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Dashti H, Sundaram D. The association between nicotine stomatitis and waterpipe smoking. Tob Induc Dis 2024; 22:TID-22-118. [PMID: 38933523 PMCID: PMC11201228 DOI: 10.18332/tid/189600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 03/15/2024] [Accepted: 06/03/2024] [Indexed: 06/28/2024] Open
Abstract
INTRODUCTION Waterpipe smoking (WPS) is gaining popularity worldwide, especially in the Middle East, and significantly affects oral health. Nicotine stomatitis (NS) is an inflammatory response of the palate to the heat and chemical irritation caused by tobacco. The high temperatures of hot beverages have been found to have a synergistic effect. This study investigated the association of NS among waterpipe smokers and hot beverage drinkers. METHODS This cross-sectional study was conducted in several public locations in Kuwait. Demographic data, smoking habits, and hot beverage intake were recorded using questionnaires. An oral examination was performed with informed consent, and the occurrence of NS was recorded. Data were analyzed using IBM SPSS statistics version 28.0 (IBM Inc., Chicago, IL, USA). RESULTS Of the 211 participants, 55 subjects (26.1%) presented with NS. All the patients with NS drank hot beverages, while 37 (67.3%) patients with NS were waterpipe smokers and hot beverage drinkers. Smokers with NS smoked significantly more tobacco heads (Z= -2.606; p=0.009) and for more hours per day (Z= -2.222; p=0.026). CONCLUSIONS This study explored the association between WPS and NS in Kuwait. Waterpipe smokers and males were more likely to present with NS. Also, the number of tobacco heads and the number of hours of WPS were found to correlate with the presence of lesions. Effective strategies to reduce WPS need to be implemented. Further studies are recommended to investigate the cause-andeffect relationships.
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Affiliation(s)
- Hussain Dashti
- Department of Diagnostic Sciences, College of Dentistry, Kuwait University, Safat, Kuwait
| | - Devipriya Sundaram
- Department of Diagnostic Sciences, College of Dentistry, Kuwait University, Safat, Kuwait
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Sabet S, Mirmohammadi SJ, Zare Sakhvidi MJ, Vakili M, Mehrparvar AH, Mirzaei M. Spirometric Parameters in Waterpipe Smokers, Cigarette Smokers, and Non-smokers of Shahedieh Cohort Study. ADDICTION & HEALTH 2023; 15:17-22. [PMID: 37560079 PMCID: PMC10408739 DOI: 10.34172/ahj.2023.1350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 05/30/2022] [Indexed: 08/11/2023]
Abstract
BACKGROUND Different kinds of smoking tobacco may affect pulmonary function and reduce some spirometric parameters. This study aimed to assess the relationship between smoking cigarettes and waterpipe and spirometric parameters. METHODS This was a cross-sectional study on 1543 middle-aged individuals, as a sub-study of the Shahedieh cohort study in Yazd. The participants were randomly selected from the Shahedieh cohort population and were divided into 6 groups according to their smoking habits: non-smokers (n=455), cigarette smokers (n=139), waterpipe smokers (n=287), ex-cigarette smokers (n=131), concurrent waterpipe and cigarette smokers (n=121), and cigarette or waterpipe passive smokers (n=410). Spirometry was performed on all participants and spirometric parameters were compared between different groups. The data were analyzed by SPSS (version 20) using Kolmogorov-Smirnov, Kruskal-Wallis, and Mann-Whitney U tests. FINDINGS FEV1 %, FEV1/FVC, and PEF25-75% were significantly lower in cigarette smokers, compared to waterpipe smokers and non-smokers. The measures were not significantly lower in waterpipe smokers in comparison to non-smokers. The frequency of obstructive pattern and small airway diseases was significantly higher in cigarette smokers compared to waterpipe smokers and non-smokers. CONCLUSION The results of this study showed that in the middle-aged population, spirometric parameters related to airway obstruction (FEV1, FEV1/FVC, and FEF25-75%) were significantly lower in cigarette smokers than in non-smokers and waterpipe smokers, but these parameters were not significantly different between waterpipe smokers and non-smokers.
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Affiliation(s)
- Sobhan Sabet
- Occupational Medicine Resident, Industrial Diseases Research Center, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Seyyed Jalil Mirmohammadi
- Department of Occupational Medicine, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Javad Zare Sakhvidi
- Department of Occupational Health, Faculty of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mahmood Vakili
- Department of Social Medicine, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Amir Houshang Mehrparvar
- Industrial Diseases Research Center, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Masoud Mirzaei
- Yazd Cardiovascular Research Center, Faculty of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Bacterial communities of hookah tobacco products are diverse and differ across brands and flavors. Appl Microbiol Biotechnol 2022; 106:5785-5795. [PMID: 35927334 PMCID: PMC9361917 DOI: 10.1007/s00253-022-12079-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 06/22/2022] [Accepted: 07/11/2022] [Indexed: 12/02/2022]
Abstract
Abstract Young adults are increasingly using non-cigarette products, such as hookahs, since they are perceived as healthier alternatives to cigarette smoking. However, hookah users are exposed to not only carcinogenic compounds but also microorganisms that may play an active role in the development of both infectious and chronic diseases among users. Nevertheless, existing hookah research in this area has focused only on microorganisms that may be transferred to users through the smoking apparatus and not on bacterial communities associated with hookah tobacco. To address this knowledge gap, we conducted time-series experiments on commercially available hookah brands (Al Fakher (flavors: two apple, mint, and watermelon) and Fumari (flavors: white gummy bear, ambrosia, and mint chocolate chill)) stored under three different temperature and relative humidity conditions over 14 days. To characterize bacterial communities, the total DNA was extracted on days 0, 5, 9, and 14, PCR-amplified for the V3V4 region of the bacterial 16S rRNA gene, sequenced on the Illumina HiSeq platform, and analyzed using R. Diversity (alpha and beta) analyses revealed that the microbiotas of Fumari and Al Fakher products differed significantly and that flavor had a significant effect on the hookah microbiota. Overall, Pseudomonas, Bacillus, Sphingomonas, and Methylobacterium were the predominant bacterial taxa across all products. Additionally, we observed compositional differences between hookah brands across the 14-day incubation. These data suggest that the bacterial communities of hookah tobacco are diverse and differ across brands and flavors, which may have critical implications regarding exposures to specific bacteria among hookah users. Key points • Commercial hookah products harbor diverse bacterial communities. • Brands and flavors impact the diversity of these communities. • Research on their viability and transmission to users’ respiratory tracts is needed. Graphical abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1007/s00253-022-12079-7.
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Ben Saad H. Blood lipids and pressures data of exclusive narghile smokers compared with healthy non-smokers: studies from thin to thick. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:31546-31547. [PMID: 31432373 DOI: 10.1007/s11356-019-06263-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 08/16/2019] [Indexed: 06/10/2023]
Affiliation(s)
- Helmi Ben Saad
- Laboratory of Physiology, Faculty of Medicine of Sousse, University of Sousse, Street Mohamed Karoui, 4000, Sousse, Tunisia.
- Heart Failure (LR12SP09) Research Laboratory, Farhat HACHED Hospital, Sousse, Tunisia.
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Hasni Y, Bachrouch S, Mahjoub M, Maaroufi A, Rouatbi S, Ben Saad H. Biochemical Data and Metabolic Profiles of Male Exclusive Narghile Smokers (ENSs) Compared With Apparently Healthy Nonsmokers (AHNSs). Am J Mens Health 2019; 13:1557988319825754. [PMID: 30819065 PMCID: PMC6440044 DOI: 10.1177/1557988319825754] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 12/19/2018] [Accepted: 12/21/2018] [Indexed: 01/01/2023] Open
Abstract
Studies evaluating the metabolic profiles of ENSs are scarce and presented controversial conclusions. This study aimed to compare the metabolic profiles of ENSs' and AHNSs' groups. Males aged 25-45 years and free from a known history of metabolic and/or cardiovascular diseases were included. According to the smoking status, two groups of ENSs and AHNSs were identified. Body mass index (BMI, kg/m2), waist circumference (WC, cm), systolic and diastolic blood pressures (SBP, DBP, mmHg), fasting blood data in mmol/L (blood glycemia [FBG], triglycerides [TG], total cholesterol [TC], high- and low- density lipoprotein cholesterol [HDL-C, LDL-C]) and obesity status were evaluated. The metabolic syndrome (MetS) was defined according to the 2006 International Diabetes Federation (IDF) recommendations. Data were expressed as mean ± standard deviation ( SD) or percentages. Compared to the AHNSs' group ( n = 29), the ENSs' one ( n = 29) had (a) higher values of BMI (26.5 ± 2.3 vs. 28.2 ± 3.6), WC (95 ± 7 vs. 100 ± 10), and TG (1.22 ± 0.40 vs. 1.87 ± 0.85); and (b) included a lower percentage of males having low HDL-C (82.7% vs. 62.0%), and higher percentages of males having obesity (6.9% vs. 37.9%) or hypertriglyceridemia (10.7% vs. 51.7%). Both the ENSs' and AHNSs' groups: (a) had similar values of FBG (5.38 ± 0.58 vs. 5.60 ± 0.37), TC (4.87 ± 1.16 vs. 4.36 ± 0.74), HDL-C (0.92 ± 0.30 vs. 0.82 ± 0.21), LDL-C (3.09 ± 0.98 vs. 2.92 ± 0.77), SBP (117 ± 9 vs. 115 ± 8), and DBP (76 ± 6 vs. 73 ± 7); and (b) included similar percentages of males having normal weight (17.2% vs. 31.0%); overweight (44.8% vs. 62.1%); android obesity (79.3% vs. 59.6%), hypertension (10.3% vs. 10.3%), hyperglycemia (37.9% vs. 48.2%), and MetS (51.7% vs. 34.5%). There is a need to monitor narghile use among male metabolic patients since it alters some components of the MetS.
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Affiliation(s)
- Yosra Hasni
- Department of Endocrinology, University Hospital Farhat Hached, Sousse, Tunisia
| | - Sabrine Bachrouch
- Department of Endocrinology, University Hospital Farhat Hached, Sousse, Tunisia
| | - Mohamed Mahjoub
- Department of Hospital Hygiene, University Hospital Farhat Hached, Sousse, Tunisia
| | - Amel Maaroufi
- Department of Endocrinology, University Hospital Farhat Hached, Sousse, Tunisia
| | - Sonia Rouatbi
- Laboratory of Physiology and Functional Explorations, Farhat Hached Hospital, Sousse, Tunisia
- Heart Failure (LR12SP09) Research Laboratory, University Hospital Farhat Hached, Sousse, Tunisia
| | - Helmi Ben Saad
- Laboratory of Physiology and Functional Explorations, Farhat Hached Hospital, Sousse, Tunisia
- Heart Failure (LR12SP09) Research Laboratory, University Hospital Farhat Hached, Sousse, Tunisia
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Shaikh RB, Sreedharan J, Al Sharbatti S, Muttappallymyalil J, Lee L, Weitzman M. Salivary cotinine concentration and carbon monoxide levels in young adults smoking midwakh in comparison with cigarette smokers. Tob Control 2018; 28:141-145. [DOI: 10.1136/tobaccocontrol-2017-054202] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 05/19/2018] [Accepted: 06/05/2018] [Indexed: 11/03/2022]
Abstract
ObjectivesTo estimate and compare the salivary cotinine levels using a semiquantitative method, called NicAlert, between three groups: non-smokers, daily smokers of cigarettes and daily smokers of midwakh, and to compare the carbon monoxide (CO) levels among these groups.Materials and methodsA total of 159 adult male volunteers aged 20 and above were included, with 54 current cigarette smokers, 52 current midwakh smokers and 53 non-smokers. Estimate of breath carbon monoxide and salivary cotinine were collected, as well as sociodemographic characteristics and details of smoking habits and second-hand smoke exposure among participants. Institutional review board approval was obtained and data were analysed using SPSS V.21 with the Kruskal-Wallis test used to obtain differences in the distribution.ResultsThere was no significant difference in the median breath CO and salivary cotinine levels between cigarette and midwakh smokers. Levels of breath CO were significantly higher in cigarette and midwakh smokers as compared with non-smokers (19.5, 17.5 and 6.0, respectively, p<0.05); the same relationship was observed for cotinine levels among cigarette and midwakh smokers as compared with non-smokers (4.0, 3.0 and 0.0, respectively, p≤0.05). Additionally, the values of both salivary cotinine and breath CO increased with the frequency of tobacco use.ConclusionThese are the first data that we are aware of that demonstrate that in terms of at least two key biomarkers of tobacco use, there are comparable levels of exposure between cigarettes and midwakh users, demonstrating a need for intensified attention to the use of midwakh.
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Saffar Soflaei S, Darroudi S, Tayefi M, Nosrati Tirkani A, Moohebati M, Ebrahimi M, Esmaily H, Parizadeh SMR, Heidari-Bakavoli AR, Ferns GA, Ghayour-Mobarhan M. Hookah smoking is strongly associated with diabetes mellitus, metabolic syndrome and obesity: a population-based study. Diabetol Metab Syndr 2018; 10:33. [PMID: 29713386 PMCID: PMC5907743 DOI: 10.1186/s13098-018-0335-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 04/10/2018] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES The adverse effects of cigarette smoking have been widely studied before, whilst the effects of hookah smoking has received less attention, although it is a common habit in the Middle East. Here we have investigated the effects of cigarette and hookah smoking on biochemical characteristics in a representative population sample derived from the Mashhad stroke and heart atherosclerotic disorder (MASHAD) cohort study, from Northeastern Iran. STUDY DESIGN A total of 9840 subjects from the MASHAD population study were allocated to five groups; non-smokers (6742), ex-smokers (976), cigarette smokers (864), hookah smokers (1067), concomitant cigarette and hookah smokers (41). METHODS Baseline characteristics were recorded in a questionnaire. Biochemical characteristics were measured by routine methods. Data were analyzed using SPSS software and p < 0.05 was considered significant. RESULTS After adjustment for age and sex; the presence of CVD, obesity, metabolic syndrome, DM and dyslipidemia were significantly (p < 0.001) related to smoking status. After multivariate analysis, HDL (p < 0.001), WBC (p < 0.001), MCV (p < 0.05), PLT (p < 0.01) and RDW (p < 0.001), and the presence of CVD (p < 0.01), obesity (p < 0.001), metabolic syndrome (p < 0.05) and DM (p < 0.01) remained significant between cigarette smokers and non-smokers. Between hookah smokers and non-smokers; uric acid (p < 0.001), PLT (p < 0.05) and RDW (p < 0.05), and the presence of obesity (p < 0.01), metabolic syndrome (p < 0.001), diabetes (p < 0.01) and dyslipidemia (p < 0.01) remained significant after logistic regression. CONCLUSION There was a positive association between hookah smoking and metabolic syndrome, diabetes, obesity and dyslipidemia which was not established in cigarette smoking.
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Affiliation(s)
- Sara Saffar Soflaei
- Neurogenic Inflammation Research Center, Department of Modern Sciences and Technologies, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Susan Darroudi
- Department of Modern Sciences and Technologies, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Tayefi
- Biochemistry of Nutrition Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abolfazl Nosrati Tirkani
- Department of Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Moohebati
- Biochemistry of Nutrition Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Cardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahmoud Ebrahimi
- Cardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Habibollah Esmaily
- Biochemistry of Nutrition Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Biostatistics and Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Mohammad Reza Parizadeh
- Biochemistry of Nutrition Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Reza Heidari-Bakavoli
- Biochemistry of Nutrition Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A. Ferns
- Division of Medical Education, Brighton and Sussex Medical School, University of Brighton, Rm 342, Mayfield House, Brighton, BN1 9PH UK
| | - Majid Ghayour-Mobarhan
- Neurogenic Inflammation Research Center, Department of Modern Sciences and Technologies, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, 99199-91766 Mashhad, Iran
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Wei Y, Lai B, Liu H, Li Y, Zhen W, Fu L. Effect of cigarette smoke extract and nicotine on the expression of thrombomodulin and endothelial protein C receptor in cultured human umbilical vein endothelial cells. Mol Med Rep 2017; 17:1724-1730. [PMID: 29257196 PMCID: PMC5780117 DOI: 10.3892/mmr.2017.8070] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 09/28/2017] [Indexed: 01/15/2023] Open
Abstract
The present study investigated the influence of cigarette smoke extract (CSE) and nicotine on the expression of thrombomodulin (TM) and endothelial protein C receptor (EPCR) in human umbilical vein endothelial cells (HUVECs). Smoking is associated with intravascular thrombosis. As a vital anticoagulation cofactor, TM is located on the endothelial cell surface and regulates intravascular coagulation by binding to thrombin, hence activating protein C. Activated protein C is a natural anticoagulant that interacts with EPCR to enhance the function of anticoagulation system. The effects of CSE (0.5–5%) and nicotine (10-3-10-9 mol/l) on the expression of TM and EPCR in HUVECs were observed. Reverse transcription-quantitative polymerase chain reaction and flow cytometric analysis techniques were used for detecting TM and EPCR mRNA and protein expression levels, respectively. After 6-h exposure, TM protein and mRNA expression levels decreased in a dose-dependent manner. Stimulation with 5% CSE for 0, 6, 10, 12 and 24 h led to a decrease in the levels of TM mRNA and protein over time, which reached a peak at 12 h. The levels were significantly reduced compared with the control group (P<0.001). However, CSE had no effect on EPCR. Furthermore, nicotine had no influence on TM and EPCR. In conclusion, the present study supports a novel molecular mechanism of cigarette smoking-associated thrombosis by the decreased expression of TM. Further studies are required to identify specific components in CSE responsible for decreasing TM expression and its associated consequences.
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Affiliation(s)
- Yujie Wei
- Institute of Cardiology, the General Hospital of Chinese People's Armed Police Forces, Beijing 100039, P.R. China
| | - Bin Lai
- Department of Emergency, the General Hospital of Chinese People's Armed Police Forces, Beijing 100039, P.R. China
| | - Huiliang Liu
- Institute of Cardiology, the General Hospital of Chinese People's Armed Police Forces, Beijing 100039, P.R. China
| | - Yi Li
- Institute of Cardiology, the General Hospital of Chinese People's Armed Police Forces, Beijing 100039, P.R. China
| | - Wang Zhen
- Institute of Cardiology, the General Hospital of Chinese People's Armed Police Forces, Beijing 100039, P.R. China
| | - Ling Fu
- Institute of Biotechnology, Academy of Military Medical Sciences, Beijing 100071, P.R. China
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Menezes AMB, Wehrmeister FC, Horta BL, Szwarcwald CL, Vieira ML, Malta DC. Frequency of the use of hookah among adults and its distribution according to sociodemographic characteristics, urban or rural area and federative units: National Health Survey, 2013. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2017; 18 Suppl 2:57-67. [PMID: 27008603 DOI: 10.1590/1980-5497201500060006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 06/10/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To assess the frequency of the use of hookah in the Brazilian adult population aged 18 to 59 years. METHODS This is a cross-sectional, population-based study using the National Health Survey (PNS), 2013. Sampling was based on three stages: census tract, household, and individual. The frequency and the 95% confidence interval (CI) of the outcome "frequency of use of hookah," among those who reported tobacco use, were described according to demographic and socioeconomic variables, urban or rural area of the country, and macroregions; the frequency of hookah use according to the age and education was also investigated; all analyzes were weighted. RESULTS Of the 60,225 adults surveyed, 15% reported the use of some tobacco product; the frequency of use of hookah among them was 1.2% (95%CI 0.8 - 1.6) and higher in male subjects, in white individuals, in the youngest age group, with average to high education and residents of urban areas and the south and midwest. Among those who have used the hookah, 50% used it occasionally, 12.8% monthly, 27.3% weekly, and 6.8% daily. CONCLUSIONS The relevance of the findings is because this is the first nationally representative study that evaluated the frequency of use of hookah in adults in the country. The results point to the need to implement surveillance regarding its use, as has occurred in relation to tobacco.
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Affiliation(s)
| | | | - Bernardo Lessa Horta
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | | | - Maria Lucia Vieira
- Instituto Brasileiro de Geografia e Estatística, Rio de Janeiro, RJ, Brasil
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Strulovici-Barel Y, Shaykhiev R, Salit J, Deeb RS, Krause A, Kaner RJ, Vincent TL, Agosto-Perez F, Wang G, Hollmann C, Shanmugam V, Almulla AM, Sattar H, Mahmoud M, Mezey JG, Gross SS, Staudt MR, Walters MS, Crystal RG. Pulmonary Abnormalities in Young, Light-Use Waterpipe (Hookah) Smokers. Am J Respir Crit Care Med 2017; 194:587-95. [PMID: 27007171 DOI: 10.1164/rccm.201512-2470oc] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
RATIONALE Waterpipes, also called hookahs, are currently used by millions of people worldwide. Despite the increasing use of waterpipe smoking, there is limited data on the health effects of waterpipe smoking and there are no federal regulations regarding its use. OBJECTIVES To assess the effects of waterpipe smoking on the human lung using clinical and biological parameters in young, light-use waterpipe smokers. METHODS We assessed young, light-use, waterpipe-only smokers in comparison with lifelong nonsmokers using clinical parameters of cough and sputum scores, lung function, and chest high-resolution computed tomography as well as biological parameters of lung epithelial lining fluid metabolome, small airway epithelial (SAE) cell differential and transcriptome, alveolar macrophage transcriptome, and plasma apoptotic endothelial cell microparticles. MEASUREMENTS AND MAIN RESULTS Compared with nonsmokers, waterpipe smokers had more cough and sputum as well as a lower lung diffusing capacity, abnormal epithelial lining fluid metabolome profile, increased proportions of SAE secretory and intermediate cells, reduced proportions of SAE ciliated and basal cells, markedly abnormal SAE and alveolar macrophage transcriptomes, and elevated levels of apoptotic endothelial cell microparticles. CONCLUSIONS Young, light-use, waterpipe-only smokers have a variety of abnormalities in multiple lung-related biological and clinical parameters, suggesting that even limited waterpipe use has broad consequences on human lung biology and health. We suggest that large epidemiological studies should be initiated to investigate the harmful effects of waterpipe smoking.
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Affiliation(s)
| | | | | | | | | | - Robert J Kaner
- 1 Department of Genetic Medicine.,2 Department of Medicine, and
| | | | | | | | | | | | | | - Hisham Sattar
- 4 Pulmonary Section, Hamad Medical Corporation, Doha, Qatar
| | - Mai Mahmoud
- 3 Weill Cornell Medical College-Qatar, Doha, Qatar; and
| | | | - Steven S Gross
- 5 Department of Pharmacology, Weill Cornell Medical College, New York, New York
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Abou Arbid S, Al Mulla A, Ghandour B, Ammar N, Adawi M, Daher R, Younes N, Chami H. Validation of an Arabic version of an instrument to measure waterpipe smoking behavior. Public Health 2017; 145:124-131. [DOI: 10.1016/j.puhe.2016.12.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 11/16/2016] [Accepted: 12/09/2016] [Indexed: 11/27/2022]
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Charab MA, Abouzeinab NS, Moustafa ME. The Protective Effect of Selenium on Oxidative Stress Induced by Waterpipe (Narghile) Smoke in Lungs and Liver of Mice. Biol Trace Elem Res 2016; 174:392-401. [PMID: 27178166 DOI: 10.1007/s12011-016-0737-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 05/04/2016] [Indexed: 10/21/2022]
Abstract
Waterpipe smoking is common in the Middle East populations and results in health problems. In this study, we investigated the effects of exposure of mice to waterpipe smoke on oxidative stress in lungs and liver and the effects of selenium administration before smoke exposure on the oxidative stress. Twenty-four mice were divided equally into four groups: (i) the control mice received no exposure or treatment; (ii) mice exposed to waterpipe smoke; (iii) mice received intraperitoneal injection of 0.59 μg selenium/kg body weight as sodium selenite 15 min before the exposure to waterpipe smoke; and (iv) mice received intraperitoneal injection of 1.78 μg selenium/kg body weight as sodium selenite 15 min before the exposure to waterpipe smoke. Mice were exposed to waterpipe smoke every other day for four times within 8 successive days. Malondialdehyde and nitric oxide levels were significantly higher in the lungs and liver, while the activities of superoxide dismutase, glutathione peroxidase-1, and catalase were significantly lower in the waterpipe smoke group when compared to control mice. Treating mice with 1.78 μg selenium/kg body weight significantly restored the normal levels of these parameters. Histological examinations of lungs and liver confirmed the protective actions of selenium against the effects of exposure to waterpipe smoke. In conclusion, exposure of mice to waterpipe smoke-induced oxidative stress in lungs and liver. Administration of low level of selenium, 1.78 μg selenium/kg body weight as sodium selenite, exerted protective effects against oxidative stress induced by exposure to waterpipe smoke.
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Affiliation(s)
- Mohamad A Charab
- Department of Biological and Environmental Sciences, Faculty of Science, Beirut Arab University, Beirut, Lebanon
| | - Noura S Abouzeinab
- Department of Biological and Environmental Sciences, Faculty of Science, Beirut Arab University, Beirut, Lebanon
| | - Mohamed E Moustafa
- Department of Biological and Environmental Sciences, Faculty of Science, Beirut Arab University, Beirut, Lebanon.
- Department of Biochemistry, Faculty of Science, Alexandria University, Alexandria, 21511, Egypt.
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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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14
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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: 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: 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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Gurung G, Bradley J, Delgado-Saborit JM. Effects of shisha smoking on carbon monoxide and PM2.5 concentrations in the indoor and outdoor microenvironment of shisha premises. THE SCIENCE OF THE TOTAL ENVIRONMENT 2016; 548-549:340-346. [PMID: 26803732 DOI: 10.1016/j.scitotenv.2015.12.093] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 11/18/2015] [Accepted: 12/20/2015] [Indexed: 06/05/2023]
Abstract
There has been significant rise in shisha premises in the United Kingdom with an unsubstantiated belief that shisha smoking is harmless and relatively safe. This study aimed to assess the public health situation by evaluating the extent of shisha environmental tobacco smoke (ETS) exposure among those that work in, and are customers of shisha businesses. Concentrations of several ETS pollutants such as carbon monoxide (CO) and particulate matter with a diameter of less than 2.5μm (PM2.5) in shisha premises were measured using real-time sensors inside and outside twelve shisha premises and at 5 pubs/restaurants where smoking is prohibited. Mean concentration of CO (7.3±2.4mg/m(3)) and PM2.5 (287±233μg/m(3)) inside active shisha premises was higher than concentrations measured within the vicinity of the shisha premises (CO: 0.9±0.7mg/m(3) and PM2.5: 34±14μg/m(3)) and strongly correlated (PM2.5 R=0.957). Concentrations were higher than indoor concentrations in pubs and restaurants where smoking is not permitted under UK law. The number of shisha pipes was a strong predictor of the PM2.5 concentrations. The study also assessed the risk perception within patrons and managers, with only 25% being aware of the risks associated to shisha smoking. The study identifies owners, employees and consumers within active shisha premises being exposed to concentrations of CO and PM2.5 at levels considered hazardous to human health. The results and outcome of this research serve as a basis to influence a discussion around the need of developing specific policies to protect consumers and employees of such premises.
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Affiliation(s)
- Gam Gurung
- Division of Environmental Health and Risk Management, School of Geography, Earth and Environmental Sciences, University of Birmingham, Birmingham, UK; Environmental Health - Regulation and Enforcement, Birmingham City Council Birmingham, UK
| | - Janet Bradley
- Environmental Health - Regulation and Enforcement, Birmingham City Council Birmingham, UK
| | - Juana Maria Delgado-Saborit
- Division of Environmental Health and Risk Management, School of Geography, Earth and Environmental Sciences, University of Birmingham, Birmingham, UK.
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Husain H, Al-Fadhli F, Al-Olaimi F, Al-Duraie A, Qureshi A, Al-Kandari W, Mitra AK. Is Smoking Shisha Safer than Cigarettes: Comparison of Health Effects of Shisha and Cigarette Smoking among Young Adults in Kuwait. Med Princ Pract 2016; 25:117-22. [PMID: 26566225 PMCID: PMC5588354 DOI: 10.1159/000442417] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 11/12/2015] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The aim of this study was to compare the health effects of shisha smoking with cigarette smoking among male college students in Kuwait. SUBJECTS AND METHODS This cross-sectional study was conducted on 525 male students in Kuwait from September to October 2013. A pretested questionnaire was used for information on demographics and health complaints. Peak expiratory flow rate (PEFR) was measured using a portable peak flow meter. The outcome variables of health status were compared between smoking shisha, cigarettes, or both, and nonsmoking. RESULTS The prevalence of current smoking was 243 of the 525 students (46%); of them, 52 (10%) were shisha smokers, 69 were (13%) cigarette smokers and 122 (23%) were both shisha and cigarette smokers. There were significantly fewer shisha smokers than cigarette smokers with symptoms of persistent cough (4 vs. 13% or 2/52 vs. 15/69; p = 0.007), chest pain (4 vs. 23% or 2/52 vs. 16/69; p = 0.004) and rapid heart rate (12 vs. 28% or 6/52 vs. 19/69; p = 0.04). Other complaints, including asthma, respiratory infections, shortness of breath, high blood pressure, increased blood sugar levels and sleep disturbances were similar in the 2 groups. Values of PEFR for shisha smokers and cigarette smokers were not significantly different. CONCLUSION This study produced evidence suggesting that shisha smoking is not safer than cigarette smoking except with regard to complaints such as cough, chest pain and rapid heart rate, and that people who smoke both experience worse health effects in terms of frequent symptoms of respiratory infections, persistent cough, rapid heartbeat and sleep disturbances.
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Affiliation(s)
| | | | | | | | | | | | - Amal K. Mitra
- *Amal K. Mitra, MD, MPH, Dr. P.H., Department of Community Medicine and Behavioural Sciences, Faculty of Medicine, Kuwait University, Jamal Abdul Nasser St, Kuwait City (Kuwait), E-Mail
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Cawkwell PB, Lee L, Weitzman M, Sherman SE. Tracking Hookah Bars in New York: Utilizing Yelp as a Powerful Public Health Tool. JMIR Public Health Surveill 2015; 1:e19. [PMID: 27227137 PMCID: PMC4869217 DOI: 10.2196/publichealth.4809] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 08/09/2015] [Accepted: 09/22/2015] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND While cigarette use has seen a steady decline in recent years, hookah (water pipe) use has rapidly increased in popularity. While anecdotal reports have noted a rise in hookah bars, methodological difficulties have prevented researchers from drawing definitive conclusions about the number of hookah bars in any given location. There is no publicly available database that has been shown to reliably provide this information. It is now possible to analyze Internet trends as a measure of population behavior and health-related phenomena. OBJECTIVE The objective of the study was to investigate whether Yelp can be used to accurately identify the number of hookah bars in New York State, assess the distribution and characteristics of hookah bars, and monitor temporal trends in their presence. METHODS Data were obtained from Yelp that captures a variety of parameters for every business listed in their database as of October 28, 2014, that was tagged as a "hookah bar" and operating in New York State. Two algebraic models were created: one estimated the date of opening of a hookah bar based on the first Yelp review received and the other estimated whether the bar was open or closed based on the date of the most recent Yelp review. These findings were then compared with empirical data obtained by Internet searches. RESULTS From 2014 onward, the date of the first Yelp review predicts the opening date of new hookah bars to within 1 month. Yelp data allow the estimate of such venues and demonstrate that new bars are not randomly distributed, but instead are clustered near colleges and in specific racial/ethnic neighborhoods. New York has seen substantially more new hookah bars in 2012-2014 compared with the number that existed prior to 2009. CONCLUSIONS Yelp is a powerful public health tool that allows for the investigation of various trends and characteristics of hookah bars. New York is experiencing tremendous growth in hookah bars, a worrying phenomenon that necessitates further investigation.
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Affiliation(s)
- Philip B Cawkwell
- Department of Pediatrics New York University School of Medicine New York, NY United States
| | - Lily Lee
- Department of PediatricsNew York University School of MedicineNew York, NYUnited States; Brooklyn CollegeBrooklyn, NYUnited States
| | - Michael Weitzman
- Department of PediatricsNew York University School of MedicineNew York, NYUnited States; College of Global Public HealthNew York UniversityNew York, NYUnited States; Department of Environmental HealthNew York University School of MedicineNew York, NYUnited States; NYU/Abu Dhabi Public Health Research CenterAbu DhabiUnited Arab Emirates
| | - Scott E Sherman
- College of Global Public HealthNew York UniversityNew York, NYUnited States; NYU/Abu Dhabi Public Health Research CenterAbu DhabiUnited Arab Emirates; Department of Population HealthNew York University School of MedicineNew York, NYUnited States; Department of MedicineVA New York Harbor Healthcare SystemNew York, NYUnited States
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18
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Zhou S, Weitzman M, Vilcassim R, Wilson J, Legrand N, Saunders E, Travers M, Chen LC, Peltier R, Gordon T. Air quality in New York City hookah bars. Tob Control 2015; 24:e193-8. [PMID: 25232045 PMCID: PMC4390442 DOI: 10.1136/tobaccocontrol-2014-051763] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 08/26/2014] [Indexed: 11/03/2022]
Abstract
BACKGROUND Hookahs are increasingly being used in the USA and elsewhere. Despite the popularity of hookah bars, there is a paucity of research assessing the health effects of hookah smoke, and although New York City (NYC) bans indoor tobacco smoking, hookah lounges claim that they only use herbal products without tobacco. This study investigated levels of multiple indices of indoor air pollution in hookah bars in NYC. METHODS Air samples were collected in 8 hookah bars in NYC. Along with venue characteristics, real-time measurements of fine particulate matter (PM2.5), black carbon (BC), and carbon monoxide (CO), and total gravimetric PM, elemental carbon (EC), organic carbon (OC), and nicotine were collected in 1-2 hour sessions. RESULTS Overall, levels of indoor air pollution increased with increasing numbers of active hookahs smoked. The mean (SD) real time PM2.5 level was 1179.9 (939.4) µg/m(3), whereas the filter-based total PM mean was 691.3 (592.6) µg/m(3). The mean real time BC level was 4.1 (2.3) µg/m(3), OC was 237.9 (112.3) µg/m(3), and CO was 32 (16) ppm. Airborne nicotine was present in all studied hookah bars (4.2 (1.5) µg/m(3)). CONCLUSIONS These results demonstrate that despite the ban on smoking tobacco products, at the very least, some NYC hookah bars are serving tobacco-based hookahs, and have elevated concentrations of indoor air pollutants that may present a health threat to visitors and employees. Therefore, there is an urgent need for better air quality monitoring in such establishments and policies to combat this emerging public health threat.
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Affiliation(s)
- Sherry Zhou
- New York University School of Medicine, New York, NY
| | - Michael Weitzman
- Department of Environmental Medicine, New York University School of Medicine, New York, NY
- Department of Pediatrics, New York University School of Medicine, New York, NY
| | - Ruzmyn Vilcassim
- Department of Environmental Medicine, New York University School of Medicine, New York, NY
| | | | | | - Eric Saunders
- Department of Environmental Medicine, New York University School of Medicine, New York, NY
| | | | - Lung-Chi Chen
- Department of Environmental Medicine, New York University School of Medicine, New York, NY
| | - Richard Peltier
- Division of Environmental Health Science, University of Massachusetts, Amherst, MA
| | - Terry Gordon
- Department of Environmental Medicine, New York University School of Medicine, New York, NY
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19
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Vestbo J, Lange P. Natural history of COPD: Focusing on change in FEV1. Respirology 2015; 21:34-43. [PMID: 26176980 DOI: 10.1111/resp.12589] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 05/03/2015] [Accepted: 05/06/2015] [Indexed: 11/28/2022]
Abstract
The natural history of chronic obstructive pulmonary disease (COPD) is usually described with a focus on change in forced expiratory volume in 1 s (FEV1 ) over time as this allows for exploration of risk factors for an accelerated decline-and thus of developing COPD. From epidemiological studies we have recognized important risk factors such as smoking, exposure to biomass and occupational exposures, but we have also learnt about features such as chronic bronchitis, airway hyper-responsiveness and asthma that seem to accelerate decline in FEV1 independent of exposures. In addition we are gradually beginning to better link early life events to subsequent risk of disease in adulthood. Although more complicated, our current understanding of COPD has come a long way from being a simple image of smoking leading to poor lungs.
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Affiliation(s)
- Jørgen Vestbo
- Centre for Respiratory Medicine and Allergy, Manchester Academic Health Science Centre, University Hospital South Manchester, NHS Foundation Trust, Manchester, UK
| | - Peter Lange
- Department of Social Medicine, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark.,Department of Respiratory Medicine, Hvidovre University Hospital, Copenhagen, Denmark
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20
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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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Layoun N, Saleh N, Barbour B, Awada S, Rachidi S, Al-Hajje A, Bawab W, Waked M, Salameh P. Waterpipe effects on pulmonary function and cardiovascular indices: a comparison to cigarette smoking in real life situation. Inhal Toxicol 2014; 26:620-7. [DOI: 10.3109/08958378.2014.945106] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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22
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The growing epidemic of water pipe smoking: health effects and future needs. Respir Med 2014; 108:1241-53. [PMID: 25130679 DOI: 10.1016/j.rmed.2014.07.014] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 07/01/2014] [Accepted: 07/29/2014] [Indexed: 11/22/2022]
Abstract
Water pipe smoking (WPS), an old method of tobacco smoking, is re-gaining widespread popularity all over the world and among various populations. Smoking machine studies have shown that the water pipe (WP) mainstream smoke (MSS) contains a wide array of chemical substances, many of which are highly toxic and carcinogenic for humans. The concentrations of some substances exceed those present in MSS of cigarettes. Despite being of low grade, current evidence indicates that WPS is associated with different adverse health effects, not only on the respiratory system but also on the cardiovascular, hematological, and reproductive systems, including pregnancy outcomes. In addition, association between WPS and malignancies, such as lung, oral and nasopharyngeal cancer, has been suggested in different studies and systematic reviews. Despite its long standing history, WPS research still harbors a lot of deficiencies. The magnitude of toxicants and carcinogen exposures, effects on human health, as well as the addiction and dependence potentials associated with WPS need to be studied in well-designed prospective trials. Unfortunately, many of the tobacco control and clean indoor policies have exempted water pipes. World wide awareness among the public, smokers, and policymakers about the potential health effects of WPS is urgently required. Furthermore, stringent policies and laws that control and ban WPS in public places, similar to those applied on cigarettes smoking need to be implemented.
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Abstract
OBJECTIVES Prevalence of hookah use is increasing significantly among adolescents. This study aimed to delineate demographic and socioeconomic correlates of hookah use among high school seniors in the United States. We hypothesized that more impoverished adolescents and those who smoked cigarettes would be more likely to use hookahs. METHODS Data were examined for 5540 high school seniors in Monitoring the Future (years 2010-2012), an annual nationally representative survey of high school students in the United States. Using data weights provided by Monitoring the Future, we used multivariable binary logistic regression to delineate correlates of hookah use in the last 12 months. RESULTS Eighteen percent of students reported hookah use in the past year. Compared with white students, black students were at lower odds for use (adjusted odds ratio [AOR] = 0.27, P < .0001). High parent education increased the odds for use (AOR = 1.58, P < .001), and student weekly income from a job of >$50/week (AOR = 1.26, P < .05) or $11 to $50 per week from other sources (AOR = 1.35, P < .01) also increased odds for use. Males and urban students were also at higher odds for use, as were users of alcohol, marijuana, and other illicit substances. Former cigarette smokers were at higher risk, and current smokers were at highest risk for use. CONCLUSIONS Adolescents of higher socioeconomic status appear to be at particularly high risk for hookah use in the United States. Prevention efforts must target this group as prevalence continues to increase.
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Affiliation(s)
| | - Sherry Zhou
- Pediatrics and Environmental Medicine, New York University Langone Medical Center, New York, New York
| | | | - Michael Weitzman
- Pediatrics and Environmental Medicine, New York University Langone Medical Center, New York, New York
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Shishani K, Howell D, McPherson S, Roll J. Young adult waterpipe smokers: Smoking behaviors and associated subjective and physiological effects. Addict Behav 2014; 39:1113-9. [PMID: 24657000 PMCID: PMC4096831 DOI: 10.1016/j.addbeh.2014.03.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Revised: 02/27/2014] [Accepted: 03/04/2014] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The purpose of this pilot study was to investigate smoking behaviors and subjective and physiological effects of nicotine on young adult occasional waterpipe smokers. METHODS This study utilized a repeated-measures design that included one repeated factor for condition (nicotine and non-nicotine). For each participant, the sequencing of the repeated factor was assigned using random allocation. The two nicotine conditions were nicotine (0.75 g) and non-nicotine (0 g placebo) tobacco. Over the course of two weeks, twenty-two participants completed subjective (Acute Subjective Effects of Nicotine) and physiological (blood pressure, heart rate, and CO level) measures. Additional measures (QSU and MNWS-R) were used to assess for withdrawal symptoms. SAMPLE The participants (n=22) were young adults (23 ± 3.1years); 71% smoked waterpipe once a month in the past year and 29% smoked waterpipe 1-2 times per week. In addition, 60% reported sharing their waterpipe with friends while smoking. None of the participants reported using any other forms of tobacco products. RESULTS Under the nicotine condition, participants tended to smoke longer (i.e. smoking duration, p=0.004), take more puffs (p=0.03), take shorter puffs (p=0.03), and inhale less volume with each puff (p=0.02). The repeated measures analysis of the factor headrush revealed an effect of the nicotine condition (F=9.69, p<0.001, partial η(2)=0.31) and time (F=8.17, p=0.02, partial η(2)=0.30). Heart rate increased significantly across the nicotine condition (F=7.92, p=0.01, partial η(2)=0.31) and over time (F=12.64, p=0.01, partial η(2)=0.41). CONCLUSIONS This study demonstrates how differences between nicotine and non-nicotine waterpipe smoking are associated with changes in smoking behaviors, experiencing a headrush and an increase in heart rate.
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Affiliation(s)
- Kawkab Shishani
- Program of Excellence in the Addictions, College of Nursing, Washington State University, WA, USA.
| | - Donelle Howell
- Program of Excellence in the Addictions, College of Nursing, Washington State University, WA, USA
| | - Sterling McPherson
- Program of Excellence in the Addictions, College of Nursing, Washington State University, WA, USA
| | - John Roll
- Program of Excellence in the Addictions, College of Nursing, Washington State University, WA, USA
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Kadhum M, Jaffery A, Haq A, Bacon J, Madden B. Measuring the acute cardiovascular effects of shisha smoking: a cross-sectional study. JRSM Open 2014; 5:2054270414531127. [PMID: 25057403 PMCID: PMC4100228 DOI: 10.1177/2054270414531127] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objectives To investigate the acute cardiovascular effects of smoking shisha. Design A cross-sectional study was carried out in six shisha cafes. Participants smoked shisha for a period between 45 min (minimum) and 90 min (maximum). The same brand of tobacco and coal was used. Setting London, UK. Participants Participants were those who had ordered a shisha to smoke and consented to have their blood pressure, heart rate and carbon monoxide levels measured. Excluded subjects were those who had smoked shisha in the previous 24 h, who smoke cigarettes or who suffered from cardiorespiratory problems. Main outcome measures Blood pressure was measured using a sphygmomanometer. Pulse was measured by palpation of the radial artery. Carbon monoxide levels were obtained via a carbon monoxide monitor. These indices were measured before the participants began to smoke shisha and after they finished or when the maximum 90 min time period was reached. Results Mean arterial blood pressure increased from 96 mmHg to 108 mmHg (p < 0.001). Heart rate increased from 77 to 91 bpm (p < 0.001). Carbon monoxide increased from an average of 3 to 35 ppm (p < 0.001). A correlation analysis showed no relationship between carbon monoxide and the other indices measured. Conclusion The acute heart rate, blood pressure and carbon monoxide levels were seen to rise significantly after smoking shisha. The weak correlation between carbon monoxide levels and the other variables suggests that carbon monoxide levels had not contributed to their significant increase.
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Affiliation(s)
- Murtaza Kadhum
- Cardiothoracic Medicine, St. George's Hospital Medical School, London SW17 0RE, UK
| | - Ali Jaffery
- Cardiothoracic Medicine, St. George's Hospital Medical School, London SW17 0RE, UK
| | - Adnaan Haq
- Cardiothoracic Medicine, St. George's Hospital Medical School, London SW17 0RE, UK
| | - Jenny Bacon
- Cardiothoracic Medicine, St. George's Hospital Medical School, London SW17 0RE, UK
| | - Brendan Madden
- Cardiothoracic Medicine, St. George's Hospital Medical School, London SW17 0RE, UK
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26
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Hawari FI, Obeidat NA, Ayub H, Ghonimat I, Eissenberg T, Dawahrah S, Beano H. The acute effects of waterpipe smoking on lung function and exercise capacity in a pilot study of healthy participants. Inhal Toxicol 2014; 25:492-7. [PMID: 23905967 DOI: 10.3109/08958378.2013.806613] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONTEXT Waterpipe tobacco smoking (WTS) has gained popularity, but its physiologic effects have not been extensively studied: rather, studies have focused on WTS's chronic effects or have evaluated limited respiratory/cardiac parameters. OBJECTIVE We sought to characterize in a more detailed manner the acute effects of WTS on lung function and exercise capacity. METHOD We recruited 24 healthy WTS males. We used a pilot single-group pre-test (abstained from WTS for ≥48 h) post-test (within 0.5 h of a 45-min WTS session) design. We performed spirometry, diffusing lung capacity and time-limited CPE testing (CPET; cycloergometer; 2-min 20-Watt warm-up and 25-Watt increase every 2-min for 10 min). RESULTS Mean age was 20.4 years; Post-WTS, the following significant changes were observed: CO level increased from 3.7 ppm to 24.4; oxygen consumption decreased (from 1.86 L/min to 1.7); baseline respiratory rate increased (from 17.7 breath/min to 19.7); forced expiratory flow over the middle half of the forced vital capacity decreased (from 5.51 L to 5.29); and perceived exertion (measured by Borg scale) at mid and peak exercise increased. Baseline resting systolic blood pressure, pulse pressure, and pulse pressure product increased post-WTS (from 118.9 mmHg to 129.2; from 45.3 mmHg to 55.6; and from 9.9 mmHg/min to 11.1 post-WTS, respectively). During exercise, a decrease in oxygen pulse was observed post-WTS (from 10.89 ml/beat to 9.97), while the heart rate-oxygen consumption relationship increased post-WTS (from 3.52 beats/ml/kg to 3.91). CONCLUSION Acute WTS appears to induce impairment in lung function and exercise capacity. Larger studies are warranted to further characterize the nature and extent of such impairment.
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Affiliation(s)
- Feras I Hawari
- King Hussein Cancer Center, Cancer Control Office, Amman, Jordan.
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Blachman-Braun R, Del Mazo-Rodríguez RL, López-Sámano G, Buendía-Roldán I. Hookah, is it really harmless? Respir Med 2014; 108:661-7. [PMID: 24582881 DOI: 10.1016/j.rmed.2014.01.013] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 01/29/2014] [Indexed: 11/18/2022]
Abstract
The hookah is a snuff smoking device whose origin dates back to the fifteenth century, has been used extensively in the Middle East in recent decades has become popular in Western culture countries, particularly in Americas and Europe. It has been reported that like other forms smoking tobacco, their use can lead to addiction also is used for inhaling and other addictive substances. Has also been considered a risk factor for various isolated diseases, including chronic obstructive pulmonary disease (COPD), different types of cancer, hemodynamic alterations, vascular disease, infectious diseases, among others. In pregnant women has been reported that there use condition a diminution on fetal growth and different diseases in the newborn. It was also mentioned that hookah smoke contains several toxic substances that can affect both, the primary and the passive smoker, so we did this review to determine the complications associated with its use.
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Affiliation(s)
- Ruben Blachman-Braun
- Facultad de Ciencias de la Salud, Universidad Anáhuac México Norte, Av. Universidad Anahuac No. 46, Col. Lomas Anáhuac, Huixquilucan, Edo. de México C.P. 52786, Mexico
| | - Raquel Lira Del Mazo-Rodríguez
- Facultad de Ciencias de la Salud, Universidad Anáhuac México Norte, Av. Universidad Anahuac No. 46, Col. Lomas Anáhuac, Huixquilucan, Edo. de México C.P. 52786, Mexico
| | - Gustavo López-Sámano
- Facultad de Ciencias de la Salud, Universidad Anáhuac México Norte, Av. Universidad Anahuac No. 46, Col. Lomas Anáhuac, Huixquilucan, Edo. de México C.P. 52786, Mexico
| | - Ivette Buendía-Roldán
- Instituto Nacional de Enfermedades Respiratorias, Calzada de Tlalpan 4502, sección XVI, Del. Tlalpan, CP14080 México, D.F., Mexico.
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Ben Saad H, Khemiss M, Nhari S, Ben Essghaier M, Rouatbi S. Pulmonary functions of narghile smokers compared to cigarette smokers: a case-control study. Libyan J Med 2013; 8:22650. [PMID: 24382307 PMCID: PMC3877776 DOI: 10.3402/ljm.v8i0.22650] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Revised: 12/03/2013] [Accepted: 12/04/2013] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Studies of the lung function profiles of exclusive narghile smokers (ENS) are few, have some methodological limits, and present contradictory conclusions. The present study aimed to compare the plethysmographic profiles of ENS with age- and height-matched exclusive cigarette smokers (ECS). METHODS Males aged 35-60 living in Sousse, Tunisia, who have been smoking narghile exclusively for more than 10 narghile-years (n = 36) or cigarettes exclusively for more than 10 pack-years (n = 106) were recruited to participate in this case-control study. The anthropometric and plethysmographic data were measured according to international recommendations using a body plethysmograph (ZAN 500 Body II, Meβgreräte GmbH, Germany). Large-airway-obstructive-ventilatory-defect (LAOVD) was defined as: first second forced expiratory volume/forced vital capacity (FEV1/FVC) below the lower-limit-of-normal (LLN). Restrictive-ventilatory-defect (RVD) was defined as total lung capacity < LLN. Lung hyperinflation was defined as residual volume > upper-limit-of-normal. Student t-test and χ(2) test were used to compare plethysmographic data and profiles of the two groups. RESULTS The subjects in the ENS and ECS groups are well matched in age (45±7 vs. 47±5 years) and height (1.73±0.06 vs. 1.72±0.06 m) and used similar quantities of tobacco (36±22 narghile-years vs. 35±19 pack-years). Compared to the ENS group, the ECS group had significantly lower FEV1 (84±12 vs. 60±21%), FVC (90±12 vs. 76±18%), and FEV1/FVC (99±7 vs. 83±17%). The two groups had similar percentages of RVD (31 vs. 36%), while the ECS group had a significantly higher percentage of LAOVD (8 vs. 58%) and lung hyperinflation (36 vs.57%). CONCLUSION Chronic exclusive narghile smoking has less adverse effects on pulmonary function tests than chronic exclusive cigarette smoking.
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Affiliation(s)
- Helmi Ben Saad
- Department of Physiology and Functional Explorations, Farhat Hached Hospital, Sousse, Tunisia; Laboratory of Physiology, Faculty of Medicine, University of Sousse, Sousse, Tunisia; Research Unit: Secondary Prevention After Myocardial Infarction, N: 04/UR/08-18, Faculty of Medicine of Sousse, Sousse, Tunisia;
| | - Mehdi Khemiss
- Department of Physiology and Functional Explorations, Farhat Hached Hospital, Sousse, Tunisia
| | - Saida Nhari
- Department of Physiology and Functional Explorations, Farhat Hached Hospital, Sousse, Tunisia
| | - Mejda Ben Essghaier
- Department of Physiology and Functional Explorations, Farhat Hached Hospital, Sousse, Tunisia
| | - Sonia Rouatbi
- Department of Physiology and Functional Explorations, Farhat Hached Hospital, Sousse, Tunisia; Laboratory of Physiology, Faculty of Medicine, University of Sousse, Sousse, Tunisia
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Waterpipe smoking among middle and high school Jordanian students: patterns and predictors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:7068-82. [PMID: 24351734 PMCID: PMC3881154 DOI: 10.3390/ijerph10127068] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Revised: 11/27/2013] [Accepted: 11/28/2013] [Indexed: 11/17/2022]
Abstract
Despite the increase in attention to waterpipe tobacco smoking, the patterns and predictors of this method of tobacco use among Jordanian youth are not well known. The current study was conducted to assess the patterns and the predictors of waterpipe tobacco smoking among school aged students in one of Jordan's Central Governorates. A cross-sectional survey was conducted to investigate the patterns and predictors of waterpipe tobacco smoking among youth (grades 6, 8, 10 and 12). Using a multistage random sampling more than 1,000 students was selected. Data were collected using the Arabic Youth Tobacco Use Composite Measure (YTUCM). Waterpipe smoking was assessed for "past 12 months", "past month" and "past week". Students' ages ranged from 11 to 18 years, (mean age ± 14.7; SD ± 1.9 years). The percentage of girls who smoked waterpipe was greater for all frequencies of use than it was for boys. Age, gender, and belief that smoking makes more friends were predictors of smoking among study participants. This is the first known study to examine waterpipe smoking among youth aged 11 and 12. Our findings illustrate the need for public health campaigns to reach and educate youth, their families, teachers and school systems regarding the growing recognized health risks of waterpipe smoking.
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Morton J, Song Y, Fouad H, Awa FE, Abou El Naga R, Zhao L, Palipudi K, Asma S. Cross-country comparison of waterpipe use: nationally representative data from 13 low and middle-income countries from the Global Adult Tobacco Survey (GATS). Tob Control 2013; 23:419-27. [PMID: 23760609 PMCID: PMC4145417 DOI: 10.1136/tobaccocontrol-2012-050841] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Evidence shows that smoking tobacco using a waterpipe is significantly associated with diseases. Despite this, waterpipe use seems to be increasing worldwide, though nationally representative data are not widely available. The Global Adult Tobacco Survey (GATS) provides an opportunity to measure various indicators of waterpipe use from nationally representative surveys. METHODS Data were obtained for adults 15 years of age or older from 13 countries (Bangladesh, Brazil, China, Egypt, India, Mexico, Philippines, Russia, Thailand, Turkey, Ukraine, Uruguay and Vietnam) who completed GATS from 2008-2010. The GATS questionnaire collected data on current waterpipe use, including daily/less than daily prevalence and number of sessions per day/week. An optional waterpipe module measured former use, age of initiation, and level of consumption during a session. RESULTS GATS was successful in producing nationally representative data on waterpipe use from 13 countries, many of which for the first time. The prevalence of waterpipe use among men was highest in Vietnam (13.0%) and Egypt (6.2%); among women, waterpipe use was highest in Russia (3.2%) and Ukraine (1.1%). While over 90% of adults in Ukraine thought smoking tobacco causes serious illness, only 31.4% thought smoking tobacco using a waterpipe causes serious illness. CONCLUSIONS GATS data provide the ability to analyse waterpipe use within a country and across countries. Monitoring of waterpipe use at a national level will better enable countries to target tobacco control interventions such as education campaigns about the negative health effects of waterpipe use.
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Affiliation(s)
- Jeremy Morton
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Yang Song
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Heba Fouad
- World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Fatimah El Awa
- World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Randa Abou El Naga
- World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Luhua Zhao
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Krishna Palipudi
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Samira Asma
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Cobb CO, Sahmarani K, Eissenberg T, Shihadeh A. Acute toxicant exposure and cardiac autonomic dysfunction from smoking a single narghile waterpipe with tobacco and with a "healthy" tobacco-free alternative. Toxicol Lett 2012; 215:70-5. [PMID: 23059956 PMCID: PMC3641895 DOI: 10.1016/j.toxlet.2012.09.026] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2012] [Revised: 09/28/2012] [Accepted: 09/30/2012] [Indexed: 12/19/2022]
Abstract
Tobacco smoking using a waterpipe (narghile, hookah, shisha) has become a global epidemic. Unlike cigarette smoking, little is known about the health effects of waterpipe use. One acute effect of cigarette smoke inhalation is dysfunction in autonomic regulation of the cardiac cycle, as indicated by reduction in heart rate variability (HRV). Reduced HRV is implicated in adverse cardiovascular health outcomes, and is associated with inhalation exposure-induced oxidative stress. Using a 32 participant cross-over study design, we investigated toxicant exposure and effects of waterpipe smoking on heart rate variability when, under controlled conditions, participants smoked a tobacco-based and a tobacco-free waterpipe product promoted as an alternative for "health-conscious" users. Outcome measures included HRV, exhaled breath carbon monoxide (CO), plasma nicotine, and puff topography, which were measured at times prior to, during, and after smoking. We found that waterpipe use acutely decreased HRV (p<0.01 for all measures), independent of product smoked. Plasma nicotine, blood pressure, and heart rate increased only with the tobacco-based product (p<0.01), while CO increased with both products (p<0.01). More smoke was inhaled during tobacco-free product use, potentially reflecting attempted regulation of nicotine intake. The data thus indicate that waterpipe smoking acutely compromises cardiac autonomic function, and does so through exposure to smoke constituents other than nicotine.
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Affiliation(s)
- Caroline O. Cobb
- Department of Psychology and Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, USA
| | - Kamar Sahmarani
- Aerosol Research Lab, Mechanical Engineering Department, American University of Beirut, Beirut, Lebanon
| | - Thomas Eissenberg
- Department of Psychology and Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, USA
| | - Alan Shihadeh
- Aerosol Research Lab, Mechanical Engineering Department, American University of Beirut, Beirut, Lebanon
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BOSKABADY MOHAMMADHOSSEIN, FARHANG LILA, MAHMODINIA MAHBOBEH, BOSKABADY MORTEZA, HEYDARI GHOLAMREZA. Comparison of pulmonary function and respiratory symptoms in water pipe and cigarette smokers. Respirology 2012; 17:950-956. [DOI: 10.1111/j.1440-1843.2012.02194.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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Al Moamary MS, Al Ghobain MA, Al Shehri SN, Alfayez AI, Gasmelseed AY, Al-Hajjaj MS. The prevalence and characteristics of water-pipe smoking among high school students in Saudi Arabia. J Infect Public Health 2012; 5:159-68. [PMID: 22541263 DOI: 10.1016/j.jiph.2012.01.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2011] [Revised: 12/02/2011] [Accepted: 01/05/2012] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVE To identify the prevalence and predictors of the water-pipe (WP) smoking epidemic in the Kingdom of Saudi Arabia (KSA). METHODS A cross-sectional study conducted with 16-18 year-old high school students in Riyadh, Saudi Arabia. RESULTS Of the 1272 participants, 414 (33.0%) reported having tried WP smoking. Of this group, 141 (34.1%) were female and 273 (65.9%) were male. Further, 129 (10.2%) students were current WP smokers who had used at least one rock in the past month; 20 were female (1.6%) and 120 were male (8.6%). Regarding age, 276 (68.1%) students who tried WP smoking at least once began when they were over 11 years of age, whereas 129 (31.9%) began WP smoking at or before 11 years of age. Adjusted odds ratios showed that trying WP smoking at least once was associated with smoking after the age of 11 (p=0.021, OR 7.7; CI: 1.4-43.6) and accepting water-pipes from a friend (p=0.024, OR 10.6; CI: 1.4-83.4). CONCLUSION A high prevalence of WP smoking exists among male and female high schools students in Riyadh, KSA. WP smoking was reported to begin in early adulthood.
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Affiliation(s)
- Mohamed S Al Moamary
- College of Medicine, King Saud Bin Abdulaziz, University for Health Sciences, Riyadh, Saudi Arabia.
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Grekin ER, Ayna D. Waterpipe smoking among college students in the United States: a review of the literature. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2012; 60:244-9. [PMID: 22420702 DOI: 10.1080/07448481.2011.589419] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
OBJECTIVE To review the literature on college student waterpipe use with a focus on undergraduates in the United States. PARTICIPANTS Undergraduate students. METHODS Studies were accessed using the databases PubMed, MEDLINE, PsycINFO, and Academic Search Premier. Searches included combinations of the following keywords: "waterpipe," "hookah," "shisha," "nargila," "argileh," "hubble bubble," "college," "university," and "student." RESULTS Results demonstrate that approximately 1 in 5 American college students report past-year waterpipe use. Results also suggest that there are a number of established correlates of waterpipe smoking, including male gender, Arab ethnicity, cigarette smoking, and the belief that waterpipe smoking is less harmful than cigarette smoking. CONCLUSIONS Despite its harmful health effects, waterpipe smoking is quite common among college students. Future research with better methodologies and theoretical frameworks are needed to advance the field.
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Affiliation(s)
- Emily R Grekin
- Department of Psychology, Wayne State University, Detroit, MI 48202, USA.
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Alamoudi OS. Lung cancer at a University Hospital in Saudi Arabia: A four-year prospective study of clinical, pathological, radiological, bronchoscopic, and biochemical parameters. Ann Thorac Med 2011; 5:30-6. [PMID: 20351958 PMCID: PMC2841806 DOI: 10.4103/1817-1737.58957] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2009] [Accepted: 11/16/2009] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES AND BACKGROUND Lung cancer accounts for 4% of all newly diagnosed cancers in Saudi Arabia. The pattern of presentation is unknown. The objectives of this study were to assess the clinical, radiological, pathological, biochemical and bronchoscopic abnormalities in lung cancer patients and to compare our findings with those reported in the literature. METHODS A total of 114 patients with proven lung cancer were selected for the study. A questionnaire concerning patients' demographic data was obtained; the abnormalities and the cell types of lung cancer were recorded prospectively in each subject. RESULTS A total of 114 patients with lung cancer were studied. Mean age ± SD was (59.8 ± 10.8) years, and (71.1%) were smokers and 95.1% of them were male, (90.1%) smoked >20 pack/yr (96.2%) for 20 years or more. Cough (76.3%) and clubbing (40.4%) were the most common symptom and physical abnormality respectively. The right lung (64.9%) was more commonly affected than the left (37.7%). Metastases were present in (49.1%) at presentation. The right and left upper bronchi (24% vs. 16%) were the mostly affected. Hypercalcemia was more common in squamous cell, while hyponatremia was more common in adenocarcinoma, and small cell. Squamous cell carcinoma was the most common cell type (51.8%) and significantly associated with smoking (P ≤ 0.001) CONCLUSION Squamous cell carcinoma was the most common cell type, and significantly associated with smoking. The incidence of metastasis was high at presentation. The right lung and right upper bronchus were often affected. Hypercalcemia and hyponatremia were the most common biochemical abnormalities.
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Affiliation(s)
- Omer S Alamoudi
- Department of Medicine, King Abdulaziz University Hospital, (KAUH), Jeddah, Saudi Arabia.
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Chaouachi K. More Rigor Needed in Systematic Reviews on “Waterpipe” (Hookah, Narghile, Shisha) Smoking. Chest 2011; 139:1250-1251. [DOI: 10.1378/chest.10-2864] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Raad D, Gaddam S, Schunemann HJ, Irani J, Abou Jaoude P, Honeine R, Akl EA. Effects of water-pipe smoking on lung function: a systematic review and meta-analysis. Chest 2011; 139:764-774. [PMID: 20671057 DOI: 10.1378/chest.10-0991] [Citation(s) in RCA: 173] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2023] Open
Abstract
BACKGROUND Although common in many Middle Eastern countries, water-pipe tobacco smoking, commonly known as water-pipe smoking (WPS), is increasingly popular in Western cultures. The primary objective of this study was to systematically review the effects of WPS on lung function. The secondary objective was to compare the effects of WPS and cigarette smoking on lung function. METHODS We conducted a systematic review using the approach of the Cochrane Collaboration to search for, select, and abstract studies. We conducted two separate meta-analyses comparing water-pipe smokers with nonsmokers, and water-pipe smokers with cigarette smokers for each of three spirometric measurements (FEV₁, FVC, and FEV₁/ FVC). We used the standardized mean difference (SMD) to pool the results. RESULTS Six cross-sectional studies were eligible for this review. Compared with no smoking, WPS was associated with a statistically significant reduction in FEV₁ (SMD = -0.43; 95% CI, -0.58 to -0.29; equivalent to a 4.04% lower FEV₁%), a trend toward lower FVC (SMD = -0.15; 95% CI, -0.34 to 0.04; equivalent to a 1.38% reduction in FVC%), and lower FEV₁/ FVC (SMD = -0.46; 95% CI, -0.93 to 0.01; equivalent to a 3.08% lower FEV₁/ FVC). Comparing WPS with cigarette smoking, there was no statistically significant difference in FEV₁, FVC, and FEV₁/ FVC. The six studies suffered from methodologic limitations. CONCLUSIONS WPS negatively affects lung function and may be as harmful as cigarette smoking. WPS, therefore, is likely to be a cause of COPD.
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Affiliation(s)
- Dany Raad
- Department of Medicine, State University of New York at Buffalo, Buffalo, NY
| | - Swarna Gaddam
- Department of Family Medicine, State University of New York at Buffalo, Buffalo, NY
| | - Holger J Schunemann
- Department of Medicine, State University of New York at Buffalo, Buffalo, NY; Department of Family Medicine, State University of New York at Buffalo, Buffalo, NY
| | - Jihad Irani
- Faculty of Health Sciences, University of Balamand, Beirut, Lebanon
| | | | - Roland Honeine
- Department of Medicine, State University of New York at Buffalo, Buffalo, NY
| | - Elie A Akl
- Department of Medicine, State University of New York at Buffalo, Buffalo, NY; Department of Family Medicine, State University of New York at Buffalo, Buffalo, NY; Departments of Clinical Epidemiology and Biostatistics and Medicine, McMaster University, Hamilton, ON, Canada.
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Hakim F, Hellou E, Goldbart A, Katz R, Bentur Y, Bentur L. The acute effects of water-pipe smoking on the cardiorespiratory system. Chest 2011; 139:775-781. [PMID: 21030492 DOI: 10.1378/chest.10-1833] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
OBJECTIVE There are limited data on the acute effects of water-pipe tobacco smoking, commonly known as water-pipe smoking (WPS), on cardiopulmonary parameters. This study evaluated the acute effects of a single 30-min session of WPS on carboxyhemoglobin (COHb) levels, pulmonary function test results, vital signs, fractional exhaled nitric oxide (Feno) levels, and exhaled breath condensate (EBC) cytokine levels in volunteers in a domestic, open-air, group smoking setting. METHODS This prospective study evaluated the above-noted outcome parameters before and after 30 min of WPS. The primary outcome parameter was the change in COHb levels. RESULTS Forty-five volunteers (30 men, 15 women), aged 32.35 ± 15.33 years, were recruited. After one session of WPS, the COHb levels rose significantly, from 1.47% ± 0.57% (median 1.4) to 9.47% ± 5.52% (median 7.4), P < .001. Systolic and diastolic BP levels significantly increased after smoking (systolic, 119.52 ± 12.07 mm Hg vs 131.98 ± 17.8 mm Hg; diastolic, 74.84 ± 7.89 mm Hg vs 82.98 ± 12.52 mm Hg, respectively; P < .001). Heart rates increased from 80.39 ± 9.92 beats/min to 95.59 ± 17.41 beats/min, P < .001; and respiratory rates increased from 14.36 ± 1.63 breaths/min to 16.68 ± 2.24 breaths/min, P < .001. There were decreases in forced expiratory flow between 25% and 75% of FVC, peak expiratory flow rate, Feno levels, percentage of eosinophils in peripheral blood, and 8-isoprostane levels in EBC. CONCLUSIONS This study shows that one session of WPS causes acute biologic changes that might result in marked health problems. It adds to the limited evidence that WPS is harmful and supports interventions to control the continuing global spread of WPS, especially among youth. TRIAL REGISTRY ClinicalTrials.gov; No.: NCT01157832; URL: www.clinicaltrials.gov.
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Affiliation(s)
- Fahed Hakim
- Pediatric Pulmonology Unit, Meyer Children's Hospital, Haifa, Israel; Rambam Health Care Campus, Haifa, Israel; The Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Elias Hellou
- Rambam Health Care Campus, Haifa, Israel; The Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Aviv Goldbart
- The Department of Pediatrics, Soroka University Medical Center, Beer-Sheva, Israel
| | - Rina Katz
- Department of Immunology, Haifa, Israel; Rambam Health Care Campus, Haifa, Israel; The Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Yedidia Bentur
- The Israel Poison Information Center, Haifa, Israel; Rambam Health Care Campus, Haifa, Israel; The Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Lea Bentur
- Pediatric Pulmonology Unit, Meyer Children's Hospital, Haifa, Israel; Rambam Health Care Campus, Haifa, Israel; The Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
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Thornton S, Schedel A, Besenfelder S, Klüter H, Bugert P. Cholinergic drugs inhibit in vitro megakaryopoiesis via the alpha7-nicotinic acetylcholine receptor. Platelets 2011; 22:390-5. [DOI: 10.3109/09537104.2010.551304] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Martinasek MP, McDermott RJ, Martini L. Waterpipe (hookah) tobacco smoking among youth. Curr Probl Pediatr Adolesc Health Care 2011; 41:34-57. [PMID: 21232693 DOI: 10.1016/j.cppeds.2010.10.001] [Citation(s) in RCA: 132] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Waterpipe tobacco smoking is a centuries old practice, influenced by cultural tradition in Eastern Mediterranean countries, the Middle East, and parts of Asia. It historically has been an activity enjoyed primarily by men. In the past 2 decades, however, this method of tobacco smoking has increased in popularity in other parts of the world, including the USA. Growing interest in this form of smoking can be traced, in part, to the advent of a flavored tobacco, called maassel. The combination of flavoring agents and the paraphernalia itself used in the smoking process, along with its mystic appeal, novelty, affordability, and the social atmosphere in which smoking often occurs, has made waterpipe smoking attractive to women as well as men, cigarette smokers and nonsmokers alike, and particular groups, including persons of college age and younger adolescents. Although waterpipe smoking is perceived by its new generation of users to be less addictive and hazardous to health than cigarette smoking, researchers draw diametrically opposed conclusions. Research demonstrates that numerous toxic agents, including carcinogens, heavy metals, other particulate matter, and high levels of nicotine, are efficiently delivered through waterpipes. Moreover, sidestream smoke exposes others in the vicinity of waterpipe smokers to the risk of respiratory diseases and other conditions. In addition, persons sharing waterpipe mouthpieces may share infectious agents as well. Waterpipe tobacco smoking has been declared a public health problem by the World Health Organization and other authorities. Recognition of the deleterious effects of waterpipe smoking has led to initial attempts to expand regulatory control. Because waterpipe tobacco is not directly burned in the smoking process, many existing control measures do not apply. Public health authorities should monitor waterpipe tobacco use carefully. Finally, pediatricians and other healthcare providers should discourage experimentation and continued use among their adolescent patients.
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Affiliation(s)
- Mary P Martinasek
- Department of Community and Family Health, University of South Florida, College of Public Health (MDC 056), Tampa, FL, USA
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Jamil H, Janisse J, Elsouhag D, Fakhouri M, Arnetz JE, Arnetz BB. Do household smoking behaviors constitute a risk factor for hookah use? Nicotine Tob Res 2011; 13:384-8. [PMID: 21330269 DOI: 10.1093/ntr/ntq249] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Much research has focused on the role played by families in cigarette smoking behavior. However, there is a lack of such research for hookah (waterpipe) smoking. This study focuses on the role of family members' hookah smoking behaviors as a possible risk factor for hookah smoking. METHODS Eight hundred and one adults in southeast Michigan responded to an anonymous self-administered survey regarding personal and family members' hookah smoking behavior and perceptions of health risks related to hookah smoking. Multinomial logistic regression modeling was used to examine risk factors for hookah use. RESULTS The prevalence of current hookah smoking in the study population was 26%. The odds ratio for an individual to smoke hookah were 9.5 (95% CI = 2.37-38.47, p < .01), 8.6 (95% CI = 3.92-19.02, p < .001), and 1.2 (95% CI = 1.14-1.41, p < .05) if the father, mother, or sibling, respectively, smoked hookah at home. Male gender and younger age were also significantly associated with hookah smoking. Household hookah smoking behaviors were also significant risk factors among former hookah smokers compared with nonsmokers, but there were no significant risk factors when comparing former hookah smokers with current hookah smokers. CONCLUSIONS Having a father, mother, or sibling smoking hookah at home, male gender and younger age are significant risk factors for current hookah smoking.
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Affiliation(s)
- Hikmet Jamil
- Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI, USA.
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Short term effect of hubble-bubble smoking on voice. The Journal of Laryngology & Otology 2011; 125:486-91. [PMID: 21281535 DOI: 10.1017/s0022215110003051] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To investigate the short term effect of hubble-bubble smoking on voice. STUDY DESIGN Prospective study. MATERIAL Eighteen non-dysphonic subjects (seven men and 11 women) with a history of hubble-bubble smoking and no history of cigarette smoking underwent acoustic analysis and laryngeal video-stroboscopic examination before and 30 minutes after hubble-bubble smoking. RESULTS On laryngeal video-stroboscopy, none of the subjects had vocal fold erythema either before or after smoking. Five patients had mild vocal fold oedema both before and after smoking. After smoking, there was a slight increase in the number of subjects with thick mucus between the vocal folds (six, vs four before smoking) and with vocal fold vessel dilation (two, vs one before smoking). Acoustic analysis indicated a drop in habitual pitch, fundamental frequency and voice turbulence index after smoking, and an increase in noise-to-harmonics ratio. CONCLUSION Even 30 minutes of hubble-bubble smoking can cause a drop in vocal pitch and an increase in laryngeal secretions and vocal fold vasodilation.
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Dar-Odeh NS, Bakri FG, Al-Omiri MK, Al-Mashni HM, Eimar HA, Khraisat AS, Abu-Hammad SM, Dudeen AAF, Abdallah MN, Alkilani SMZ, Al-Shami L, Abu-Hammad OA. Narghile (water pipe) smoking among university students in Jordan: prevalence, pattern and beliefs. Harm Reduct J 2010; 7:10. [PMID: 20497563 PMCID: PMC2893172 DOI: 10.1186/1477-7517-7-10] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2009] [Accepted: 05/24/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Narghile is becoming the favorite form of tobacco use by youth globally. This problem has received more attention in recent years. The aim of this study was to investigate the prevalence and pattern of narghile use among students in three public Jordanian universities; to assess their beliefs about narghile's adverse health consequences; and to evaluate their awareness of oral health and oral hygiene. METHODS The study was a cross-sectional survey of university students. A self-administered, anonymous questionnaire was distributed randomly to university students in three public Jordanian universities during December, 2008. The questionnaire was designed to ask specific questions that are related to smoking in general, and to narghile smoking in specific. There were also questions about oral health awareness and oral hygiene practices. RESULTS 36.8% of the surveyed sample indicated they were smokers comprising 61.9% of the male students and 10.7% of the female students in the study sample. Cigarettes and narghile were the preferred smoking methods among male students (42%). On the other hand, female students preferred narghile only (53%). Parental smoking status but not their educational level was associated with the students smoking status. Smokers had also significantly poor dental attendance and poor oral hygiene habits. CONCLUSION This study confirmed the spreading narghile epidemic among young people in Jordan like the neighboring countries of the Eastern Mediterranean region. Alarming signs were the poor oral health awareness among students particularly smokers.
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Affiliation(s)
- Najla S Dar-Odeh
- Dept, of Oral and Maxillofacial Surgery, Oral Medicine and Periodontology, Faculty of Dentistry, University of Jordan, Amman, Jordan.
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Laryngeal findings and acoustic changes in hubble-bubble smokers. Eur Arch Otorhinolaryngol 2010; 267:1587-92. [PMID: 20480370 DOI: 10.1007/s00405-010-1273-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2009] [Accepted: 04/30/2010] [Indexed: 10/19/2022]
Abstract
The purpose of our investigation was to evaluate the laryngeal findings and acoustic changes in hubble-bubble smokers. A total of 42 subjects with history of hubble-bubble smoking were recruited for this study. A corresponding group with a history of cigarette smoking and controls were matched. All subjects underwent laryngeal video-endostroboscopic evaluation and acoustic analysis. In the hubble-bubble smoking group, 61.9% were males. The average age was 30.02 +/- 9.48 years and the average number of years of smoking was 8.09 +/- 6.45 years. Three subjects had dysphonia at the time of examination. The incidence of benign lesions of the vocal folds in the hubble-bubble group was 21.5%, with edema being the most common at 16.7% followed by cyst at 4.8%. The incidence of laryngeal findings was significantly higher in the hubble-bubble group compared to controls. In the cigarette-smoking group, the most common finding was vocal fold cyst in 14.8% followed by polyps in 7.4%, and edema, sulcus vocalis and granuloma. These findings were not significantly different from the hubble-bubble group except for the thick mucus, which was significantly higher in the latter. There were no significant changes in any of the acoustic parameters between hubble-bubble smokers and controls except for the VTI and MPT, which were significantly lower in the hubble-bubble group. In comparison with the cigarette-smoking group, hubble-bubble smokers had significantly higher Fundamental frequency and habitual pitch (p value 0.042 and 0.008, respectively). The laryngeal findings in hubble-bubble smokers are comparable to cigarette smokers. These laryngeal findings are not translated acoustically, as all the acoustic parameters are within normal range compared to controls.
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Jamil H, Elsouhag D, Hiller S, Arnetz JE, Arnetz BB. Sociodemographic risk indicators of hookah smoking among White Americans: a pilot study. Nicotine Tob Res 2010; 12:525-9. [PMID: 20308223 DOI: 10.1093/ntr/ntq026] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Despite the sustained public health efforts to decrease cigarette smoking, there is an increasing trend in the use of alternative tobacco products that are perceived by some as less harmful. One example is hookah smoking. This study aimed to assess hookah trends among White Americans. METHODS Two hundred and forty-five White American adults residing in southeast Michigan answered a self-administered standardized questionnaire that included basic demographics, socioeconomic status, and questions related to hookah smoking behavior. Logistic regression was used to determine risk indicators for hookah smoking. RESULTS The combined prevalence of hookah smoking in the White American study population was 19%, with 10% of the sample smoking hookah only and 9% smoking both hookah and cigarettes. Approximately 19% of respondents believed that smoking hookah was less harmful than smoking cigarettes. Significant risk indicators for smoking hookah were being younger than 22 years and living with a family member who used tobacco. DISCUSSION In addition to reporting the prevalence of use in this important group of potential users, we outline important sociodemographic risk factors for hookah use in a non-Arab American population. More research is needed with a larger population to better understand this new tobacco trend in order to curb a new potential health threat.
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Affiliation(s)
- Hikmet Jamil
- Division of Occupational and Environmental Health, Department of Family Medicine and Public Health Sciences, Wayne State University, 3800 Woodward Ave., Suite 808, Detroit, MI 48201, USA.
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Hannoun A, Nassar AH, Usta IM, Abu Musa A. Effect of female nargile smoking on in vitro fertilization outcome. Eur J Obstet Gynecol Reprod Biol 2010; 150:171-4. [PMID: 20223580 DOI: 10.1016/j.ejogrb.2010.02.036] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2009] [Revised: 02/06/2010] [Accepted: 02/15/2010] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Smoking is a significant health hazard that has been associated with poor reproductive outcome and reduced fertility in reproductive age women. The aim of this study was to assess the effect of nargile smoking on intra-cytoplasmic sperm injection (ICSI) outcome. STUDY DESIGN A prospective analysis of the outcomes of 297 women who underwent ICSI treatment at the ART Unit at the American University of Beirut Medical Center between January 1, and December 31, 2006 was done. The patients were divided into 3 groups based on their smoking status: cigarette smokers (n=42), nargile smokers (n=51) and non-smokers (n=204). RESULTS The mean age of nargile smokers was significantly lower than the other groups; however, the 3 groups were similar with respect to the cause of infertility, total dose of follicular stimulating hormone (FSH), number of oocytes and embryos obtained, and number and quality of embryos transferred. There was no significant difference in the clinical pregnancy rate between nargile smokers and non-smokers (51.0% vs 43.6%). However, cigarette smokers had a significantly lower clinical pregnancy rate compared to non-smokers (23.8% vs 43.6%, p=0.0238). On multiple logistic regression analysis, factors that decreased the clinical pregnancy rates were cigarette smoking and maternal age. CONCLUSION Although this study did not find a deleterious effect of nargile smoking on ICSI outcome, the results need to be confirmed in prospective studies that would include larger number of women with more objective measures of nargile smoke exposure.
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Affiliation(s)
- Antoine Hannoun
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon.
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Eissenberg T, Shihadeh A. Waterpipe tobacco and cigarette smoking: direct comparison of toxicant exposure. Am J Prev Med 2009; 37:518-23. [PMID: 19944918 PMCID: PMC2805076 DOI: 10.1016/j.amepre.2009.07.014] [Citation(s) in RCA: 326] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2009] [Revised: 07/01/2009] [Accepted: 07/24/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND Waterpipe (hookah, shisha) tobacco smoking has spread worldwide. Many waterpipe smokers believe that, relative to cigarettes, waterpipes are associated with lower smoke toxicant levels and fewer health risks. For physicians to address these beliefs credibly, waterpipe use and cigarette smoking must be compared directly. PURPOSE The purpose of this study is to provide the first controlled, direct laboratory comparison of the toxicant exposure associated with waterpipe tobacco and cigarette smoking. METHODS Participants (N=31; M=21.4 years, SD=2.3) reporting monthly waterpipe use (M=5.2 uses/month, SD=4.0) and weekly cigarette smoking (M=9.9 cigarettes/day, SD=6.4) completed a crossover study in which they each smoked a waterpipe for a maximum of 45 minutes, or a single cigarette. Outcome measures included expired-air carbon monoxide (CO) 5 minutes after session's end, and blood carboxyhemoglobin (COHb), plasma nicotine, heart rate, and puff topography. Data were collected in 2008-2009 and analyzed in 2009. RESULTS On average, CO increased by 23.9 ppm for waterpipe use (SD=19.8) and 2.7 ppm for cigarette smoking (SD=1.8), while peak waterpipe COHb levels (M=3.9%, SD=2.5) were three times those observed for cigarette smoking (M=1.3%, SD=0.5; p's<0.001). Peak nicotine levels did not differ (waterpipe M=10.2 ng/mL, SD=7.0; cigarette M=10.6 ng/mL, SD=7.7). Significant heart rate increases relative to pre-smoking were observed at 5, 10, 15, 20, 25, and 35 minutes during the cigarette session and at 5-minute intervals during the waterpipe session (p's<0.001). Mean total puff volume was 48.6 L for waterpipe use as compared to 1.0 L for cigarette smoking (p<0.001). CONCLUSIONS Relative to cigarette smoking, waterpipe use is associated with greater CO, similar nicotine, and dramatically more smoke exposure. Physicians should consider advising their patients that waterpipe tobacco smoking exposes them to some of the same toxicants as cigarette smoking and therefore the two tobacco-smoking methods likely share some of the same health risks.
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Affiliation(s)
- Thomas Eissenberg
- Department of Psychology and Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia 23298, USA.
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Afifi RA, Yeretzian JS, Rouhana A, Nehlawi MT, Mack A. Neighbourhood influences on narghile smoking among youth in Beirut. Eur J Public Health 2009; 20:456-62. [PMID: 19884160 DOI: 10.1093/eurpub/ckp173] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Increasingly neighbourhoods are identified as influencing health. Neighbourhood characteristics have been linked to cigarette use. In Lebanon, the water pipe (narghile) use is most frequent among youth. The current study is aimed at identifying differential neighbourhood influences on smoking narghile among youth. METHODS A quantitative interview was completed with 1294 adolescents, 13-20 years, in three urban disadvantaged neighbourhoods of Beirut. Individual and social factors, suggested by the literature, were associated with smoking narghile. The neighbourhood variation in the influence of these factors was then explored. Bivariate and stratified logistic regression analysis were conducted, neighbourhood being the stratification variable. RESULTS About 60% of respondents had ever tried a narghile, about one-fifth continued to smoke. Several individual-level and social variables predicted narghile smoking bivariately. The influences on narghile smoking varied by neighbourhood. Neighbourhood differences persisted at the multivariate level. Consistently across neighbourhoods, the influence of friends was the predominant predictor of narghile smoking. In one neighbourhood, maternal smoking was a risk factor for narghile smoking of youth, in another paternal smoking. Being female seems to be protective in two of the three neighbourhoods. Other factors also differentially influence narghile use by neighbourhood. CONCLUSIONS The mechanisms of influence of neighbourhoods on health are not clearly understood, but a transactional paradigm seems most fitting with the results found in this research. Interventions to prevent the narghile smoking should address multiple levels of influence; and must be tailored to the particular aspects of neighbourhoods which are influential in the uptake of this behaviour.
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Affiliation(s)
- Rema A Afifi
- Department of Health Behavior and Education, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
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Khater AEM, Abd El-Aziz NS, Al-Sewaidan HA, Chaouachi K. Radiological hazards of Narghile (hookah, shisha, goza) smoking: activity concentrations and dose assessment. JOURNAL OF ENVIRONMENTAL RADIOACTIVITY 2008; 99:1808-14. [PMID: 18768240 DOI: 10.1016/j.jenvrad.2008.07.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2008] [Revised: 06/13/2008] [Accepted: 07/20/2008] [Indexed: 05/26/2023]
Abstract
Narghile (hookah, shisha, goza, "water-pipe") smoking has become fashionable worldwide. Its tobacco pastes, known as moassel and jurak, are not standardized and generally contain about 30-50% (sometimes more) tobacco, molasses/juice of sugarcane, various spices and dried fruits (particularly in jurak) and, in the case of moassel, glycerol and flavoring essences. Tobacco contains minute amounts of radiotoxic elements such as (210)Pb, (210)Po and uranium, which are inhaled via smoking. Only very few data have been published on the concentrations of natural radionuclides in narghile tobacco mixtures. Consequently, the aim of this study was to draw first conclusions on the potential hazards of radioactivity in moassel tobacco in relation to narghile smoking. The results indicate the existence of a wide range in the radioactivity contents where the average (range) activity concentrations of (238)U, (234)Th (226)Ra, (210)Pb, (210)Po, (232)Th and (40)K, in Bq/kg dry weight were 55 (19-93), 11 (3-23), 3 (1.2-8), 14 (3-29), 13 (7-32), 7 (4-10) and 719 (437-1044)Bq/kg dry weight, respectively. The average concentrations of natural radionuclides in moassel tobacco pastes are comparable to their concentration in Greek cigarettes and tobacco leaves, and lower than that of Brazilian tobacco leaves. The distribution pattern of these radionuclides after smoking, between smoke, ash and filter, is unknown, except for (210)Po during cigarette smoking and from one existing study during moassel smoking. Radiological dose assessment due to intake of natural radionuclides was calculated and the possible radio-toxicity of the measured radionuclides is briefly discussed.
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Affiliation(s)
- Ashraf E M Khater
- National Center for Nuclear Safety and Radiation Control, Atomic Energy Authority, Cairo, Egypt.
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Abstract
BACKGROUND The extent of smoking related health and economic problems is causing increasing alarm throughout the world. In the last few years a great number of subjects, especially in the developing world, have been smoking narghile and epidemiological studies on narghile smoking are an essential subject for investigation. The objectives of this study are to describe the social and cultural characteristics of narghile smokers in Lebanon compared to tobacco smokers. MATERIALS AND METHODS Our sample is based on the data of 37579 subjects who consulted a non-governmental organisation (NGO), the Hariri Foundation, between 2003 and 2005. This NGO comprises 22 specialised centres distributed throughout Lebanon. The following data concerning exclusive narghile and cigarette smokers were collected: age, sex, the type and duration of tobacco addiction and the level of education. RESULTS 13776 subjects (36.6% of the sample) were smokers of whom 88% smoked mostly cigarettes. 1529 subjects (11.1%) smoked narghile exclusively, a prevalence of 4.06%. The narghile smokers were younger than the cigarette smokers with a mean age of 36.2+/-8.63 years compared to 45.52+/-1.87 years. The majority of narghile smokers were women (56.57%) giving a male/female ratio of 0.77. A large number of narghile smokers were recent consumers with an exposure of less than 5 years. They differed from the cigarette smokers of whom the majority (72.2%) had smoked for more than 10 years. The proportion of illiterate subjects was greater among the narghile smokers (36.2%) than the cigarette smokers (24.2%). CONCLUSION The consumption of tobacco is a real and frequent problem in Lebanon. The consumption of narghile is scourge that is gaining popularity, notably among women and the young. This problem is becoming a public health issue that needs to be taken into account within the framework of an anti-smoking policy in Lebanon.
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