmacology, Jawaharlal Institute of Postgraduate Medical Eductaion and Research, Puducherry, India
| | - Anubhuti Sood
- Translational Health Science and Technology Institute, Faridabad, India
| | - Chaya Rani Hazarika
- Socio-Behavioral Health Systems and Implementation Research Division, Indian Council of Medical Research, New Delhi, India
| | | | - Joy Kumar Chakma
- Division of Non Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Leimapokpam Swasticharan
- Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, New Delhi, India
| | | | | | - Shalini R Gupta
- Department of Oral Medicine and Radiology, Centre for Dental Education and Research, All India institute of Medical Sciences, New Delhi, India
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Abstract
Objectives Health warning messages could be an effective means of communicating the health risks associated with waterpipe (WP) smoking. The objective of this study was to select a message that conveyed the risks associated with WP smoking. Methods A mixed-methods approach was used to explore the effectiveness of the Food and Drug Administration's (FDA's) mandated message, and others, among young adults using focus groups and surveys. Two focus group studies and one convenience survey were conducted to examine the FDA's mandated message and 11 other WP warning messages. The final study, conducted with a random sample of first-year university students, examined the effectiveness and reactance of the chosen message using previously validated items (scored on a 1-5 scale). Results The FDA's mandated message did not resonate well with focus group participants. In the random sample of students, the top message (WARNING: Hookah smoke contains poisons that cause lung and oral cancers) had high effectiveness (M = 4.49) and a low reactance (M = 2.12). Conclusions Our studies suggest that other messages are more effective for communicating the risks associated with WP smoking than the FDA's message for WP tobacco.
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Shadel WG, Tucker JS, Seelam R, Golinelli D, Siconolfi D. Associations of Tobacco Advertising Appeal With Intentions to Use Alternative Tobacco Products Among Young Tobacco Users Experiencing Homelessness. Am J Health Promot 2019; 34:132-141. [PMID: 31581783 DOI: 10.1177/0890117119878350] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE Virtually nothing is known about the potential effects of tobacco advertising on tobacco use among youth experiencing homelessness, a vulnerable population with high tobacco use rates. This study examines associations between the appeal of advertising for 5 classes of tobacco product (electronic cigarettes, hookah, cigars, cigarillos, and smokeless tobacco) and future intentions to use those products again among homeless youth who had indicated any level of lifetime use. DESIGN A cross-sectional design was used. SETTING Settings were 25 service and street sites in Los Angeles County. PARTICIPANTS A probability sample of 469 young tobacco users experiencing homelessness (mean age = 22; 71% male; 29% non-Hispanic White) was recruited. MEASURES Assessments included product-specific tobacco advertising appeal and future intentions to use the product again, as well as a range of covariate controls (eg, demographics, homelessness severity, current tobacco use, general advertising exposure). ANALYSIS Linear regression tested for associations between the appeal of advertising for a specific tobacco product and intentions to use that product again in the future, controlling for myriad covariates. RESULTS Advertising appeal was positively associated with future intentions to use again for electronic cigarettes (P = .006) and hookah (P = .001), but not cigars (P = .486), cigarillos (P = .126), or smokeless tobacco (P = .109). CONCLUSION Results suggest that advertising appeal may increase use of certain tobacco products among youth experiencing homelessness. However, differences in themes emphasized by advertising for specific tobacco products could differentially influence use in this population.
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Araújo RDS, Milhomem YDO, Pereira HFS, Silva Junior JLRD. Fatores relacionados ao consumo do narguilé entre estudantes de medicina. J Bras Pneumol 2019; 45:e20180184. [PMID: 31644706 PMCID: PMC8653977 DOI: 10.1590/1806-3713/e20180184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 02/13/2019] [Indexed: 11/21/2022] Open
Abstract
Objective This study evaluated the factors related to the use of hookah among medical students, the level of knowledge about the involved harms, and their relationship with the use and intention to stop using it. Methods Students of the 1st and 6th year of medical school were evaluated. A multivariate logistic regression model was used to evaluate the association between the outcome (use of hookah in the last 30 days) and demographic, subjective psychosocial data and level of knowledge about the harms of hookah use. Results The experimentation rate of hookah and current use was high (59.6% and 27.7%, respectively), with no difference between the 1st and 6th year groups (p=0.70). The 6th grade students were more knowledgeable about the harm of using hookah when compared to the 1st year students (p <0.0001), and there was no association between the use of hookah in the last 30 days and the knowledge about its harms. Cigarette smoking and the use of alcoholic beverages were associated with the use of hookah in the last 30 days, with unadjusted Odds Ratio (OR) of 11.3; 95% CI 4.62-27.7; p <0.0001 and OR 8.74; 95% CI 3.78-20.2; p <0.0001; respectively. Conclusion There is a high experimentation, current use of hookah and cigarettes among medical students. Sixth year students are more knowledgeable about the harms involved. There was no association between the use of hookah in the last 30 days and the knowledge about its harms. Smoking and the use of alcoholic beverages are independent predictors of use of hookah.
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Lopez AA, Redner R, Kurti AN, Keith DR, Villanti AC, Stanton CA, Gaalema DE, Bunn JY, Doogan NJ, Cepeda-Benito A, Roberts ME, Higgins ST. Tobacco and nicotine delivery product use in a U.S. national sample of women of reproductive age. Prev Med 2018; 117:61-68. [PMID: 29559222 PMCID: PMC6141351 DOI: 10.1016/j.ypmed.2018.03.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 03/01/2018] [Accepted: 03/09/2018] [Indexed: 01/07/2023]
Abstract
This study examined prevalence and correlates of using cigarettes, e-cigarettes, and other tobacco/nicotine delivery products in a U.S. national sample of women of reproductive age. Weighted data were obtained from women aged 15-44 years who were not currently pregnant in the first wave of the Population Assessment of Health and Tobacco (PATH, 2013-2014) study (N = 12,848). 20.1% of women were current cigarette smokers, 5.9% current e-cigarette users, 4.9% current cigar smokers, and 6.5% current hookah users. Prevalence of current use of other tobacco products was <1.0%. Current cigarette smoking was the strongest correlate of current e-cigarette use (OR = 65.7, 95% CI = 44.8-96.5), cigar smoking (OR = 19.2, 95% CI = 14.1-26.1), and hookah use (OR = 6.6, 95% CI = 5.1-8.5). Among former cigarette smokers, 3.8%, 6.9%, and 3.2% were also currently using e-cigarettes, hookah, and cigars, respectively. Use of other tobacco and nicotine delivery products was low among those who never smoked tobacco cigarettes: 2.5% used hookah and <1.0% used other products. Cigarette smoking prevalence remains relatively high among women of reproductive age and strongly correlated with use of other tobacco products. Monitoring tobacco and nicotine use in this population is important due to the additional risk of adverse health impacts should they become pregnant. Clinicians working with cigarette smokers should assess for use of other tobacco products. Among women of reproductive age, use of emerging tobacco and nicotine products appears to be largely, although not exclusively, restricted to current cigarette smokers.
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Affiliation(s)
- Alexa A Lopez
- Vermont Center on Behavior and Health, University of Vermont, United States
| | - Ryan Redner
- Vermont Center on Behavior and Health, University of Vermont, United States; Rehabilitation Institute, Southern Illinois University, United States.
| | - Allison N Kurti
- Vermont Center on Behavior and Health, University of Vermont, United States; Department of Psychiatry, University of Vermont, United States
| | - Diana R Keith
- Vermont Center on Behavior and Health, University of Vermont, United States; Department of Psychiatry, University of Vermont, United States
| | - Andrea C Villanti
- Vermont Center on Behavior and Health, University of Vermont, United States; Department of Psychiatry, University of Vermont, United States
| | - Cassandra A Stanton
- Westat, Center for Evaluation and Coordination of Training and Research (CECTR) in Tobacco Regulatory Science, Department of Oncology, Georgetown University Medical Center, United States
| | - Diann E Gaalema
- Vermont Center on Behavior and Health, University of Vermont, United States; Department of Psychiatry, University of Vermont, United States
| | | | - Nathan J Doogan
- College of Public Health, The Ohio State University, United States
| | | | - Megan E Roberts
- College of Public Health, The Ohio State University, United States
| | - Stephen T Higgins
- Vermont Center on Behavior and Health, University of Vermont, United States; Department of Psychiatry, University of Vermont, United States; Department of Psychological Science, University of Vermont, United States
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Lazard AJ, Horrell L, Pikowski J, Cornacchione Ross J, Noar SM, Sutfin EL. Message and Delivery Preferences for Online Tobacco Education among Adolescents and Young Adults. JOURNAL OF HEALTH COMMUNICATION 2018; 23:735-742. [PMID: 30280989 PMCID: PMC6421838 DOI: 10.1080/10810730.2018.1523259] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Use of cigarettes and noncigarette tobacco products (NCTPs) among adolescents and young adults remains high. Strategies to communicate the risks of cigarettes and NCTPs are needed. Online tobacco education is one such strategy; however, there is little guidance for message development. We conducted four focus groups (n = 39) with adolescent and young adult to identify message and delivery preferences for online tobacco education. Participants evaluated three existing tobacco education websites. Transcripts were coded for preferred tobacco education message content, delivery, and willingness to use online tobacco education. Participants preferred novel, concise facts, embedded links to credible sources, and an anti-industry tone for website messages. Participants expressed an aversion to message strategies that relied on scare tactics or attempted to simulate youth media trends (e.g., overuse of hashtags). To increase exposure, participants recommended using social media to drive engagement. Results serve as guidelines for what information adolescents and young adults desire, as well as how they want this information communicated with online tobacco education. Our findings - youth prefer new, fact-based information that is conveyed concisely, with sources, without authoritative tones, and delivered via social media - provides guidance for how to develop online tobacco education for this at-risk population.
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Affiliation(s)
- Allison J Lazard
- a School of Media and Journalism , University of North Carolina at Chapel Hill , Chapel Hill , USA
- b Lineberger Comprehensive Cancer Center , University of North Carolina at Chapel Hill , Chapel Hill , USA
| | - Lindsey Horrell
- c School of Nursing , University of North Carolina at Chapel Hill , Chapel Hill , USA
- d Gillings School of Global Public Health , University of North Carolina at Chapel Hill , Chapel Hill , USA
| | - Jessica Pikowski
- e Center for Health Policy and Tobacco Research , RTI International - Research Triangle Park , Durham , USA
| | - Jennifer Cornacchione Ross
- f Department of Social Sciences and Health Policy , Wake Forest School of Medicine , Winston-Salem , USA
| | - Seth M Noar
- a School of Media and Journalism , University of North Carolina at Chapel Hill , Chapel Hill , USA
- b Lineberger Comprehensive Cancer Center , University of North Carolina at Chapel Hill , Chapel Hill , USA
| | - Erin L Sutfin
- f Department of Social Sciences and Health Policy , Wake Forest School of Medicine , Winston-Salem , USA
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Mehrotra A, Dean KM, Sinaiko AD, Sood N. Americans Support Price Shopping For Health Care, But Few Actually Seek Out Price Information. Health Aff (Millwood) 2018; 36:1392-1400. [PMID: 28784731 DOI: 10.1377/hlthaff.2016.1471] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The growing awareness of the wide variation in health care prices, increased availability of price data, and increased patient cost sharing are expected to drive patients to shop for lower-cost medical services. We conducted a nationally representative survey of 2,996 nonelderly US adults who had received medical care in the previous twelve months to assess how frequently patients are price shopping for care and the barriers they face in doing so. Only 13 percent of respondents who had some out-of-pocket spending in their last health care encounter had sought information about their expected spending before receiving care, and just 3 percent had compared costs across providers before receiving care. The low rates of price shopping do not appear to be driven by opposition to the idea: The majority of respondents believed that price shopping for care is important and did not believe that higher-cost providers were of higher quality. Common barriers to shopping included difficulty obtaining price information and a desire not to disrupt existing provider relationships.
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Affiliation(s)
- Ateev Mehrotra
- Ateev Mehrotra is an associate professor of health care policy and medicine in the Department of Health Care Policy at Harvard Medical School and the Beth Israel Deaconess Medical Center, both in Boston, Massachusetts
| | - Katie M Dean
- Katie M. Dean is a research assistant in the Department of Health Care Policy at Harvard Medical School
| | - Anna D Sinaiko
- Anna D. Sinaiko is an assistant professor in the Department of Health Policy and Management at the Harvard T. H. Chan School of Public Health, in Boston
| | - Neeraj Sood
- Neeraj Sood is a professor and vice dean for research at the Sol Price School of Public Policy and director of research at the Leonard D. Schaeffer Center for Health Policy and Economics, both at the University of Southern California, in Los Angeles
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Sutfin EL, Soule EK, McKelvey K, Jenson D. Implications and challenges for implementation of the FDA's final deeming rule for waterpipe tobacco. Tob Control 2018; 27:347-351. [PMID: 28667092 PMCID: PMC5748017 DOI: 10.1136/tobaccocontrol-2017-053634] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 04/28/2017] [Accepted: 05/09/2017] [Indexed: 11/04/2022]
Abstract
For the first time, the Food and Drug Administration's (FDAs) Center for Tobacco Products now has regulatory authority over all tobacco products, including waterpipe tobacco. In the rule expanding its authority to cover all tobacco products, the FDA uses largely a one-size-fits-all approach. However, several aspects of waterpipe tobacco smoking make it unique from other tobacco products, which may require more specific, tailored rules. This paper describes the distinct features of waterpipe tobacco products and accessories, and identifies unique challenges to the current regulation posed by this form of tobacco use. Additionally, we highlight the need for further research-generated evidence to support additional rulemaking.
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Affiliation(s)
- Erin L Sutfin
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Eric K Soule
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Karma McKelvey
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA, USA
| | - Desmond Jenson
- Tobacco Control Legal Consortium, a program of the Public Health Law Center, Mitchell Hamline School of Law, St Paul, MN, USA
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Abudayyeh HS, Glasser AM, Johnson AL, Cohn AM, Wagener TL, Mays D, Villanti AC. Social and substance use correlates of adult hookah use, 2016. Addict Behav 2018; 79:39-44. [PMID: 29245025 PMCID: PMC5807119 DOI: 10.1016/j.addbeh.2017.12.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 12/07/2017] [Accepted: 12/08/2017] [Indexed: 12/24/2022]
Abstract
Introduction Hookah prevalence has been increasing in U.S. adults. This study examines correlates and frequency of hookah use in a national sample of U.S. adults (18–44 years). Methods Data were drawn from Wave 10 (October 2016) respondents aged 18–44 years from the Truth Initiative Young Adult Cohort Study (n=4,085). Weighted bivariate analyses were used to estimate correlates and frequency of hookah use, and differences between past 30-day and noncurrent hookah users on social and substance use (alcohol, marijuana, and other drugs) correlates. Results Twenty percent of the sample ever used hookah, and 2% used hookah in the past 30 days. Compared to never users and non-current users, a significantly greater proportion of ever and past 30-day hookah users reported past 30-day e-cigarette, tobacco, and substance use (p’s<0.01). Eighty-one percent of past 30-day hookah users had at least one close friend who also used hookah, and 35% self-identified as social/occasional smokers. The majority (68%) of past 30-day users reported hookah use on fewer than five of the past 30 days, and 58% engaged in two or more hookah sessions on those days. Conclusions Ever and past 30-day hookah use are associated with concurrent tobacco, e-cigarette, and substance use. They are also correlated with peer hookah use and self-identification as a social/occasional smoker. Even infrequent hookah sessions can expose users to health risks. Research identifying contexts in which hookah is used and how it is used with other substances is needed to inform interventions to reduce hookah use.
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Affiliation(s)
- Haneen S Abudayyeh
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, 900 G St NW, Fourth Floor, Washington, DC 20001, USA; Battelle Memorial Institute, 2111 Wilson Blvd, #1000, Arlington, VA 22201, USA.
| | - Allison M Glasser
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, 900 G St NW, Fourth Floor, Washington, DC 20001, USA
| | - Amanda L Johnson
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, 900 G St NW, Fourth Floor, Washington, DC 20001, USA
| | - Amy M Cohn
- Battelle Memorial Institute, 2111 Wilson Blvd, #1000, Arlington, VA 22201, USA; Department of Oncology, Georgetown University Medical Center, Cancer Prevention and Control Program, Georgetown Lombardi Comprehensive Cancer Center, 3800 Reservoir Road NW, Washington, DC 20057, USA
| | - Theodore L Wagener
- Department of Pediatrics, University of Oklahoma Health Sciences Center, 1200 Children's Ave, Suite 14000, Oklahoma city, OK 73104, USA; Oklahoma Tobacco Research Center, University of Oklahoma Health Sciences Center, 655 Research Pkwy #400, Oklahoma City, OK 73104, USA
| | - Darren Mays
- Department of Oncology, Georgetown University Medical Center, Cancer Prevention and Control Program, Georgetown Lombardi Comprehensive Cancer Center, 3800 Reservoir Road NW, Washington, DC 20057, USA
| | - Andrea C Villanti
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, 900 G St NW, Fourth Floor, Washington, DC 20001, USA; Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont College of Medicine, 1 South Prospect Street, MS 482, Burlington, VT 05401, USA
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Jawad M, Charide R, Waziry R, Darzi A, Ballout RA, Akl EA. The prevalence and trends of waterpipe tobacco smoking: A systematic review. PLoS One 2018; 13:e0192191. [PMID: 29425207 PMCID: PMC5806869 DOI: 10.1371/journal.pone.0192191] [Citation(s) in RCA: 164] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 01/19/2018] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Waterpipe tobacco smoking is harmful to health however its prevalence estimates remain uncertain. We aimed to systematically review the medical literature on waterpipe tobacco prevalence and trends. METHODS We searched Medline, Embase and ISI Web of Science for 'waterpipe' and its synonyms, without using language or date restrictions. We included any measure of waterpipe tobacco smoking prevalence in jurisdictionally representative populations. We stratified findings by prevalence measure (past 30 day, ever, regular or occasional, daily, other or unspecified) and age (adults or youth). RESULTS We included 129 studies reporting 355 estimates for 68 countries. In general, prevalence estimates among adults were highest in the Eastern Mediterranean, and among youth were about equal between Eastern Mediterranean and European regions. Past 30 day use was highest among Lebanese youth (37.2% in 2008), ever use was highest among Lebanese youth in 2002 and Lebanese university students in 2005 (both 65.3%), regular or occasional use was highest in among Iranian university students (16.3% in 2005), and daily use was highest among Egyptian youth (10.4% in 2005). Trend data were limited but most studies reported increased use over time, ranging from 0.3-1.0% per year among youth in the US to 2.9% per year among youth in Jordan (both for past 30 day use). Results were similar for ever use trends. Turkey (2.3% in 2008 to 0.8% in 2010) and Iraq (6.3% in 2008 and 4.8% in 2012) both witnessed decreased waterpipe use. CONCLUSION Waterpipe tobacco smoking is most prevalent in Eastern Mediterranean and European countries, and appears higher among youth than adults. Continued surveillance will be important to assess and inform policy measures to control waterpipe tobacco use.
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Affiliation(s)
- Mohammed Jawad
- Public Health Policy Evaluation Unit, Imperial College London, London, United Kingdom
- * E-mail:
| | - Rana Charide
- Clinical Research Institute, American University of Beirut, Beirut, Lebanon
| | - Reem Waziry
- Department of Epidemiology Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Andrea Darzi
- AUB GRADE Center, Clinical Research Institute, American University of Beirut, Beirut, Lebanon
| | - Rami A. Ballout
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Elie A. Akl
- Clinical Research Institute, American University of Beirut, Beirut, Lebanon
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
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Majeed BA, Sterling KL, Weaver SR, Pechacek TF, Eriksen MP. Prevalence and harm perceptions of hookah smoking among U.S. adults, 2014-2015. Addict Behav 2017; 69:78-86. [PMID: 28161620 DOI: 10.1016/j.addbeh.2017.01.032] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 01/18/2017] [Accepted: 01/24/2017] [Indexed: 10/20/2022]
Abstract
This study aimed to determine the prevalence and factors associated with hookah smoking and perceptions of harm among U.S. adults. Data were pooled from the Tobacco Products and Risk Perceptions Surveys conducted separately in the summers of 2014 and 2015, among a probability sample selected from an online research panel. Descriptive, logistic regression, and multinomial logistic regression analyses were conducted. In 2014/2015, prevalence of ever and past 30-day hookah smoking among U.S. adults were 15.8% (95% C.I.: 15.0%, 16.7%) and 1.5% (95% C.I.: 1.2%, 1.8%), respectively. Adults who used other alternative tobacco products had a higher odds of hookah smoking than those who did not. Adults with some college education (AOR, 1.53) and with a college degree or more (AOR, 2.21), those identified as non-Hispanic other (AOR, 1.38) were more likely to be ever hookah smokers. Being a young adult (AOR, 2.7), college-educated (AOR, 2.3), never smoker (AOR, 2.1), and an ever hookah smoker (AOR, 2.8) were associated with lower perceptions of harm. Findings suggest that young college students are at higher risk of smoking hookah and that hookah smoking is more prevalent among individuals who use other tobacco products, such as little cigars and cigarillos, traditional cigars, and e-cigarettes, indicating a distinct group of users of alternative tobacco products. Regarding potential harm of hookah, the study highlights a knowledge gap and misperception especially among young, college-educated, and never smokers. Public health interventions should target these subpopulations to provide them with accurate information on hookah smoking.
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Mohammed KA, Geneus CJ, Yadgir S, Subramaniam DS, Burroughs TE. Correlates of Hookah Pipe Awareness and Perceived Harmfulness Among U.S. Adults. Am J Prev Med 2017; 52:513-518. [PMID: 27989450 DOI: 10.1016/j.amepre.2016.10.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 10/10/2016] [Accepted: 10/25/2016] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Hookah smoking has recently become a common form of smoking, and its prevalence has increased worldwide. This study determined the prevalence and correlates of hookah awareness and perceived harmfulness among U.S. adults. METHODS Weighted multivariable logistic regression analyses were performed on 6,711 adults aged ≥18 years collected from the 2013-2014 Health Information National Trends Survey (Cycles 3 and 4). Analysis was conducted in 2016. RESULTS Overall, 74.3% were aware of hookah. Of these, 73.4% believed hookah pipes were equally harmful as cigarettes whereas 15.7% believed otherwise. Older (OR=0.13, 95% CI=0.09, 0.18), black (OR=0.51, 95% CI=0.38, 0.71), Hispanic (OR=0.52, 95% CI=0.37, 0.71), and less-educated (OR=0.42, 95% CI=0.27, 0.65) respondents had lower odds of being aware of hookah. Compared with non-smokers, former smokers had 83% (95% CI=1.44, 2.33) higher odds of hookah awareness. Among those aware of hookah, older (OR=0.44, 95% CI=0.31, 0.62), black (OR=0.64, 95% CI=0.43, 0.96), and less-educated (OR=0.55, 95% CI=0.33, 0.92) respondents had lower odds of perceiving hookah as less harmful than cigarettes. CONCLUSIONS Most adults in U.S. are aware of hookah, but only 15.7% believe it is less harmful than cigarettes. This small proportion are mostly young, white, and college graduates. Targeted behavioral interventions will be necessary to increase individuals' perceived risk, knowledge, and perceived harmfulness of hookah smoking.
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Affiliation(s)
- Kahee A Mohammed
- Saint Louis University Center for Outcomes Research (SLUCOR), St. Louis, Missouri.
| | - Christian J Geneus
- Department of Biostatistics and Bioinformatics, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Simon Yadgir
- Saint Louis University College of Public Health and Social Justice, St. Louis, Missouri
| | - Divya S Subramaniam
- Saint Louis University Center for Outcomes Research (SLUCOR), St. Louis, Missouri
| | - Thomas E Burroughs
- Saint Louis University Center for Outcomes Research (SLUCOR), St. Louis, Missouri
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13
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Allem JP, Unger JB. Emerging adulthood themes and hookah use among college students in Southern California. Addict Behav 2016; 61:16-9. [PMID: 27208879 DOI: 10.1016/j.addbeh.2016.05.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 03/22/2016] [Accepted: 05/01/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Hookah (or waterpipe) use is increasing worldwide with implications for public health. Emerging adults (ages 18 to 25) have a higher risk for hookah use relative to younger and older groups. While research on the correlates of hookah use among emerging adults begins to accumulate, it may be useful to examine how transition-to-adulthood themes, or specific thoughts and feelings regarding emerging adulthood, are associated with hookah use. This study determined which transition-to-adulthood themes were associated with hookah use to understand the risk and protective factors for this tobacco-related behavior. METHODS Participants (n=555; 79% female; mean age 22) completed surveys on demographic characteristics, transition-to-adulthood themes, hookah, and cigarette use. RESULTS Past-month hookah use was more common than past-month cigarette use (16% versus 12%). In logistic regression analyses, participants who felt emerging adulthood was a time of experimentation/possibility were more likely to report hookah use. However, transition-to-adulthood themes were not statistically significantly related to cigarette use. CONCLUSIONS The profile for hookah use may differ from that of cigarettes among emerging adults. Themes of experimentation/possibility should be addressed in prevention programs on college campuses and popular recreational spots where emerging adults congregate. These findings can inform future studies of risk and protective factors for hookah use among emerging adults.
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14
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Cornacchione J, Wagoner KG, Wiseman KD, Kelley D, Noar SM, Smith MH, Sutfin EL. Adolescent and Young Adult Perceptions of Hookah and Little Cigars/Cigarillos: Implications for Risk Messages. JOURNAL OF HEALTH COMMUNICATION 2016; 21:818-825. [PMID: 27337629 PMCID: PMC5003089 DOI: 10.1080/10810730.2016.1177141] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Use of hookah and little cigars/cigarillos (LCCs) is high among adolescents and young adults. Although these products have health effects similar to cigarettes, adolescents and young adults believe them to be safer. This study examined adolescent and young adult perceptions of hookah and LCCs to develop risk messages aimed at discouraging use among users and at-risk nonusers. Ten focus groups with 77 adolescents and young adults were conducted to explore their perceptions about the perceived risks and benefits of hookah and LCC use. Participants were users of other (non-cigarette) tobacco products (n = 47) and susceptible nonusers (n = 30). Transcripts were coded for emergent themes on participants' perceptions of hookah and LCCs. Participants did not perceive health effects associated with hookah and LCC use to be serious or likely to happen given their infrequency of use and perceptions that they are less harmful than cigarettes. Participants generally had positive associations with smoking hookah and LCCs for several reasons, including that they are used in social gatherings, come in various flavors, and can be used to perform smoke tricks. Because adolescents and young adults underestimate and discount the long-term risks associated with hookah and LCC use, effective messages may be those that focus on the acute/immediate health and cosmetic effects.
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Affiliation(s)
| | - Kimberly G. Wagoner
- Department of Social Sciences & Health Policy, Wake Forest School of Medicine
| | - Kimberly D. Wiseman
- Department of Social Sciences & Health Policy, Wake Forest School of Medicine
| | | | - Seth M. Noar
- UNC School of Media & Journalism
- UNC Lineberger Comprehensive Cancer Center
| | - Margaret H. Smith
- UNC Lineberger Comprehensive Cancer Center
- Department of Health Behavior, UNC Gillings School of Global Public Health
| | - Erin L. Sutfin
- Department of Social Sciences & Health Policy, Wake Forest School of Medicine
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15
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Martinasek MP, Gibson-Young LM, Davis JN, McDermott RJ. Waterpipe tobacco smoking impact on public health: implications for policy. Risk Manag Healthc Policy 2015; 8:121-9. [PMID: 26346473 PMCID: PMC4556249 DOI: 10.2147/rmhp.s68267] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Background Given the increasing evidence of its negative health effects, including contributions to both infectious and chronic diseases, waterpipe tobacco smoking raises public health concerns beyond even those presented by traditional smoking. Methods Identification of Clean Indoor Air Acts (CIAAs) from each of the 50 United States and District of Columbia were retrieved and examined for inclusion of regulatory measures where waterpipe tobacco smoking is concerned. Several instances of exemption to current CIAAs policies were identified. The cumulative policy lens is presented in this study. Results States vary in their inclusion of explicit wording regarding CIAAs to the point where waterpipe tobacco smoking, unlike traditional smoking products, is excluded from some legislation, thereby limiting authorities’ ability to carry out enforcement. Conclusion Consistent, comprehensive, and unambiguous legislative language is necessary to prevent establishments where waterpipe tobacco smoking occurs from skirting legislation and other forms of regulatory control. Stricter laws are needed due to the increasing negative health impact on both the smoker and the bystander. Actions at both the federal and state levels may be needed to control health risks, particularly among youth and young adult populations.
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Affiliation(s)
- Mary P Martinasek
- Public Health Department of Health Sciences and Human Performance, University of Tampa, Kennedy Boulevard, Tampa, FL, USA
| | - Linda M Gibson-Young
- College of Nursing and Health Sciences, Texas A&M University: Corpus Christi, Corpus Christi, TX, USA
| | - Janiece N Davis
- Department of Health - Palm Beach County, West Palm beach, FL, USA
| | - Robert J McDermott
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
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