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Rezk-Hanna M, Maziak W. Unsubstantiated Claims by the Hookah Tobacco Industry to Exempt Flavored Hookah Tobacco Products From Flavor Bans. Nicotine Tob Res 2024:ntae114. [PMID: 38902866 DOI: 10.1093/ntr/ntae114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 04/10/2024] [Accepted: 04/30/2024] [Indexed: 06/22/2024]
Affiliation(s)
- Mary Rezk-Hanna
- School of Nursing, University of California, Los Angeles, Los Angeles, CA, USA
| | - Wasim Maziak
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
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Ferdous Z, Beegam S, Zaaba NE, Nemmar A. Exposure to Waterpipe Smoke Disrupts Erythrocyte Homeostasis of BALB/c Mice. BIOLOGY 2024; 13:453. [PMID: 38927333 DOI: 10.3390/biology13060453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 06/14/2024] [Accepted: 06/15/2024] [Indexed: 06/28/2024]
Abstract
The prevalence of waterpipe tobacco smoking (WPS) is increasing worldwide and is relatively high among youth and young adults. It has been shown, both experimentally and clinically, that WPS exposure adversely affects the cardiovascular and hematological systems through the generation of oxidative stress and inflammation. Our study aimed to evaluate the impact of WPS exposure on erythrocytes, a major component of the hematological system, of BALB/c mice. Here, we assessed the effect of nose-only WPS exposure for four consecutive weeks on erythrocyte inflammation, oxidative stress, and eryptosis. The duration of the session was 30 min/day, 5 days/week. Control mice were exposed to air. Our results showed that the levels of C-reactive protein, lipid peroxidation (LPO), superoxide dismutase, and total nitric oxide (NO) were significantly increased in the plasma of WPS-exposed mice. The number of erythrocytes and the hematocrit were significantly decreased in WPS-exposed mice compared with the control group. Moreover, there was an increase in the erythrocyte fragility in mice exposed to WPS compared with those exposed to air. The levels of lactate dehydrogenase, LPO, reduced glutathione, catalase, and NO were significantly increased in the red blood cells (RBCs) of WPS-exposed mice. In addition, erythrocytes of the WPS-exposed group showed a significant increase in ATPase activity, Ca2+, annexin V binding, and calpain activity. Taken together, our findings suggest that WPS exposure elevated inflammation and oxidative stress in the plasma and induced hemolysis in vivo. It also caused alterations of RBCs oxidative stress and eryptosis in vitro. Our data confirm the detrimental impact of WPS on erythrocyte physiology.
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Affiliation(s)
- Zannatul Ferdous
- Department of Physiology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
| | - Sumaya Beegam
- Department of Physiology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
| | - Nur E Zaaba
- Department of Physiology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
| | - Abderrahim Nemmar
- Department of Physiology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
- Zayed Center for Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
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Yan YY, Ye F, Ho MH, Yeung KCY, Lee JJ. Biomarkers of Waterpipe Tobacco Smoke Exposure: A Systematic Review and Meta-Analysis. Nicotine Tob Res 2024; 26:655-662. [PMID: 38157415 DOI: 10.1093/ntr/ntad262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 12/01/2023] [Accepted: 12/26/2023] [Indexed: 01/03/2024]
Abstract
INTRODUCTION The prevalence of waterpipe tobacco smoking is increasing globally. Biomarkers of waterpipe tobacco smoke (WTS) exposure are less studied. AIMS AND METHODS To identify the types of biomarkers of WTS exposure and estimate changes in biomarker concentrations pre- to post-WTS exposure. PubMed, Embase, Web of Science, CINAHL Plus, PsycINFO, and Cochrane Library were searched for studies up to April 24, 2023. The types of biomarkers were identified. Random-effects models were used to estimate changes in biomarker concentrations pre- to post-WTS exposure. RESULTS Seventy-three studies involving 3755 participants exposed to WTS (49% male, mean age: 24.8 years) and 11 types of biomarkers of WTS exposure were identified. The biomarkers included tobacco alkaloids, expired carbon monoxide (eCO), carboxyhemoglobin (COHb), tobacco-specific nitrosamines, volatile organic compounds (VOCs), polycyclic aromatic hydrocarbons (PAHs), heavy metals, unmetabolized VOCs, unmetabolized PAHs, furan metabolites, and heterocyclic aromatic amines. Compared with pre-WTS exposure, eCO (breath; mean difference [MD] 27.00 ppm; 95% confidence interval [CI]: 20.91 to 33.08), COHb (blood; MD 4.30%; 95%CI: 2.57 to 6.03), COHb (breath; MD 7.14%; 95%CI: 4.96 to 9.31), nicotine (blood; MD 8.23 ng/mL; 95%CI: 6.27 to 10.19), and cotinine (urine; MD 110.40 ng/mL; 95%CI: 46.26 to 174.54) significantly increased post-WTS exposure. CONCLUSIONS Biomarkers of WTS exposure were systematically identified. The similarity between the biomarkers of WTS exposure and those of cigarette smoke and higher concentrations of some biomarkers post-WTS exposure underscore the need for further research on applying biomarkers in surveillance, interventions, and regulations to mitigate the harms of waterpipe tobacco smoking. IMPLICATIONS This study provides the first comprehensive overview of biomarkers investigated and available for assessing WTS exposure and their concentration changes in the human body. Researchers can use biomarkers such as eCO, COHb, nicotine, and cotinine to measure the health risks associated with WTS exposure and objectively evaluate the effectiveness of public health interventions aimed at reducing waterpipe tobacco smoking. Public health policymaking can also be informed through increased biomarker concentrations following WTS exposure, to implement regulations and public health education campaigns on limiting or preventing waterpipe tobacco smoking.
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Affiliation(s)
- Yong Yang Yan
- LKS Faculty of Medicine, School of Nursing, University of Hong Kong, Hong Kong SAR, China
| | - Fen Ye
- LKS Faculty of Medicine, School of Nursing, University of Hong Kong, Hong Kong SAR, China
| | - Mu-Hsing Ho
- LKS Faculty of Medicine, School of Nursing, University of Hong Kong, Hong Kong SAR, China
| | | | - Jung Jae Lee
- LKS Faculty of Medicine, School of Nursing, University of Hong Kong, Hong Kong SAR, China
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Haile ZT, Karim S, Murton K, Patibandla S, Haider MR. Association between history of hookah use and symptoms of postpartum depression: A population-based study. Int J Gynaecol Obstet 2024; 165:746-755. [PMID: 38063019 DOI: 10.1002/ijgo.15285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/19/2023] [Accepted: 11/20/2023] [Indexed: 04/17/2024]
Abstract
OBJECTIVE Although several biologic, psychosocial, and behavioral factors have been linked to postpartum depressive symptoms, studies examining the association between non-cigarette tobacco products and symptoms of postpartum depression are currently lacking. This study examined the association between hookah use and postpartum depressive symptoms. METHODS A cross-sectional study was conducted using data from the US Centers for Disease Control and Prevention's Pregnancy Risk Assessment Monitoring System 2016-2020. Self-reported data on hookah use in the last 2 years and maternal mental health were captured using a structured questionnaire. Descriptive and inferential statistics were performed. RESULTS The final study sample consisted of 106 894 participants. Approximately 8.2% of the participants reported postpartum depressive symptoms and 4.1% reported hookah use in the past 2 years. Compared with those without postpartum depressive symptoms, participants with postpartum depressive symptoms were more likely to be hookah users (5.5% vs 4.0%, P < 0.001). After adjustment for confounders, the odds of having postpartum depressive symptoms were significantly higher among participants who used a hookah in the past 2 years compared with non-users; adjusted odds ratio (95% confidence interval) 1.20 (1.03-1.40); P = 0.022. CONCLUSION In a large, population-based sample of US women, hookah use in the past 2 years significantly increased the odds of having postpartum depressive symptoms, independent of potential confounders. This finding underscores the need for healthcare providers to communicate effectively about the health risks of hookah use.
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Affiliation(s)
- Zelalem T Haile
- Department of Social Medicine, Ohio University Heritage College of Osteopathic Medicine, Dublin, Ohio, USA
| | - Sabrina Karim
- Institute for Families in Society, College of Social Work, University of South Carolina, Columbia, South Carolina, USA
| | - Kasey Murton
- Ohio University Heritage College of Osteopathic Medicine, Cleveland, Ohio, USA
| | - Sravya Patibandla
- Ohio University Heritage College of Osteopathic Medicine, Dublin, Ohio, USA
| | - Mohammad Rifat Haider
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, Georgia, USA
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Ismail A, Hamdar L, Dirawi H, Kanso M, Salem I, Tamim H, Mahfoud Z. Predictors and health outcomes of tobacco smoking among the population of Gaza: A large-scale study. RESEARCH SQUARE 2024:rs.3.rs-4195976. [PMID: 38746468 PMCID: PMC11092850 DOI: 10.21203/rs.3.rs-4195976/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Tobacco smoking, a significant public health concern globally, is associated with a rise in noncommunicable diseases and preventable deaths, with pronounced impacts in conflict zones like Gaza. A study in Gaza focused on individuals over 40 years of age, aiming to identify predictors of tobacco use and its links to diseases like coronary artery disease, chronic lung disease, and stroke. The research, based on the Gaza NCD study data with 4576 participants and a 96.6% response rate, found an overall tobacco smoking prevalence of 19.4%, with higher rates among men. Adjusting for various factors, the study revealed significant associations between cigarette smoking in men and adverse health outcomes, such as coronary artery disease and chronic lung disease. However, after adjusting for independent variables, shisha smoking in men showed no association with these health outcomes. In conflict-affected regions like Gaza, this large-scale study sheds light on predictors of cigarette and shisha smoking and their impact on health outcomes, offering valuable insights for researchers, public health officials, healthcare professionals, and policymakers. The findings aid in predicting smoking prevalence, addressing current health challenges, and mitigating potential health and financial burdens associated with tobacco use in conflict zones.
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Affiliation(s)
- Ali Ismail
- American University of Beirut Medical Center
| | | | - Hiba Dirawi
- American University of Beirut Medical Center
| | | | | | - Hani Tamim
- American University of Beirut Medical Center
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Mdege ND, Ekpo R, Ogolla S, Ali SJ, Camara A, Mugweni E. Reasons for shisha smoking: Findings from a mixed methods study among adult shisha smokers in Nigeria. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002853. [PMID: 38306320 PMCID: PMC10836660 DOI: 10.1371/journal.pgph.0002853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 01/02/2024] [Indexed: 02/04/2024]
Abstract
Shisha smoking has increased significantly worldwide over the past decade including in developing countries such as Nigeria. We aimed to understand the reasons for shisha smoking in Nigeria in order to address the lack of context-specific evidence to inform the national response to the growing threat posed by shisha smoking. We adopted the Theory of Planned Behaviour to conduct in-depth interviews among 78 purposely sampled current shisha smokers in 13 states (six in each state), and a quantitative survey including a random sample of 611 current shisha smokers in 12 states, across the six geopolitical zones in Nigeria. The in-depth interview data was analysed using thematic analysis whilst the quantitative survey data was analysed descriptively. We triangulated the key findings from the two datasets using a triangulation matrix organised by the three meta-themes: attitude, subjective norms, perceived behavioural control. Positive attitudes towards shisha smoking stem from shisha flavours, perceived pleasure from shisha smoking, curiosity about product attributes, beliefs about health benefits, limited knowledge on the health effects, and weak regulation. Having friends and family members who smoke shisha and the need to belong, particularly during social events, also promote shisha smoking. Negative societal views towards shisha smoking are potentially a protective factor. The availability of and ability to smoke shisha in many places makes shisha more accessible, whilst the high costs of shisha are potentially prohibitive. The findings also indicate that quitting shisha smoking without support is difficult. Restrictions on flavours, strengthening compliance monitoring and enforcement of the tobacco control laws in relation to shisha (e.g., smoke-free environments in indoor and outdoor public places; health warnings in English on shisha products including the pots; and tax and price measures) have the potential to minimise initiation and use, and to protect the health and wellbeing of Nigeria's general public.
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Affiliation(s)
- Noreen Dadirai Mdege
- Department of Health Sciences, University of York, York, United Kingdom
- Development Gateway: An IREX Venture, Washington, DC, United States of America
- Centre for Research in Health and Development, York, United Kingdom
| | - Ranti Ekpo
- Voice of Children Foundation, Abuja, Nigeria
| | - Sharon Ogolla
- Development Gateway: An IREX Venture, Washington, DC, United States of America
| | - Seember Joy Ali
- Development Gateway: An IREX Venture, Washington, DC, United States of America
| | - Aminata Camara
- Development Gateway: An IREX Venture, Washington, DC, United States of America
| | - Esther Mugweni
- Centre for Health Services Studies, University of Kent Canterbury, Kent, United Kingdom
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Le PH, Van Phan C, Truong DTT, Ho NM, Shuyna I, Le NT. Waterpipe tobacco smoking and risk of all-cause mortality: a prospective cohort study. Int J Epidemiol 2024; 53:dyad140. [PMID: 37843876 DOI: 10.1093/ije/dyad140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 09/29/2023] [Indexed: 10/17/2023] Open
Abstract
BACKGROUND Despite an increasing proportion of smokers who use non-cigarette products, the harmfulness of these is inconsistent. This study aimed to evaluate the impact of waterpipe tobacco (WTP) smoking on all-cause mortality. METHODS A prospective cohort study followed up on 35 646 participants from 2007 to 2019 in Northern Viet Nam. Data for each type of cigarette and WTP smoking were collected based on demographic lifestyle and semi-quantitative food frequency questionnaires. Smokers were categorized as current smokers and former smokers who were lifetime ever smokers but stopped smoking >6 months before the interview. Data on all-cause mortality (2449 deaths) were obtained from medical records at the state health facilities. The hazard ratios (HRs) and 95% CIs for mortality were estimated using a Cox proportional-hazards model. RESULTS Compared with non-smokers, ever smokers had a higher all-cause mortality risk (HR = 1.29, 95% CI = 1.16-1.43). Current WTP (HR = 1.37, 95% CI = 1.19-1.57), current cigarette (HR = 1.40, 95% CI = 1.22-1.60) and former WTP smokers (HR = 1.39, 95% CI = 1.10-1.76) showed an elevated risk of dying. The mortality risk was significantly elevated in dual smokers using WTP and cigarettes (HR = 1.55, 95% CI = 1.35-1.79) and exclusive WTP smokers (HR = 1.38, 95% CI = 1.21-1.57). Elevated risk was observed for the main targeted attractions of cancer, diabetes and heart diseases. Smoking cessation of >10 years decreased the risk of all-cause mortality (HR = 0.61, 95% CI = 0.44-0.85) and cancer (HR = 0.24, 95% CI = 0.11-0.52). CONCLUSIONS WTP smoking increases the risk of all-cause mortality. A unique programme to control exposure to WTP should be a high priority in Viet Nam and other countries.
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Affiliation(s)
- Phuoc Hong Le
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam
| | - Can Van Phan
- Center for Population Health Sciences, Hanoi University of Public Health, Ha Noi City, Viet Nam
| | - Dung Thuy Thi Truong
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam
- Graduate School of Public Health, International University of Health and Welfare, Narita City, Japan
| | - Nguyet Minh Ho
- Department of Non-Communicable Disease Control, Ho Chi Minh City Center for Disease Control, Ho Chi Minh City, Viet Nam
| | - Ikeda Shuyna
- The Canon Institute for Global Studies, Tokyo, Japan
- Department of Public Health, School of Medicine, International University of Health and Welfare, Japan
| | - Ngoan Tran Le
- Institute of Research and Development, Duy Tan University, Da Nang City, Viet Nam
- Department of Occupational Health, Institute for Preventive Medicine and Public Health, Hanoi Medical University, Ha Noi, Viet Nam
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Awada Z, Cahais V, Cuenin C, Akika R, Silva Almeida Vicente AL, Makki M, Tamim H, Herceg Z, Khoueiry Zgheib N, Ghantous A. Waterpipe and cigarette epigenome analysis reveals markers implicated in addiction and smoking type inference. ENVIRONMENT INTERNATIONAL 2023; 182:108260. [PMID: 38006773 PMCID: PMC10716859 DOI: 10.1016/j.envint.2023.108260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/02/2023] [Accepted: 10/09/2023] [Indexed: 11/27/2023]
Abstract
Waterpipe smoking is frequent in the Middle East and Africa with emerging prevalence worldwide. The epigenome acts as a molecular sensor to exposures and a crucial driver in several diseases. With the widespread use of waterpipe smoking, it is timely to investigate its epigenomic markers and their role in addiction, as a central player in disease prevention and therapeutic strategies. DNA methylome-wide profiling was performed on an exposure-rich population from the Middle East, constituting of 216 blood samples split equally between never, cigarette-only and waterpipe-only smokers. Waterpipe smokers showed predominantly distinct epigenetic markers from cigarette smokers, even though both smoking forms are tobacco-based. Moreover, each smoking form could be accurately (∼90 %) inferred from the DNA methylome using machine learning. Top markers showed dose-response relationship with extent of smoking and were validated using independent technologies and additional samples (total N = 284). Smoking markers were enriched in regulatory regions and several biological pathways, primarily addiction. The epigenetically altered genes were not associated with genetic etiology of tobacco use, and the methylation levels of addiction genes, in particular, were more likely to reverse after smoking cessation. In contrast, other epigenetic markers continued to feature smoking exposure after cessation, which may explain long-term health effects observed in former smokers. This study reports, for the first time, blood epigenome-wide markers of waterpipe smokers and reveals new markers of cigarette smoking, with implications in mechanisms of addiction and the capacity to discriminate between different smoking types. These markers may offer actionable targets to reverse the epigenetic memory of addiction and can guide future prevention strategies for tobacco smoking as the most preventable cause of illnesses worldwide.
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Affiliation(s)
- Zainab Awada
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer, Lyon, France
| | - Vincent Cahais
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer, Lyon, France
| | - Cyrille Cuenin
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer, Lyon, France
| | - Reem Akika
- Department of Pharmacology and Toxicology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Anna Luiza Silva Almeida Vicente
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer, Lyon, France; Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Maha Makki
- Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hani Tamim
- Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Zdenko Herceg
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer, Lyon, France
| | - Nathalie Khoueiry Zgheib
- Department of Pharmacology and Toxicology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
| | - Akram Ghantous
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer, Lyon, France.
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Chami HA, Diab M, Zaouk N, Arnaout S, Mitchell GF, Isma'eel H, Shihadeh A. Central and Peripheral Hemodynamics in Young Adults Who Use Water Pipes and the Acute Effects of Water-Pipe Use. Chest 2023; 164:1481-1491. [PMID: 37541338 DOI: 10.1016/j.chest.2023.07.070] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 07/24/2023] [Accepted: 07/26/2023] [Indexed: 08/06/2023] Open
Abstract
BACKGROUND Tobacco use via water pipe (commonly referred to as water-pipe smoking [WPS]) is popular among young adults globally and exposes those who smoke to toxicants. RESEARCH QUESTION Is WPS associated with impaired measures of arterial function and does WPS acutely impair these measures in young adults? STUDY DESIGN AND METHODS We assessed heart rate (HR), brachial and aortic BP, HR-adjusted augmentation index (AI), and carotid-femoral pulse wave velocity (CFPWV) in 62 individuals who use water pipes and 34 individuals who have never used a water pipe recruited from the community (mean age, 22.5 ± 3.0 years; 48% female). Measurements were obtained before and after an outdoor session of WPS among participants who use water pipes and among the control group of participants who have never used a water pipe. Measurements were compared after vs before exposure and between those who use and those who do not use water pipes, adjusting for possible confounders using linear regression. RESULTS Participants who use water pipes and control participants had similar demographic characteristics. BP and HR increased acutely after WPS (brachial systolic BP by 4.13 mm Hg [95% CI, 1.91-6.36 mm Hg]; aortic systolic BP by 2.31 mm Hg [95% CI, 0.28-4.33 mm Hg]; brachial diastolic BP by 3.69 mm Hg [95% CI, 1.62-5.77 mm Hg]; aortic diastolic BP by 3.03 mm Hg [95% CI, 0.74-5.33 mm Hg]; and HR by 7.75 beats/min [95% CI, 5.46-10.04 beats/min]), but not in the control group. AI was significantly higher in participants who use water pipes compared with those who do not (9.02% vs 3.06%; P = .03), including after adjusting for BMI and family history of cardiovascular disease (β = 6.12; 95% CI, 0.55-11.69; P = .03) and when assessing habitual tobacco use via water-pipe extent (water pipes used/day × water-pipe use duration) in water-pipe-years (β = 2.51/water-pipe-year; 95% CI, 0.10-4.92/water-pipe-year; P = .04). However, CFPWV was similar in those who use water pipes and those who do not, and AI and CFPWV did not change acutely after WPS. INTERPRETATION In apparently healthy young individuals from the community, habitual WPS was associated with increased AI, a predictor of cardiovascular risk, and one WPS session acutely increased HR and brachial and aortic BP.
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Affiliation(s)
- Hassan A Chami
- School of Medicine, Johns Hopkins University, Baltimore, MD; School of Medicine, American University of Beirut, Beirut, Lebanon.
| | - Maya Diab
- University of Michigan, Ann Arbor, MI
| | - Nour Zaouk
- School of Medicine, American University of Beirut, Beirut, Lebanon
| | - Samir Arnaout
- School of Medicine, American University of Beirut, Beirut, Lebanon
| | | | | | - Alan Shihadeh
- School of Engineering, American University of Beirut, Beirut, Lebanon
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Ben Taleb Z, Barrientos SA, Kalan ME, Cobb CO. Next generation waterpipe devices: the rise of electrical heating elements. Tob Control 2023:tc-2023-058188. [PMID: 37963772 DOI: 10.1136/tc-2023-058188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 11/01/2023] [Indexed: 11/16/2023]
Affiliation(s)
- Ziyad Ben Taleb
- Department of Kinesiology, College of Nursing and Health Innovation, The University of Texas at Arlington, Arlington, Texas, USA
| | - Steven Alec Barrientos
- Department of Kinesiology, College of Nursing and Health Innovation, The University of Texas at Arlington, Arlington, Texas, USA
| | | | - Caroline Oates Cobb
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Psychology, College of Humanities & Sciences, Virginia Commonwealth University, Richmond, Virginia, USA
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11
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Jebai R, Asfar T, Nakkash R, Chehab S, Wu W, Bursac Z, Maziak W. Impact of pictorial health warning labels on smoking beliefs and perceptions among waterpipe smokers: an online randomised cross-over experimental study. Tob Control 2023; 32:715-722. [PMID: 35444030 PMCID: PMC9582042 DOI: 10.1136/tobaccocontrol-2021-057202] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 04/04/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE Waterpipe tobacco smoking (WTS) has substantially increased among young people in Lebanon, who perceive WTS as safer than cigarettes. Health warning labels (HWLs) can inform the adverse effects associated with smoking. Thus, their application to waterpipe offers a favourable policy to limit WTS epidemic. This study assessed the effectiveness of pictorial HWLs and their placements on waterpipe parts (device, tobacco and charcoal package) on several communication outcomes. METHODS We conducted a randomised cross-over experimental study among 276 waterpipe smokers (aged 18-34) between 13 and 26 August 2021. Participants observed three conditions: pictorial HWLs on tobacco packages, pictorial HWLs on three parts of the waterpipe (device, tobacco and charcoal package) and text only on tobacco package in random order. Participants completed baseline and postexposure assessments evaluating HWL effectiveness on attention, reaction, attitudes and beliefs, perceived effectiveness of HWLs and intention to quit WTS. Planned comparisons using Friedman test followed by pairwise Wilcoxon signed-rank test for multiple comparisons were conducted. RESULTS Compared with text only, pictorial HWLs elicited greater attention (p=0.011), higher cognitive elaboration (p=0.021), perceived message effectiveness (p=0.007), negative affect reactions (p<0.01) and greater psychological reactance (p=0.01). No significant differences were found for most communication outcomes between pictorial HWLs on three parts of the waterpipe compared with tobacco package only. CONCLUSIONS Pictorial HWLs on tobacco package were superior to text only for several communication outcomes. These findings provide strong evidence for potential implementation of pictorial HWLs on waterpipe tobacco packages to increase smokers' awareness of the health effects of WTS and correct false safety perceptions.
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Affiliation(s)
- Rime Jebai
- Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, USA
| | - Taghrid Asfar
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, Florida, USA
- Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, Florida, USA
- Syrian Center for Tobacco Studies, Aleppo, Syria
| | - Rima Nakkash
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
- Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, Virginia, USA
| | - Sara Chehab
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Wensong Wu
- Department of Mathematics and Statistics, College of Arts, Sciences & Education, Florida International University, Miami, Florida, USA
| | - Zoran Bursac
- Department of Biostatistics, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, USA
| | - Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, USA
- Syrian Center for Tobacco Studies, Aleppo, Syria
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Almomen S, Aldossari M, Khaleel Y, Altamimi M, Alharbi O, Alsuwaydani A, Almutairi M, Alyousef S, Hafiz R, Alshomer F, Alqahtani AS. Effect of glycerol concentration on levels of toxicants emissions from water-pipe tobacco smoking (WTS). BMC Public Health 2023; 23:1858. [PMID: 37749520 PMCID: PMC10518960 DOI: 10.1186/s12889-023-16740-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 09/11/2023] [Indexed: 09/27/2023] Open
Abstract
Glycerol, flavorings and sweeteners constitute approximately 70% of water-pipe tobacco smoking (WTS) mixtures. Tobacco mixture combustion produces smoke toxins (e.g. carbonyl compounds), of which the type and amount are highly dependable on tobacco mixture formula. While glycerol in tobacco mixture contribute to enhanced smoking experience, its' combustion produces toxicants such as acrolein. According to WHO, there are no approved international upper limits regulations on WTS ingredients. This study aims to assess toxicant emission levels corresponding to increasing glycerol concentration in WTS mixtures, which may aid in developing tobacco regulations towards harm reduction.MethodsLaboratory experimental study. Using laboratory water-pipe smoking machine, levels of toxicant emissions in the smoke from WTS mixture samples containing varying glycerol concentrations were measured using High-performance Liquid Chromatography (HPLC). Smoke from 5 consecutive smoking cycles with 35 puffs each (ISO 22486 standard) was led through a trapping system as described in the Cooperation Centre for Scientific Research Relative to Tobacco (CORESTA) recommended method No. 74 (Determination of selected carbonyls in mainstream cigarette smoke by HPLC). Trapped carbonyls were then analysed by HPLC with a DAD detector.ResultsAcrolein emission is associated with glycerol addition in WTS mixture indicated by lab-made samples throughout all glycerol concentrations (10%, 20%, 40% and 60%), and brand samples with glycerol concentrations 10% to 20%. However, brand samples showed no increase in acrolein emission corresponding to the increase in glycerol concentrations from 20% to 60%.ConclusionThe effect of glycerol addition in waterpipe tobacco on acrolein emission varies between products. Tobacco fillers, additives and contents quality and other factors may affect toxicant emission levels. Therefore, regulatory recommendations towards defining upper limits of content concentrations require further investigations regarding potential confounders in acrolein emissions and health effects of market-available glycerol concentrations in waterpipe tobacco smoking.
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Affiliation(s)
- Salwa Almomen
- Saudi Food and Drug Authority (SFDA), 4904 Northern Ring Branch Rd, Riyadh, Saudi Arabia.
- Saudi Food and Drug Authority, 3904 Northern Ring Road, Hittin-Riyadh, 1351307148, Saudi Arabia.
| | - Mobarak Aldossari
- Saudi Food and Drug Authority (SFDA), 4904 Northern Ring Branch Rd, Riyadh, Saudi Arabia
| | | | - Mishal Altamimi
- Saudi Food and Drug Authority (SFDA), 4904 Northern Ring Branch Rd, Riyadh, Saudi Arabia
| | - Ohoud Alharbi
- Eurofins-Ajal, 14813 Al Anwar St, Riyadh, Saudi Arabia
| | | | - Malak Almutairi
- Saudi Food and Drug Authority (SFDA), 4904 Northern Ring Branch Rd, Riyadh, Saudi Arabia
| | - Sarah Alyousef
- Saudi Food and Drug Authority (SFDA), 4904 Northern Ring Branch Rd, Riyadh, Saudi Arabia
| | - Radwan Hafiz
- Saudi Food and Drug Authority (SFDA), 4904 Northern Ring Branch Rd, Riyadh, Saudi Arabia
| | | | - Amani S Alqahtani
- Saudi Food and Drug Authority (SFDA), 4904 Northern Ring Branch Rd, Riyadh, Saudi Arabia
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13
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Nguyen TG, Kieu HD, Truong DTT, Ngo KX, Ikeda S, Le NT. Exclusive waterpipe smoking and the risk of nasopharynx cancer in Vietnamese men, a prospective cohort study. Sci Rep 2023; 13:13237. [PMID: 37580413 PMCID: PMC10425396 DOI: 10.1038/s41598-023-40253-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 08/07/2023] [Indexed: 08/16/2023] Open
Abstract
Tobacco smoking is carcinogenic to humans. Besides cigarettes, the most common form of tobacco smoking, there was sparse evidence of waterpipe's carcinogenicity-induced nasopharyngeal cancer (NPC). This study investigated the association between waterpipe smoking and NPC mortality. Our study followed up with 20,144 eligible man participants from nine northern Vietnam communes between 2007 and 2019. Face-to-face interviews were conducted to gather data on exclusive waterpipe and cigarette smoking and dietary intake using structured semi-quantitative food frequency and lifestyle questionnaires. Nasopharyngeal cancer was determined by accessing the medical records at the state health facilities. We estimated the Cox proportional hazard ratio and 95% confidence intervals, HR (95% CI). The proportion of never smokers, exclusive waterpipe, exclusive cigarette, and dual waterpipe and cigarette smokers was 55.8%, 14.5%, 16.6%, and 13.1%, respectively. Exclusively waterpipe smokers increased the risk of NPC death compared to exclusively cigarette smokers, HR (95% CI): 4.51 (1.25, 16.31), p = 0.022. A dose-dependent positive relationship between NPC and exclusive waterpipe smoking was significantly seen for higher intensity HR (95% CI): 1.35 (1.07, 1.71), earlier age of smoking initiation HR (95% CI): 1.26 (1.06, 1.50), longer duration HR (95% CI): 1.31 (1.04, 1.66), and the cumulative number of a smoke lifetime HR (95% CI): 1.37 (1.08, 1.74). We observed a significant positive association between exclusive waterpipe smoking and NPC in men. The findings suggested that waterpipe smoking is likely more harmful than cigarettes in developing this cancer. A firm tobacco control against waterpipe smoking is highly recommended.
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Affiliation(s)
- Thinh Gia Nguyen
- School of Medicine, International University of Health and Welfare, Narita, Japan
| | - Hung Dinh Kieu
- Department of Surgery, Hanoi Medical University, Hanoi, Vietnam
| | - Dung Thuy Thi Truong
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Graduate School of Public Health, International University of Health and Welfare, Narita, Japan
| | - Khoa Xuan Ngo
- Department of Anatomy, Hanoi Medical University, Hanoi, Vietnam
| | - Shunya Ikeda
- Graduate School of Public Health, International University of Health and Welfare, Narita, Japan
| | - Ngoan Tran Le
- Institute of Research and Development, Duy Tan University, Da Nang, Vietnam.
- Department of Occupational Health, Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.
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14
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Alasmari AM, Almudarra SS. Unveiling the Tapestry of Tobacco Consumption: Exploring the Sociodemographic Factors Impacting Smokers at Smoking Cessation Clinics in Jeddah. Cureus 2023; 15:e43050. [PMID: 37680435 PMCID: PMC10480578 DOI: 10.7759/cureus.43050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2023] [Indexed: 09/09/2023] Open
Abstract
Background The World Health Organization (WHO) has identified tobacco smoking as a global epidemic, causing an estimated three million deaths annually. This study aims to examine the sociodemographic characteristics and smoking-related behaviors among individuals attending smoking cessation clinics in Jeddah during 2022. By identifying these factors, appropriate interventions can be developed to combat the smoking epidemic. Methodology The study enrolled male and female participants who visited the Smoking Cessation Clinics in Jeddah from January 2022 to December 2022. Eligible participants were between 18 and 60 years old and agreed to take part in the study. Data on smoking status, medical history, previous attempts at quitting, and medication use were collected. Statistical analysis, including chi-square tests and P-values, was conducted to assess the associations between participants' medical history and smoking cessation attempts. Results A total of 5,869 participants were included in the study. The findings revealed that approximately one-fifth of the participants had previously attempted to quit smoking, while the majority 4,780 (81.4%) had not made any cessation attempts. Among those who had made quit attempts, the majority had tried quitting between one and four times 968 (16.5%). The duration of successful cessation reported by participants was generally short, with the majority 4,781 (81.5%) not experiencing any extended period of quitting. Common reasons for relapse included cravings, social influences, mood changes, stress, and withdrawal symptoms. The study also found significant associations between specific medical conditions and smoking cessation attempts. Conclusions The study identified significant associations between male gender, older age group (51-60 years), divorced marital status, intermediate educational levels, higher income levels, retired status, extreme body mass index (BMI) categories, and previous attempts at smoking cessation. Healthcare providers and policymakers should consider these findings when developing and implementing smoking cessation programs. The insights gained from this research can contribute to the development of targeted interventions to reduce smoking rates and improve public health outcomes.
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Affiliation(s)
| | - Sami S Almudarra
- Public Health and Epidemiology, Ministry of Health (MOH), Riyadh, SAU
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15
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Alalwan MA, Keller-Hamilton B, Long L, Lipkus I, Wagener TL, Mays D. Correlates of motivation to quit waterpipe tobacco smoking among US young adults: implications for cessation interventions. HEALTH EDUCATION RESEARCH 2023; 38:338-349. [PMID: 36880171 PMCID: PMC10558042 DOI: 10.1093/her/cyad010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 02/06/2023] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
Waterpipe tobacco smoking is a public health concern that poses many of the same health risks as cigarette smoking, especially among young adults-a subpopulation characterized by the highest prevalence of waterpipe tobacco smoking. Nevertheless, it remains understudied relative to other forms of tobacco use. We examined sociodemographic, behavioral and cognitive factors associated with young adults' motivation to quit waterpipe smoking using a theory-informed approach. We completed a secondary analysis of baseline data on waterpipe tobacco smoking beliefs and behavior collected from 349 US young adults aged 18-30 years. We analyzed sociodemographics, tobacco use and cessation behaviors and perceptions, and theory-related constructs associated with motivation to quit waterpipe tobacco smoking using linear regression. Overall, participants reported low motivation (mean = 2.68, SD = 1.56, scale range 1-7) and high self-efficacy (mean = 5.12, SD = 1.79) to quit waterpipe tobacco smoking. In multivariable analysis, prior quit attempts (β = 1.10, P < 0.01), greater perceived risks of waterpipe tobacco smoking (β = 0.42, P < 0.01) and increasingly negative attitudes toward waterpipe tobacco smoking (β = 0.29, P < 0.01) were associated with higher motivation to quit. These findings highlight the importance of those factors as potential cessation determinants. These findings can help guide the development and refinement of interventions targeting young adult waterpipe tobacco smoking.
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Affiliation(s)
- Mahmood A Alalwan
- Division of Epidemiology, College of Public Health, The Ohio State University, 1841 Neil Ave., Columbus, OH 43210, USA
| | - Brittney Keller-Hamilton
- Department of Internal Medicine, Wexner Medical Center, Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, 3650 Olentangy River Road, Suite 410/420, Columbus, OH 43214, USA
| | - Lauren Long
- Department of Internal Medicine, Wexner Medical Center, Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, 3650 Olentangy River Road, Suite 410/420, Columbus, OH 43214, USA
| | - Isaac Lipkus
- Duke University School of Nursing, 307 Trent Dr., Durham, NC 27710, USA
| | - Theodore L Wagener
- Department of Internal Medicine, Wexner Medical Center, Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, 3650 Olentangy River Road, Suite 410/420, Columbus, OH 43214, USA
| | - Darren Mays
- Department of Internal Medicine, Wexner Medical Center, Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, 3650 Olentangy River Road, Suite 410/420, Columbus, OH 43214, USA
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16
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Whelan AR, Gimovsky AC, Jao NC, Werner EF, Vergara-Lopez C, Stroud LR. Waterpipe Tobacco (Hookah) Use in Pregnancy: Associations with Nausea and Vomiting of Pregnancy. Am J Perinatol 2023; 40:1033-1039. [PMID: 36724874 PMCID: PMC10483021 DOI: 10.1055/a-2024-0987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Waterpipe tobacco (WPT) use is common among reproductive age patients and is often perceived as safer than cigarette use. Prior studies have shown a decrease in nausea and vomiting symptoms among pregnant women who use cigarettes, but no studies to date have examined these symptoms in pregnant women who use WPT. This study was aimed to investigate the extent of symptoms of nausea/vomiting of pregnancy among participants who self-reported WPT use during pregnancy. STUDY DESIGN Secondary analysis of a prospective cohort study examining WPT use during pregnancy. Participants completed the Pregnancy-Unique Quantification of Emesis (PUQE) during first and third trimesters. Medical conditions were determined by medical record review. Participants were evaluated by sole WPT use versus dual/polysubstance WPT use and frequency of WPT use. RESULTS Ninety-nine (100%) participants completed the PUQE questionnaire during first trimester and 82 (82.8%) completed the PUQE during third trimester. Almost all (91.9%) participants reported moderate nausea/vomiting symptoms at both assessments. There was no difference in frequency of WPT use in pregnancy or rates of dual/polysubstance WPT use in participants with all levels of the PUQE questionnaire. There was also no difference in rates of WPT use or PUQE scores between sole WPT users and dual/polysubstance users. When comparing low and high WPT use, those who were in the higher frequency use group had higher waterpipe dependence scale scores (7.2 vs. 5.3, p < 0.02). With regard to maternal medical comorbidities, the only difference between groups was that sole WPT users were more likely to have a diagnosis of asthma than dual/polysubstance users (36.8 vs. 14.9%, p < 0.02). CONCLUSION There were no differences in symptoms of nausea and vomiting of pregnancy or medical conditions in pregnant women who use WPT with any frequency during pregnancy. However, sole WPT users had higher rates of asthma than dual/polysubstance WPT users. KEY POINTS · Waterpipe tobacco use is one of the most common forms of tobacco use among reproductive age patients.. · Waterpipe tobacco use was not associated with any changes in nausea/vomiting of pregnancy symptoms.. · Future research on the use of waterpipe tobacco in pregnancy can aid in public health responses..
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Affiliation(s)
- Anna R Whelan
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Women & Infants Hospital of Rhode Island, The Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Alexis C Gimovsky
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Women & Infants Hospital of Rhode Island, The Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Nancy C Jao
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois
| | - Erika F Werner
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Tufts Medical Center, Boston, Massachusetts
| | - Chrystal Vergara-Lopez
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Laura R Stroud
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School, Brown University, Providence, Rhode Island
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17
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Asfar T, Livingstone-Banks J, Ward KD, Eissenberg T, Oluwole O, Bursac Z, Ghaddar T, Maziak W. Interventions for waterpipe smoking cessation. Cochrane Database Syst Rev 2023; 6:CD005549. [PMID: 37286509 PMCID: PMC10245833 DOI: 10.1002/14651858.cd005549.pub4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND While cigarette smoking has declined globally, waterpipe smoking is rising, especially among youth. The impact of this rise is amplified by mounting evidence of its addictive and harmful nature. Waterpipe smoking is influenced by multiple factors, including appealing flavors, marketing, use in social settings, and misperceptions that waterpipe is less harmful or addictive than cigarettes. People who use waterpipes are interested in quitting, but are often unsuccessful at doing so on their own. Therefore, developing and testing waterpipe cessation interventions to help people quit was identified as a priority for global tobacco control efforts. OBJECTIVES: To evaluate the effectiveness of tobacco cessation interventions for people who smoke waterpipes. SEARCH METHODS We searched the Cochrane Tobacco Addiction Review Group Specialized Register from database inception to 29 July 2022, using variant terms and spellings ('waterpipe' or 'narghile' or 'arghile' or 'shisha' or 'goza' or 'narkeela' or 'hookah' or 'hubble bubble'). We searched for trials, published or unpublished, in any language. SELECTION CRITERIA We sought randomized controlled trials (RCTs), quasi-RCTs, or cluster-RCTs of any smoking cessation interventions for people who use waterpipes, of any age or gender. In order to be included, studies had to measure waterpipe abstinence at a three-month follow-up or longer. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Our primary outcome was abstinence from waterpipe use at least three months after baseline. We also collected data on adverse events. Individual study effects and pooled effects were summarized as risk ratios (RR) and 95% confidence intervals (95% CI), using Mantel-Haenszel random-effects models to combine studies, where appropriate. We assessed statistical heterogeneity with the I2 statistic. We summarized secondary outcomes narratively. We used the five GRADE considerations (risk of bias, inconsistency of effect, imprecision, indirectness, and publication bias) to assess the certainty of the body of evidence for our primary outcome in four categories high, moderate, low, or very low. MAIN RESULTS This review included nine studies, involving 2841 participants. All studies were conducted in adults, and were carried out in Iran, Vietnam, Syria, Lebanon, Egypt, Pakistan, and the USA. Studies were conducted in several settings, including colleges/universities, community healthcare centers, tuberculosis hospitals, and cancer treatment centers, while two studies tested e-health interventions (online web-based educational intervention, text message intervention). Overall, we judged three studies to be at low risk of bias, and six studies at high risk of bias. We pooled data from five studies (1030 participants) that tested intensive face-to-face behavioral interventions compared with brief behavioral intervention (e.g. one behavioral counseling session), usual care (e.g. self-help materials), or no intervention. In our meta-analysis, we included people who used waterpipe exclusively, or with another form of tobacco. Overall, we found low-certainty evidence of a benefit of behavioral support for waterpipe abstinence (RR 3.19 95% CI 2.17 to 4.69; I2 = 41%; 5 studies, N = 1030). We downgraded the evidence because of imprecision and risk of bias. We pooled data from two studies (N = 662 participants) that tested varenicline combined with behavioral intervention compared with placebo combined with behavioral intervention. Although the point estimate favored varenicline, 95% CIs were imprecise, and incorporated the potential for no difference and lower quit rates in the varenicline groups, as well as a benefit as large as that found in cigarette smoking cessation (RR 1.24, 95% CI 0.69 to 2.24; I2 = 0%; 2 studies, N = 662; low-certainty evidence). We downgraded the evidence because of imprecision. We found no clear evidence of a difference in the number of participants experiencing adverse events (RR 0.98, 95% CI 0.67 to 1.44; I2 = 31%; 2 studies, N = 662). The studies did not report serious adverse events. One study tested the efficacy of seven weeks of bupropion therapy combined with behavioral intervention. There was no clear evidence of benefit for waterpipe cessation when compared with behavioral support alone (RR 0.77, 95% CI 0.42 to 1.41; 1 study, N = 121; very low-certainty evidence), or with self-help (RR 1.94, 95% CI 0.94 to 4.00; 1 study, N = 86; very low-certainty evidence). Two studies tested e-health interventions. One study reported higher waterpipe quit rates among participants randomized to either a tailored mobile phone or untailored mobile phone intervention compared with those randomized to no intervention (RR 1.48, 95% CI 1.07 to 2.05; 2 studies, N = 319; very low-certainty evidence). Another study reported higher waterpipe abstinence rates following an intensive online educational intervention compared with a brief online educational intervention (RR 1.86, 95% CI 1.08 to 3.21; 1 study, N = 70; very low-certainty evidence). AUTHORS' CONCLUSIONS: We found low-certainty evidence that behavioral waterpipe cessation interventions can increase waterpipe quit rates among waterpipe smokers. We found insufficient evidence to assess whether varenicline or bupropion increased waterpipe abstinence; available evidence is compatible with effect sizes similar to those seen for cigarette smoking cessation. Given e-health interventions' potential reach and effectiveness for waterpipe cessation, trials with large samples and long follow-up periods are needed. Future studies should use biochemical validation of abstinence to prevent the risk of detection bias. Finally, there has been limited attention given to high-risk groups for waterpipe smoking, such as youth, young adults, pregnant women, and dual or poly tobacco users. These groups would benefit from targeted studies.
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Affiliation(s)
- Taghrid Asfar
- Syrian Center for Tobacco Studies, Aleppo, Syrian Arab Republic
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | | | - Kenneth D Ward
- Syrian Center for Tobacco Studies, Aleppo, Syrian Arab Republic
- School of Public Health, University of Memphis, Memphis, Tennessee, USA
| | - Thomas Eissenberg
- Syrian Center for Tobacco Studies, Aleppo, Syrian Arab Republic
- Department of Psychology and Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Olusanya Oluwole
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Zoran Bursac
- Biostatistics, Florida International University, Miami, FL, USA
| | - Tarek Ghaddar
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
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18
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Laqqan MM, Al-Ghora SS, Yassin MM. Impact of waterpipe and tobacco cigarette smoking on global DNA methylation and nuclear proteins genes transcription in spermatozoa: a comparative investigation. Inhal Toxicol 2023:1-10. [PMID: 37145555 DOI: 10.1080/08958378.2023.2208608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
BACKGROUND Waterpipe smoking is harmful and dangerous, and it is a growing threat to public health. OBJECTIVES This study was performed to evaluate the influence of waterpipe smoking on global DNA methylation, DNA fragmentation, and protamine deficiency in spermatozoa compared to cigarette heavy smokers and nonsmokers, and to determine whether the transcription levels of spermatozoa nuclear proteins genes 'PRM1, PRM2, and H2BFWT' in waterpipe smokers are different compared to cigarette heavy smokers and nonsmokers. METHODS A total of 900 semen samples were collected from males with a mean age of 32.5 ± 6.3 years (300 waterpipe smokers, 300 cigarette heavy smokers, and 300 nonsmokers). The nucleic acids were isolated from purified spermatozoa, and then the global DNA methylation and transcription levels of the PRM1, PRM2, and H2BFWT genes were assessed using ELISA and qPCR, respectively. RESULTS A significant increase was found in the level of global DNA methylation (8.6 ± 0.6 ng/μl vs. 7.1 ± 0.6 ng/μl and 4.7 ± 0.6 ng/μl, p < 0.001), protamine deficiency (72.8 ± 15.3 vs. 51.7 ± 19.2 and 15.3 ± 5.9%, p < 0.001), and DNA fragmentation (73.4 ± 13.4 vs. 50.5 ± 18.9 and 9.3 ± 4.3%, p < 0.001) in waterpipe smokers compared to cigarette heavy smokers and nonsmokers. A significant increase was shown in the transcription levels of PRM1, PRM2, and H2BFWT genes in waterpipe smokers compared to cigarette heavy smokers and nonsmokers (p < 0.001). A down-regulation was found in the transcription level of these genes in different smoker groups compared to nonsmokers (<0.001). CONCLUSION This study suggests that waterpipe smoking is more harmful than cigarette smoking on semen parameters, global DNA methylation, and transcription of nuclear protein genes.
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Affiliation(s)
- Mohammed M Laqqan
- Faculty of Health Sciences, Department of Medical Laboratory Sciences, Islamic University of Gaza, Gaza, Palestine
| | - Said S Al-Ghora
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Maged M Yassin
- Faculty of Medicine, Department of Human Physiology, Islamic University of Gaza, Gaza, Palestine
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Sutfin EL, Lazard AJ, Wagoner KG, King JL, Ross JC, Wiseman KD, Orlan EN, Suerken CK, Reboussin DM, Wolfson M, Noar SM, Reboussin BA. Point-of-Sale Health Communication Campaigns for Cigarillos and Waterpipe Tobacco: Effects and Lessons Learned from Two Cluster Randomized Trials. HEALTH COMMUNICATION 2023; 38:1201-1212. [PMID: 34781799 PMCID: PMC9107525 DOI: 10.1080/10410236.2021.1996910] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Many adolescents and young adults hold erroneous beliefs that cigarillos and waterpipe tobacco (WT) are safer than cigarettes, contributing to use. Communication campaigns can correct misperceptions and increase risk beliefs. We tested point-of-sale (POS) communication campaigns focused on chemical exposure for cigarillos and WT. We conducted two cluster randomized trials at 20 gas stations with convenience stores (10 stores for cigarillos, 10 for WT) in North Carolina between June and November 2017. Within each trial, stores were randomly assigned to either the intervention (campaign messages displayed) or a no message control condition. We conducted intercept surveys with repeated cross-sectional samples of 50 adolescents and young adults (ages 16-25) per store, at baseline and follow-up. There were 978 participants (mean age = 20.9 years) in the cigarillo trial, and 998 participants (mean age = 21.0 years) in the WT trial. Rates of campaign exposure were low (26% for cigarillos; 24.3% for WT). The cigarillo campaign increased knowledge that ammonia is in cigarillo smoke (p < .01). There were also significant increases in knowledge about ammonia and cyanide in cigarillo smoke and arsenic in WT smoke (p < .05) in the sub-sample who reported exposure to the campaign. No differences were found in outcome expectancies, product attitudes, worry about chemical exposure, or behavioral intentions in either campaign. Garnering attention for communication campaigns in saturated POS environments, often dominated by tobacco advertising, is challenging. Our study demonstrates the feasibility of anti-tobacco campaigns at the POS and points to several lessons learned for future POS campaigns.
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Affiliation(s)
- Erin L Sutfin
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, N.C., United States
| | - Allison J. Lazard
- Hussman School of Journalism and Media and Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, N.C., United States
| | - Kimberly G. Wagoner
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, N.C., United States
| | - Jessica L. King
- Department of Health and Kinesiology, University of Utah, Salt Lake City, U.T., United States
| | - Jennifer Cornacchione Ross
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, N.C., United States
| | - Kimberly D. Wiseman
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, N.C., United States
| | - Elizabeth N. Orlan
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, N.C., United States
| | - Cynthia K. Suerken
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, N.C., United States
| | - David M. Reboussin
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, N.C., United States
| | - Mark Wolfson
- Department of Social Medicine, Population, and Public Health, University of California at Riverside, Riverside, C.A., United States
| | - Seth M. Noar
- Hussman School of Journalism and Media and Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, N.C., United States
| | - Beth A. Reboussin
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, N.C., United States
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20
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Shafiee A, Oraii A, Jalali A, Alaeddini F, Saadat S, Masoudkabir F, Tajdini M, Ashraf H, Omidi N, Heidari A, Shamloo AS, Sadeghian S, Boroumand M, Vasheghani-Farahani A, Karimi A, Franco OH. Epidemiology and prevalence of tobacco use in Tehran; a report from the recruitment phase of Tehran cohort study. BMC Public Health 2023; 23:740. [PMID: 37085856 PMCID: PMC10122292 DOI: 10.1186/s12889-023-15629-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 04/07/2023] [Indexed: 04/23/2023] Open
Abstract
INTRODUCTION Tobacco use is a major health concern worldwide, especially in low/middle-income countries. We aimed to assess the prevalence of cigarette smoking, waterpipe, and pipe use in Tehran, Iran. METHODS We used data from 8272 participants of the Tehran Cohort Study recruitment phase. Tobacco use was defined as a positive answer to using cigarettes, waterpipes, or pipes. Participants who did not report tobacco use during the interview but had a previous smoking history were categorized as former users. Age- and sex-weighted prevalence rates were calculated based on the national census data, and characteristics of current and former tobacco users were analyzed. RESULTS Age- and sex-weighted prevalence of current tobacco users, cigarette smokers, waterpipe, and pipe users in Tehran was 19.8%, 14.9%, 6.1%, and 0.5%, respectively. Current tobacco use was higher in younger individuals (35-45 years: 23.4% vs. ≥ 75 years: 10.4%, P < 0.001) and men compared to women (32.9% vs. 7.7% P < 0.001). The prevalence of tobacco use increased with more years of education (> 12 years: 19.3% vs. illiterate: 9.7%, P < 0.001), lower body mass index (< 20 kg/m2: 31.3% vs. ≥ 35 kg/m2: 13.8%, P < 0.001), higher physical activity (high: 23.0% vs. low: 16.4%, P < 0.001), opium (user: 66.6% vs. non-user: 16.5%, P < 0.001), and alcohol use (drinker: 57.5% vs. non-drinker: 15.4%, P < 0.001). Waterpipe users were younger (46.1 vs. 53.2 years) and had a narrower gender gap in prevalence than cigarette smokers (male/female ratio in waterpipe users: 2.39 vs. cigarette smokers: 5.47). Opium (OR = 5.557, P < 0.001) and alcohol consumption (OR = 4.737, P < 0.001) were strongly associated with tobacco use. Hypertension was negatively associated with tobacco use (OR = 0.774, P = 0.005). CONCLUSION The concerning prevalence of tobacco use in Tehran and its large gender gap for cigarette and waterpipe use warrant tailored preventive policies.
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Affiliation(s)
- Akbar Shafiee
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Oraii
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Jalali
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Farshid Alaeddini
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheil Saadat
- Department of Emergency Medicine, University of California, Irvine, CA, USA
| | - Farzad Masoudkabir
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Masih Tajdini
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Haleh Ashraf
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Omidi
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirhossein Heidari
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Alireza Sepehri Shamloo
- Department of Electrophysiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany
| | - Saeed Sadeghian
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohamamdali Boroumand
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Vasheghani-Farahani
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbasali Karimi
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Oscar H Franco
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
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21
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Kalan ME, Jebai R, Li W, Gautam P, Osibogun O, Alqahtani MM, Ward KD, Behaleh R, Bursac Z, Taleb ZB. High on Hookah: Smoking Marijuana from a Hookah among Adults in the United States, Population Assessment of Tobacco and Health Study, 2015-2019. Subst Use Misuse 2023; 58:657-665. [PMID: 36786640 PMCID: PMC10069405 DOI: 10.1080/10826084.2023.2177966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Background: This study aimed to examine the trend and factors associated with smoking marijuana from a hookah device among US adults. Methods: Data were drawn from the Population Assessment of Tobacco and Health (PATH) Study, an ongoing nationally representative, longitudinal cohort study of the US population. Adult respondents who self-reported ever smoking marijuana from a hookah at Wave 5 (2018-19, N = 34,279 US adults) were included in the multivariable analysis. Trend analysis also was conducted using National Cancer Institute JoinPoint software from 2015 to 2019. Results: In 2018-19, an estimated 23.6 million (9.7%) US adults reported ever smoking marijuana from a hookah. Trend analysis showed the increasing prevalence of using marijuana from a hookah device from Wave 3 (8.9%) to Wave 5 (9.7%; time trend p = .007). Adults aged 25-44 years old (vs. 18-24; 13%, vs. 9%), whites (vs. Black; 11% vs. 9%), and lesbian, gay, or bisexual (LGB vs. straight; 17% vs. 9%) were more likely to report ever smoking marijuana from a hookah (ps < .05). Former and current users (vs. never users) of e-cigarettes (19% and 25% vs. 5%), cigarettes (11% and 21% vs. 2%), cigars (17% and 27% vs. 3%), and pipes (21% and 33% vs. 7%) and past 30-day blunt users (vs. non-users; 39% vs. 9%) were more likely to ever smoke marijuana from a hookah (ps < .05). Pregnant women (vs. non-pregnant; 12.8% vs. 8.6%; p = 0.03) were more likely to smoke marijuana from a hookah. Conclusions: Smoking marijuana from a hookah device is prevalent among young adults in the US, especially among vulnerable populations, and has increased significantly from 2015-2019.
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Affiliation(s)
| | - Rime Jebai
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL
| | - Wei Li
- Department of Psychiatry, Yale School of Medicine, Yale University, New Haven, CT
| | - Prem Gautam
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL
| | - Olatokunbo Osibogun
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL
| | - Mohammed M Alqahtani
- School of Health Professions, University of Alabama at Birmingham, Birmingham, AL
| | - Kenneth D Ward
- School of Public Health, University of Memphis, Memphis, TN
| | - Raed Behaleh
- School of Health Sciences, Baldwin Wallace University, Berea, OH
| | - Zoran Bursac
- Department of Biostatistics, Robert Stempel College of Public Health, Florida International University, Miami, FL
| | - Ziyad Ben Taleb
- Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX
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22
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Mahfooz K, Vasavada AM, Joshi A, Pichuthirumalai S, Andani R, Rajotia A, Hans A, Mandalia B, Dayama N, Younas Z, Hafeez N, Bheemisetty N, Patel Y, Tumkur Ranganathan H, Sodala A. Waterpipe Use and Its Cardiovascular Effects: A Systematic Review and Meta-Analysis of Case-Control, Cross-Sectional, and Non-Randomized Studies. Cureus 2023; 15:e34802. [PMID: 36915837 PMCID: PMC10008028 DOI: 10.7759/cureus.34802] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 02/09/2023] [Indexed: 02/11/2023] Open
Abstract
Approximately 100 million people globally smoke cigarettes, making it a significant and quickly spreading global tobacco epidemic. Substance use disorders are frequently evaluated by non-randomized studies. Tobacco use and its impacts on the cardiovascular system were the subjects of a comprehensive search across five electronic databases: Cochrane, MEDLINE, Scopus, Embase, and PubMed. The findings demonstrated that waterpipe smokers in comparison to non-smokers have immediate elevations in heart rate and blood pressure, lower levels of high-density lipoprotein, higher levels of low-density lipoprotein, higher levels of triglycerides, higher levels of fasting blood glucose, and a higher heart rate. Users of waterpipes and cigarettes had similar average heart rates, blood pressure, and lipid levels, with the exception that waterpipe smokers had greater total cholesterol. Smoking a waterpipe has significant negative effects on the cardiovascular system comparable to cigarette smoking, and non-randomized studies proved to yield substantial evidence related to its cardiovascular effects. Such study designs can be used to evaluate substance use and its cardiovascular impact.
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Affiliation(s)
- Kamran Mahfooz
- Internal Medicine, Lincoln Medical Center, New York, USA
| | - Advait M Vasavada
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.,Medicine, Shri M. P. Shah Government Medical College, Jamnagar, IND
| | - Arpit Joshi
- Medicine, B. J. (Byramjee Jeejeebhoy) Medical, Ahmedabad, IND
| | | | - Rupesh Andani
- Internal Medicine, Jeevandhara Hospital, Jamnagar, IND
| | | | - Aakash Hans
- Internal Medicine, Henry Ford Health System, Detroit, USA
| | - Bilvesh Mandalia
- House Officer, Lokmanya Tilak Municipal General Hospital and Medical College, Sion Mumbai, Mumbai, IND
| | - Neeraj Dayama
- Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, USA
| | - Zara Younas
- Medicine, King Edward Medical University, Lahore, PAK
| | | | - Niharika Bheemisetty
- Pediatrics, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Yash Patel
- Medicine, Gujarat Cancer Society Medical College, Ahmedabad, IND
| | | | - Ashok Sodala
- Medicine, Shri M. P. Shah Government Medical College, Jamnagar, IND
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23
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Gautam P, Kalan ME, Li W, Taleb ZB, Vargas-Rivera M, Jebai R, Osibogun O, Maziak W. The Effects of Pictorial Health Warning Label on Waterpipe (Low- and High-Frequency) Smokers' Experiences, Toxicant Exposures, and Puffing Behavior. Int J Behav Med 2023; 30:146-153. [PMID: 35260948 PMCID: PMC10127153 DOI: 10.1007/s12529-022-10074-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Pictorial health warning label (PHWL) is an effective risk communication measure among cigarette smokers. However, there is a lack of knowledge regarding the effect of PHWL on low- and high-frequency waterpipe (WP) smokers. This study examined the effects of PHWL on puffing behavior, subjective experiences, and toxicant exposures among low- and high-frequency WP smokers in the United States (US). METHODS Sixty current (past-month) WP smokers (low-frequency; n = 30 and high-frequency; n = 30) completed two 45-min ad libitum WP smoking sessions in a cross-over design study (WP with no-PHWL vs. WP with PHWL). We compared the mean differences of puff topography, expired carbon monoxide (eCO), plasma nicotine concentration, and subjective experiences between the two smoking groups. RESULTS Mean age of low-frequency smokers was 21.5 years and high-frequency smokers was 21.3 years. Compared to high-frequency, low-frequency smokers had significant reduction in average total smoking time [mean difference (SD) = -7.6 (10.2) min vs. -2.6 (6.7) min, p = 0.03] and number of puffs [mean difference (SD) = -33.37 (70.7) vs. -0.70 (29.2), p = 0.02] following exposure to PHWL compared to no-PHWL condition. Post-session subjective experiences were lower among high-frequency smokers compared to low-frequency smokers following smoking WP with PHWL compared to the no-PHWL session (puff liking -1.2 vs. -0.5; puff satisfaction -1.0 vs. -0.3; craving reduction -0.5 vs. 1.2) (p < 0.05 for all). CONCLUSION Our findings indicate that placing PHWL on the WP device may be a promising strategy with differential effectiveness among WP smokers: low-frequency (reduce puffing behaviors) and high-frequency (reduce smoking experience).
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Affiliation(s)
- Prem Gautam
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, 1240 S.W. 108 AVE, Path, University Park, Miami, FL, 33174, USA
| | - Mohammad Ebrahimi Kalan
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Wei Li
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, 1240 S.W. 108 AVE, Path, University Park, Miami, FL, 33174, USA
| | - Ziyad Ben Taleb
- Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, USA
| | - Mayra Vargas-Rivera
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, 1240 S.W. 108 AVE, Path, University Park, Miami, FL, 33174, USA
| | - Rime Jebai
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, 1240 S.W. 108 AVE, Path, University Park, Miami, FL, 33174, USA
| | - Olatokunbo Osibogun
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, 1240 S.W. 108 AVE, Path, University Park, Miami, FL, 33174, USA
| | - Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, 1240 S.W. 108 AVE, Path, University Park, Miami, FL, 33174, USA. .,Syrian Center for Tobacco Studies, Tishreen Street, P.O.Box: 16542, Sheehan, Aleppo, Syria.
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24
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Chami HA, Houjeij N, Makki M, Itani L, Tamim H, Al Mulla A, Celli B, Zeineldine S. Increased airway resistance among exclusive waterpipe smokers detected using impulse oscillometry. Ann Thorac Med 2023; 18:23-30. [PMID: 36968332 PMCID: PMC10034824 DOI: 10.4103/atm.atm_165_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 11/05/2022] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Waterpipe smoking is increasing in popularity, yet the evidence implicating waterpipe smoking in lung disease is limited. We hypothesized that impulse oscillometry (IOS) would detect airway abnormalities in waterpipe smokers (WPS). METHODS We studied 210 participants, 40 years or older, from the community, of whom 92 were exclusive WPS and 118 were never-smokers. Waterpipe smoking history was assessed using a validated questionnaire. All participants underwent spirometry, and IOS and absolute and percentage predicted results (for age, sex, height, and weight) were compared between WPS and nonsmokers. The association of IOS parameters with waterpipe smoking duration and extent (waterpipe smoked/day * smoking duration) was evaluated using linear regression. RESULTS WPS smoked on average 1.8 ± 1.2 waterpipes/day, over an average duration of 23.3 ± 39.8 years. WPS and nonsmokers were largely asymptomatic and had similar age, body mass index, sex distribution, and spirometric values. Nevertheless, WPS had higher IOS measured resistance at 5Hz compared to nonsmokers, (0.53 ± 0.2 vs. 0.48 ± 0.2 kPa/L/s, P = 0.03) and higher percentage-predicted resistance (124.5 ± 36.3 vs. 115.7% ± 35.6%, P = 0.04). Waterpipe smoking duration was also associated with resistance (β = 0.04 kPa/L/s/year, P = 0.01) and with percentage-predicted resistance (β = 0.05/year, P = 0.02). Waterpipe smoking extent was associated with resistance (β = 0.009 kPa/L/s/waterpipe-year, P = 0.04), while the association with percentage-predicted resistance was near significance (β = 0.009/waterpipe-year, P = 0.07). CONCLUSIONS Waterpipe smoking is associated with increased airway resistance assessed by IOS but not by spirometry in largely asymptomatic individuals from the community.
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Affiliation(s)
- Hassan A. Chami
- School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America, Beirut, Lebanon
- Department of Medicine and Clinical Research Institute, American University of Beirut, Beirut, Lebanon
| | - Nourhan Houjeij
- Department of Nephrology, Saint Louis University, St Louis, Missouri, United States of America
| | - Maha Makki
- Department of Medicine and Clinical Research Institute, American University of Beirut, Beirut, Lebanon
| | - Lina Itani
- Department of Medicine and Clinical Research Institute, American University of Beirut, Beirut, Lebanon
| | - Hani Tamim
- Department of Medicine and Clinical Research Institute, American University of Beirut, Beirut, Lebanon
- College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia
| | - Ahmad Al Mulla
- Tobacco Control Center, WHO Collaborative Center, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Bartolome Celli
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Salah Zeineldine
- Department of Medicine and Clinical Research Institute, American University of Beirut, Beirut, Lebanon
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25
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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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26
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Bangera DS, Takana MT, Gopakumar A, Muttappallymyalil J. Dentists' perception of health-risk associated with cigarettes and alternative tobacco products: A descriptive study. Nepal J Epidemiol 2022; 12:1248-1255. [PMID: 36741770 PMCID: PMC9886558 DOI: 10.3126/nje.v12i4.48488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 11/20/2022] [Accepted: 12/02/2022] [Indexed: 01/02/2023] Open
Abstract
Cigarettes and alternative tobacco products cause various oral health issues ranging from minor tooth decay/gum-diseases to oral cancer. According to the Centre for Disease Control (CDC), over 40% of adult cigarette smokers have untreated tooth decay which later leads to severe oral health problems. The present study intended to assess the impact of dentists' perceived risk of smoking tobacco products on their attitude and practice toward tobacco cessation advice. It was a cross-sectional study to collect data on the perception of dentists who are smokers, regarding smoking-related health risks. Dentists' attitude was measured using a questionnaire with a 5-point rating scale and a practice list of items with a 3-point rating scale. Descriptive/inferential techniques were applied, and a significance level was fixed at 5%. Among the 31 tobacco users, 80.6% of dentists perceived severe risk with cigarette use as compared to alternative tobacco products (71%). Positive attitude and good practice were observed among those who perceived severe risk; however, no statistical significance was observed (p-value >0.05). Young dentists, males, Arab nationals, highly educated and specialists had a positive attitude toward smoking cessation activities. Among the smokers, dentists recognize their role and responsibility very seriously in building a smoke-free community, but their risk perception and good attitude did not positively reflect on their clinical practice in smoking cessation programs. Though the dentists had a better perception and attitude towards smoking cessation, their clinical practice in offering advising sessions is inversely related to their perception/attitude.
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Affiliation(s)
| | | | - Aji Gopakumar
- Data & Statistics Department, Emirates Health Services, Dubai, United Arab Emirates
| | - Jayakumary Muttappallymyalil
- College of Medicine, Gulf Medical University, Ajman, United Arab Emirates,Correspondence: Dr. Jayakumary Muttappallymyalil, College of Medicine, Gulf Medical University, Ajman, UAE
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27
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Hussein T. Indoor Exposure and Regional Inhaled Deposited Dose Rate during Smoking and Incense Stick Burning-The Jordanian Case as an Example for Eastern Mediterranean Conditions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:587. [PMID: 36612906 PMCID: PMC9819828 DOI: 10.3390/ijerph20010587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/20/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
Tobacco smoking and incense burning are commonly used in Jordanian microenvironments. While smoking in Jordan is prohibited inside closed spaces, incense burning remains uncontrolled. In this study, particle size distributions (diameter 0.01-25 µm) were measured and inhaled deposited dose rates were calculated during typical smoking and incense stick-burning scenarios inside a closed room, and the exposure was summarized in terms of number and mass concentrations of submicron (PNSub) and fine particles (PM2.5). During cigarette smoking and incense stick-burning scenarios, the particle number concentrations exceeded 3 × 105 cm-3. They exceeded 5 × 105 cm-3 during shisha smoking. The emission rates were 1.9 × 1010, 6.8 × 1010, and 1.7 × 1010 particles/s, respectively, for incense, cigarettes, and shisha. That corresponded to about 7, 80, and 120 µg/s, respectively. Males received higher dose rates than females, with about 75% and 55% in the pulmonary/alveolar during walking and standing, respectively. The total dose rates were in the order of 1012-1013 #/h (103-104 µg/h), respectively, for PNSub and PM2.5. The above reported concentrations, emissions rates, and dose rates are considered seriously high, recalling the fact that aerosols emitted during such scenarios consist of a vast range of toxicant compounds.
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Affiliation(s)
- Tareq Hussein
- Environmental and Atmospheric Research Laboratory (EARL), Department of Physics, School of Science, The University of Jordan, Amman 11942, Jordan;
- Institute for Atmospheric and Earth System Research (INAR/Physics), University of Helsinki, FI-00014 Helsinki, Finland
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28
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Chan L, Harris-Roxas B, Freeman B, MacKenzie R, Woodland L, O'Hara BJ. Attitudes towards the 'Shisha No Thanks' campaign video: Content analysis of Facebook comments. Tob Induc Dis 2022; 20:88. [PMID: 36330277 PMCID: PMC9578129 DOI: 10.18332/tid/153543] [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: 06/16/2022] [Revised: 09/01/2022] [Accepted: 09/05/2022] [Indexed: 11/07/2022] Open
Abstract
INTRODUCTION While social media are commonly used in public health campaigns, there is a gap in our understanding of what happens after the campaign is seen by the target audience. This study aims to understand how the Shisha No Thanks campaign video was received by the Facebook audience by analyzing Facebook comments posted to it. Specifically, this study aims to determine whether the Facebook audience accepted or rejected the campaign’s message. METHODS A sample of the Facebook comments was extracted, and the study team, which included cultural support workers, developed content categories consistent with the research question. Each comment was then coded by three team members, and only assigned a category if there was agreement by at least two members. RESULTS Of the 4990 comments that were sampled, 9.1% (456) accepted the campaign message, 22.9% (1144) rejected the message, 21.8% (1089) were unclear, and 46.1% (2301) contained only tagged names. Of the sample, 2.8% (138) indicated the commenter took on board the campaign message by expressing an intention to stop smoking shisha, or asking a friend to stop smoking shisha. Of the comments that showed rejection of the campaign, the majority were people dismissing the campaign by laughing at it or expressing pro-shisha sentiments. CONCLUSIONS This study demonstrates that conducting content analyses of social media comments can provide important insight into how a campaign message is received by a social media audience.
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Affiliation(s)
- Lilian Chan
- Prevention Research Collaboration, Charles Perkins Centre, University of Sydney, Camperdown, Australia
| | - Ben Harris-Roxas
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Becky Freeman
- Prevention Research Collaboration, Charles Perkins Centre, University of Sydney, Camperdown, Australia
| | - Ross MacKenzie
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
| | - Lisa Woodland
- New South Wales Multicultural Health Communication Service, Sydney, Australia
| | - Blythe J O'Hara
- Prevention Research Collaboration, Charles Perkins Centre, University of Sydney, Camperdown, Australia
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Kedia S, Ahuja N, Hammal F, Asfar T, Eissenberg T, Maziak W, Ward KD. "Waterpipe Is Like a Wife": Qualitative Assessment of Perspectives on Waterpipe Smoking Dependence. ADDICTION & HEALTH 2022; 14:268-278. [PMID: 37559789 PMCID: PMC10408748 DOI: 10.34172/ahj.2022.1377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 10/08/2022] [Indexed: 08/11/2023]
Abstract
BACKGROUND Waterpipe (WP) smoking has become a global public health problem in recent decades and growing evidence indicates that it can cause nicotine dependence. Most evidence on WP dependence to date has been derived from survey- or laboratory-based studies. This study employed qualitative methods to explore WP users' perceptions of dependence in Aleppo, Syria. METHODS A total of 15 focus groups were conducted with 64 adult WP smokers (51 males and 13 females) using a semi-structured interview. All focus group discussions were audiotaped, transcribed, and coded using directed content analysis. FINDINGS Several WP dependence features were consistent with those commonly reported by cigarette smokers. These included positively reinforced features, such as smoking's association with social gatherings and cultural connectedness, and negatively reinforced features including relief of withdrawal symptoms, stress, and boredom. Although interest in quitting was low, many users perceived quitting WP to be difficult and an indicator of loss of control over smoking, a common marker of dependence. Several observed dependence features were specific to WP, including transitioning from social smoking to smoking alone, and adapting one's behavior to the considerable effort normally required to engage in WP smoking despite inconvenience or cost, and often at the expense of other reinforcers such as social interaction. CONCLUSION The general and specific features of WP dependence need to be considered in developing instruments to measure WP dependence, in clinical assessment of WP dependence, and in developing cessation programs.
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Affiliation(s)
- Satish Kedia
- Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, TN, USA
| | - Nikhil Ahuja
- Department of Public Health and Social Work, Slippery Rock University, PA, USA
| | - Fadi Hammal
- School of Public Health, University of Alberta, Edmonton, Canada
- Syrian Center for Tobacco Studies, Aleppo, Syria
| | - Taghrid Asfar
- Syrian Center for Tobacco Studies, Aleppo, Syria
- Department of Public Health Sciences, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, USA
- Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Thomas Eissenberg
- Syrian Center for Tobacco Studies, Aleppo, Syria
- Center for the Study of Tobacco Products and Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Wasim Maziak
- Syrian Center for Tobacco Studies, Aleppo, Syria
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Kenneth D. Ward
- Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, TN, USA
- Syrian Center for Tobacco Studies, Aleppo, Syria
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Tabatabaei Z, Shamsedini N, Mohammadpour A, Baghapour MA, Hoseini M. Exposure assessment of children living in homes with hookah smoking parents to polycyclic aromatic hydrocarbons: urinary level, exposure predictors, and risk assessment. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:68667-68679. [PMID: 35543784 PMCID: PMC9091547 DOI: 10.1007/s11356-022-20589-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 04/29/2022] [Indexed: 06/15/2023]
Abstract
Children are extremely liable to indoor air pollutants as their physiology and a few metabolic pathways are different from those of adults. The present cross-sectional study aimed to assess exposure of children living with parents who use hookah tobacco smoke to polycyclic aromatic hydrocarbons (PAHs) using a biomonitoring approach. The study was conducted on 25 children (7-13 years of age) exposed to hookah smoke at home and 25 unexposed age-matched children. Urinary levels of five metabolites of PAHs were quantified via headspace gas chromatography-mass spectrometry (GC-MS). Urinary malondialdehyde (MDA) was measured, as well. Information regarding the sociodemographic and lifestyle conditions was collected through interviews using managed questionnaires. The urinary 1-OH-NaP and 9-OH-Phe concentrations were respectively 1.7- and 4.6-folds higher in the case samples compared to the control group (p < 0.05). In addition, urinary MDA levels were 1.4 times higher in the exposed children than in the unexposed group, but the difference was not statistically significant (p > 0.05). Increasing the consumption of grilled and meat food in the diet increased the participants' urinary 2-OH-Flu and 1-OH-Pyr levels, respectively. Moreover, sleeping in the living room instead of the bedroom at night was a significant predictor of high 1-OH-NaP and 2-OH-NaP concentrations in the children's urine. Overall, the findings confirmed that children living in their homes with hookah-smoking parents were significantly exposed to naphthalene and phenanthrene. Hence, implementing protective measures is critical to reduce the exposure of this group of children.
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Affiliation(s)
- Zeynab Tabatabaei
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Narges Shamsedini
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Fars Water and Wastewater Company, Shiraz, Iran
| | - Amin Mohammadpour
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Ali Baghapour
- Research Center for Health Sciences, Department of Environmental Health Engineering, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hoseini
- Research Center for Health Sciences, Department of Environmental Health Engineering, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
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Haile ZT, Chertok IRA, Haider MR. Association Between a History of Hookah Use and Breastfeeding Duration. Breastfeed Med 2022; 17:678-686. [PMID: 35675681 DOI: 10.1089/bfm.2021.0307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: There is limited evidence on the relationship between hookah use and breastfeeding. This study examines the association between a history of hookah use and breastfeeding duration among women in the United States. Materials and Methods: This cross-sectional study examined 96,392 women from the Pregnancy Risk Assessment and Monitoring System (PRAMS) 2016-2019 data. The main outcome of interest was any breastfeeding for at least 3 months. Descriptive statistics, chi-square test, and multivariable regression analyses were performed. Results: Overall, 68.3% of women breastfed for at least 3 months and 4.6% reported using hookah in the last 2 years. Women who reported using hookah in the last 2 years were significantly less likely to breastfeed for at least 3 months compared with women who did not report using hookah in the last 2 years (56.0% versus 68.9%; p < 0.001). In the multivariable model, the odds of breastfeeding for at least 3 months were significantly lower in women who used hookah in the last 2 years compared with those who did not use hookah; odds ratio (95% confidence interval) 0.82 (0.74-0.92; p < 0.001). Additionally, the odds of breastfeeding for at least 3 months were significantly lower for dual users of hookah and cigarettes 0.48 (0.33-0.68; p < 0.001). Conclusion: A history of hookah use is associated with early weaning, independent of potential confounders. This finding suggests the need for educating women about the negative consequences of hookah use on breastfeeding during preconception, prenatal, and postpartum care encounters.
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Affiliation(s)
- Zelalem T Haile
- Department of Social Medicine, Ohio University Heritage College of Osteopathic Medicine, Dublin, Ohio, USA
| | - Ilana R Azulay Chertok
- School of Nursing, Ohio University College of Health Sciences and Professions, Athens, Ohio, USA
| | - Mohammad Rifat Haider
- Department of Health Policy and Management, University of Georgia College of Public Health, Athens, Georgia, USA
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Kader Z, Crutzen R, Roman NV. Adolescent hookah pipe use: Comparing users’ and non-users’ harm perception, needs, and motivation. JOURNAL OF PSYCHOLOGY IN AFRICA 2022. [DOI: 10.1080/14330237.2022.2027631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Zainab Kader
- The Centre for Interdisciplinary Studies of Children, Family and Society, University of the Western Cape, Cape Town, South Africa
| | - Rik Crutzen
- Department of Health Promotion, Maastricht University, Maastricht, The Netherlands
| | - Nicolette V. Roman
- The Centre for Interdisciplinary Studies of Children, Family and Society, University of the Western Cape, Cape Town, South Africa
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Stroud LR, Papandonatos GD, Sharma E, Jao NC, Goldman S, Vergara-Lopez C, Scott-Sheldon LA. Flavored waterpipe tobacco preferences, perceptions, and use in pregnant women: A latent factor mapping approach. Addict Behav 2022; 126:107194. [PMID: 34864479 PMCID: PMC8926392 DOI: 10.1016/j.addbeh.2021.107194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 11/17/2021] [Accepted: 11/20/2021] [Indexed: 11/16/2022]
Abstract
Waterpipe tobacco (WPT) use is increasingly common in young adults including pregnant and reproductive-age women. Sweet flavors contribute to the appeal of WPT and are a promising regulatory target. The present study utilized correspondence analysis of contingency tables, a latent factor mapping technique, to investigate preferences and perceptions of WPT flavors in a sample of racially/ethnically diverse, low-income pregnant women. One hundred pregnant women (mean age = 26 years, 65% racial/ethnic minorities) completed a detailed interview regarding their use, preferences, and perceptions of WPT flavors. Eighty-three percent of participants reported lifetime WPT use; 11% reported prenatal WPT use. Pregnant women reported greatest use of and stronger preferences for sweet (fruit, candy, alcohol) and menthol/mint flavors, and weaker preferences for tobacco flavored WPT. Latent factor mapping revealed clustering of preferred sweet (fruit, candy, alcohol) and menthol/mint flavors versus tobacco flavors, with pungent flavors (coffee, chocolate, spice) clustering between sweet and tobacco flavors. Preferences for sweet and menthol/mint flavors distinguished pregnant women who reported lifetime WPT versus no lifetime WPT use, and prenatal WPT use versus no prenatal WPT use. Harm perceptions did not vary by flavor. Regulations to restrict the availability of WPT flavors may reduce the appeal and use of WPT, especially among pregnant women.
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Affiliation(s)
- Laura R. Stroud
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Coro West, Suite 309, 164 Summit Avenue, Providence, RI, 02906, United States,Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Box G-BH, Providence, RI 02912, United States
| | - George D. Papandonatos
- Department of Biostatistics, School of Public Health, Brown University, 121 South Main Street, Room 703, Providence, RI 02903, United States
| | - Eva Sharma
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA.
| | - Nancy C. Jao
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Coro West, Suite 309, 164 Summit Avenue, Providence, RI, 02906, United States,Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Box G-BH, Providence, RI 02912, United States
| | - Samantha Goldman
- Department of Psychology, Adelphi University, Hy Weinberg Center, Room 308, Garden City, NY 11530, USA.
| | - Chrystal Vergara-Lopez
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Coro West, Suite 309, 164 Summit Avenue, Providence, RI 02906, USA; Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Box G-BH, Providence, RI 02912, USA.
| | - Lori A.J. Scott-Sheldon
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Coro West, Suite 309, 164 Summit Avenue, Providence, RI, 02906, United States,Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Box G-BH, Providence, RI 02912, United States
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Alaouie H, Krishnamurthy Reddiar S, Tleis M, El Kadi L, A Afifi R, Nakkash R. Waterpipe tobacco smoking (WTS) control policies: global analysis of available legislation and equity considerations. Tob Control 2022; 31:187-197. [PMID: 35241587 DOI: 10.1136/tobaccocontrol-2021-056550] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 01/06/2022] [Indexed: 11/04/2022]
Abstract
INTRODUCTION The Framework Convention on Tobacco Control (FCTC) offers guidance on evidence-based policies to reduce tobacco consumption and its burden of disease. Recently, it has provided guidance for alternative tobacco products, such as the waterpipe. Waterpipe tobacco smoking (WTS) is prevalent worldwide and policies to address it need to take into consideration its specificities as a mode of smoking. In parallel, a growing body of literature points to the potential of evidence-based tobacco control policies to increase health inequities. This paper updates a previous global review of waterpipe tobacco policies and adds an equity lens to assess their impact on health inequities. METHODS We reviewed policies that address WTS in 90 countries, including 10 with state-owned tobacco companies; 47 were included in our final analysis. We relied primarily on the Tobacco-Free Kids organisation's Tobacco Control Laws website, providing access to tobacco control laws globally. We categorised country tobacco policies by the clarity with which they defined and addressed waterpipe tobacco in relation to nine FCTC articles. We used the PROGRESS (Place of residence, Race/ethnicity/culture/language, Occupation, Gender/sex, Religion, Education, Socioeconomic status and Social capital) framework for the equity analysis, by reviewing equity considerations referenced in the policies of each country and including prevalence data disaggregated by equity axis and country where available. RESULTS Our results revealed very limited attention to waterpipe policies overall, and to equity in such policies, and highlight the complexity of regulating WTS. We recommend that WTS policies and surveillance centre equity as a goal. CONCLUSIONS Our recommendations can inform global policies to reduce WTS and its health consequences equitably across population groups.
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Affiliation(s)
- Hala Alaouie
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | | | - Malak Tleis
- Health Promotion and Community Health Department, American University of Beirut, Beirut, Lebanon
| | - Lama El Kadi
- Health Promotion and Community Health Department, American University of Beirut, Beirut, Lebanon
| | - Rima A Afifi
- College of Public Health, University of Iowa, Iowa City, Iowa, USA
| | - Rima Nakkash
- Health Promotion and Community Health Department, American University of Beirut, Beirut, Lebanon
- Global and Community Health Department, College of Health and Human Services, George Mason University, Fairfax, Virginia, USA
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Zhou M, Hu Y, Huang R, Zhou Y, Xie X, Zhang S, Jia S, Zhang Y, Xue T, Dong F, Lu X, Yuan K, Yu D. Right arcuate fasciculus and left uncinate fasciculus abnormalities in young smoker. Addict Biol 2022; 27:e13132. [PMID: 35229948 DOI: 10.1111/adb.13132] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 12/01/2021] [Accepted: 12/07/2021] [Indexed: 11/29/2022]
Abstract
Previous diffusion tensor imaging (DTI) studies had investigated the white matter (WM) integrity abnormalities in smokers. Exposure to nicotine disrupts neurodevelopment during adolescence, possibly by disrupting the trophic effects of acetylcholine. However, little is known about the diffusion parameters of specific fibre bundles at multiple locations in young smokers. Thirty-seven young smokers and 29 age-, education- and gender-matched healthy non-smokers participated in this study. Automated Fibre Quantification (AFQ) was employed to investigate the WM microstructure in young smokers by integrating multiple indices. Diffusion parameters, that is, fractional anisotropy (FA), axial diffusion (AD), radial diffusion (RD) and mean diffusion (MD), were calculated at 100 points along the length of 18 major brain tracts. The relationships between neuroimaging differences and smoking behaviours were explored, including Fagerström Test of Nicotine Dependence (FTND) and pack-years. Compared with non-smokers, young smokers showed significantly increased FA, AD and decreased RD in the left uncinate fasciculus (UF) and right thalamic radiation (TR), increased AD, RD and decreased FA in the right arcuate fasciculus (Arc). Correlation analyses revealed that FA values of the left UF and RD values of the right Arc were negatively correlated with FTND score in smokers and FA values of the right Arc were positively correlated with FTND scores. Positive correlation was observed between AD values of the left UF and pack-years in smokers. The findings enhanced our understanding of the potential effect of adolescent smoking on WM microstructure.
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Affiliation(s)
- Mi Zhou
- Inner Mongolia Key Laboratory of Pattern Recognition and Intelligent Image Processing, School of Information Engineering Inner Mongolia University of Science and Technology Baotou China
| | - Yiting Hu
- Inner Mongolia Key Laboratory of Pattern Recognition and Intelligent Image Processing, School of Information Engineering Inner Mongolia University of Science and Technology Baotou China
| | - Ruoyan Huang
- Inner Mongolia Key Laboratory of Pattern Recognition and Intelligent Image Processing, School of Information Engineering Inner Mongolia University of Science and Technology Baotou China
| | - Yang Zhou
- Inner Mongolia Key Laboratory of Pattern Recognition and Intelligent Image Processing, School of Information Engineering Inner Mongolia University of Science and Technology Baotou China
| | - Xiaoyan Xie
- Inner Mongolia Key Laboratory of Pattern Recognition and Intelligent Image Processing, School of Information Engineering Inner Mongolia University of Science and Technology Baotou China
| | - Shidi Zhang
- Inner Mongolia Key Laboratory of Pattern Recognition and Intelligent Image Processing, School of Information Engineering Inner Mongolia University of Science and Technology Baotou China
| | - Shaodi Jia
- Inner Mongolia Key Laboratory of Pattern Recognition and Intelligent Image Processing, School of Information Engineering Inner Mongolia University of Science and Technology Baotou China
| | - Yunmiao Zhang
- Inner Mongolia Key Laboratory of Pattern Recognition and Intelligent Image Processing, School of Information Engineering Inner Mongolia University of Science and Technology Baotou China
| | - Ting Xue
- Inner Mongolia Key Laboratory of Pattern Recognition and Intelligent Image Processing, School of Information Engineering Inner Mongolia University of Science and Technology Baotou China
| | - Fang Dong
- Inner Mongolia Key Laboratory of Pattern Recognition and Intelligent Image Processing, School of Information Engineering Inner Mongolia University of Science and Technology Baotou China
| | - Xiaoqi Lu
- School of Information Engineering Inner Mongolia University of Technology Huhhot China
| | - Kai Yuan
- Inner Mongolia Key Laboratory of Pattern Recognition and Intelligent Image Processing, School of Information Engineering Inner Mongolia University of Science and Technology Baotou China
- School of Life Science and Technology Xidian University Xi'an China
- Engineering Research Center of Molecular and Neuro Imaging Ministry of Education Xi'an China
| | - Dahua Yu
- Inner Mongolia Key Laboratory of Pattern Recognition and Intelligent Image Processing, School of Information Engineering Inner Mongolia University of Science and Technology Baotou China
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Chan L, El-Haddad N, Freeman B, MacKenzie R, Woodland L, O'Hara BJ, Harris-Roxas BF. Evaluation of 'Shisha No Thanks' - a co-design social marketing campaign on the harms of waterpipe smoking. BMC Public Health 2022; 22:386. [PMID: 35197044 PMCID: PMC8866041 DOI: 10.1186/s12889-022-12792-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 02/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Waterpipe (shisha) is becoming increasingly popular worldwide, particularly among young people; and in some countries, it is one of the few forms of tobacco use that is increasing. While there is a growing body of evidence of the harms of waterpipe smoke, there is a scarcity of research of interventions to address this form of tobacco consumption. METHODS The Shisha No Thanks project was a co-design social marketing campaign that aimed to raise awareness of the harms of waterpipe smoking among young people from an Arabic speaking background in Sydney, Australia. The campaign distributed material through social media and community events. We evaluated the project through an SMS community panel using a longitudinal study design. The cohort were sent questions before and after the project asking about their awareness of messages of harms, attitudes, intention to reduce waterpipe smoking, and awareness of support services. Data was analysed as matched pre- post- data. RESULTS The evaluation recruited 133 people to the panel. There was a significantly greater proportion of people who reported seeing, hearing or reading something about the harms of waterpipe smoking after the campaign (67.5%) compared with before (45.0%) (p=0.003). Post-campaign, there were higher proportions of people who strongly agreed that waterpipe smoking causes damage, and that it contains cancer-causing substances, but these increases were not statistically significant. There was low awareness of waterpipe cessation services at baseline and post campaign (22.5%). CONCLUSIONS The Shisha No Thanks project increased awareness of messages about the harms of waterpipe smoking. Although this is a small study, the longitudinal evaluation findings have international relevance and make a useful contribution to the understanding of the impact such interventions can have in addressing one of the few forms of tobacco use that is growing in both developed and developing countries.
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Affiliation(s)
- Lilian Chan
- Prevention Research Collaboration, Sydney School of Public Health and Charles Perkins Centre, The University of Sydney, 2006, Camperdown, NSW, Australia.
| | - Nouhad El-Haddad
- Centre for Primary Health Care and Equity, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Becky Freeman
- Prevention Research Collaboration, Sydney School of Public Health and Charles Perkins Centre, The University of Sydney, 2006, Camperdown, NSW, Australia
| | - Ross MacKenzie
- Centre for Primary Health Care and Equity, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Lisa Woodland
- Population and Community Health, South Eastern Sydney Local Health District, Darlinghurst, Australia
| | - Blythe J O'Hara
- Prevention Research Collaboration, Sydney School of Public Health and Charles Perkins Centre, The University of Sydney, 2006, Camperdown, NSW, Australia
| | - Ben F Harris-Roxas
- School of Population Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
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Asfar T, Chehab S, Schmidt M, Ward KD, Maziak W, Nakkash R. "Scary and Effective, Definitely Pushes Me to Quit Smoking": Developing Waterpipe Pictorial Health Warnings Targeting Young Adults in Lebanon. Nicotine Tob Res 2022; 24:1458-1468. [PMID: 35196373 PMCID: PMC9356692 DOI: 10.1093/ntr/ntac053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 01/26/2022] [Accepted: 02/21/2022] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Waterpipe (WP) smoking is the leading tobacco use method among young adults in Lebanon. WP use is harmful, yet misperceptions about its safety exist. Implementing pictorial health warning labels (HWLs) on WP products is a promising strategy to correct this misperception. This study aimed to culturally adapt a set of 12 pictorial HWLs recently developed by an international expert panel to young adults in Lebanon. HWLs were grouped into four themes: WP health risks, WP harm to others, WP-specific harms, and WP harm compared to cigarettes. AIMS AND METHODS We conducted nine focus groups among WP smokers and nonsmokers (N = 77; 52% females; age 18-34 years) to explore participants' perceptions of the developed HWLs on attention, reaction (fear, avoidance), effectiveness (harm perception), and improvement (design/content, relatedness). Sessions were audio-taped, transcribed verbatim, and analyzed using directed qualitative content analysis. RESULTS Emotionally provocative warnings were perceived as most effective, while symbolic and abstract warnings were found not believable. Warnings depicting visible bodily health effects and harm to babies seemed most promising. Participants were generally skeptical about Theme 4 because it might encourage switching to cigarettes. For cultural adaptation, participants recommended using shorter text with affirmative phrases, increasing the picture's size and improving their quality, adding the WP device picture to enhance HWLs' relatability, and develop testimonial messages that depict real people and stories. CONCLUSIONS Results will provide Lebanon and perhaps other countries in the Eastern Mediterranean Region with evidence-based HWLs that they can further develop, test, and implement within their specific culture. IMPLICATIONS Results provide Lebanon with evidence-based WP-specific pictorial HWLs that can be further developed and tested. HWLs provoking negative affect, with visible health consequences, and depicting harm to babies are promising. Participants recommended using definitive scientific claims presenting the health risks in numerical form. However, this needs to be balanced against protecting the credibility of HWLs scientifically and legally. Increasing the HWLs size and adding the WP device picture to the HWLs can enhance their relatability. Further research can help address some questions raised by this study, such as the potential of testimonial warnings that depict real people.
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Affiliation(s)
- Taghrid Asfar
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL, USA,Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, FL, USA,Syrian Center for Tobacco Studies, Aleppo, Syria
| | - Sara Chehab
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | | | - Kenneth D Ward
- Syrian Center for Tobacco Studies, Aleppo, Syria,School of Public Health, University of Memphis, Memphis, TN, USA
| | - Wasim Maziak
- Syrian Center for Tobacco Studies, Aleppo, Syria,Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International, Miami, FL, USA
| | - Rima Nakkash
- Corresponding Author: Rima Nakkash, DrPH, Department of Health Promotion and Community Health, Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Van Dyck Building, PO Box 11-0236, Beirut, Lebanon. Telephone: 961 1 350000 ext. 4667; Fax: 961-1-744470; E-mail:
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Kassem M, Rahme C, Hallit S, Obeid S. Is the presence of a psychiatric patient at home associated with higher addictions (alcohol, cigarette, and waterpipe dependence) in caregivers? The role of work fatigue, mental illness, spirituality, and religiosity. Perspect Psychiatr Care 2022; 58:383-394. [PMID: 33908628 DOI: 10.1111/ppc.12804] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 03/07/2021] [Accepted: 04/03/2021] [Indexed: 02/03/2023] Open
Abstract
PURPOSE To assess if living with a psychiatric patient, depression, anxiety, stress, fatigue, insomnia, spirituality, and religiosity would be associated with more problematic alcohol use, cigarette, and waterpipe dependence in Lebanese caregivers. METHODS A case-control study was performed in Lebanon that recruited 587 caregivers (July-September 2019). RESULTS Higher religiosity was associated with lower problematic alcohol use. Having low versus no income was significantly associated with more cigarette dependence. Being Christian and high anxiety were significantly associated with more waterpipe dependence, whereas higher insomnia was significantly associated with lower waterpipe dependence. PRACTICAL IMPLICATIONS: Family caregivers go through a lot of stress and burden and need help coping with it in a healthy way for better outcomes for them and the care recipient.
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Affiliation(s)
- Maha Kassem
- Department of Research, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Clara Rahme
- Department of Research, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.,INSPECT-LB, Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie-Liban, Beirut, Lebanon
| | - Sahar Obeid
- Department of Research, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.,INSPECT-LB, Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie-Liban, Beirut, Lebanon.,Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
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Tabatabaei Z, Baghapour MA, Hoseini M, Fararouei M, Abbasi F, Baghapour M. Assessing BTEX concentrations emitted by hookah smoke in indoor air of residential buildings: health risk assessment for children. JOURNAL OF ENVIRONMENTAL HEALTH SCIENCE & ENGINEERING 2021; 19:1653-1665. [PMID: 34900296 PMCID: PMC8617227 DOI: 10.1007/s40201-021-00721-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 08/07/2021] [Indexed: 05/24/2023]
Abstract
Hookah smoke is one of the major indoor sources of Volatile Organic Compounds (VOCs), including Benzene, Toluene, Ethylbenzene, and Xylenes (BTEX). The present study aimed to investigate potential exposure to BTEX compounds among primary school children whose parents smoked hookah at home. BTEX concentrations in indoor air were measured in 60 residential buildings of Khesht, southwestern Iran (case = 30 and control = 30). Target compounds were sampled by charcoal tubes, and the samples were then analyzed by GC-FID. Monte Carlo simulation was used to assess the carcinogenic and non-carcinogenic risks of BTX exposure for the children aged 7-13 years. The concentrations of benzene (7.19 ± 3.09 vs. 0.82 ± 0.5 μg/m3), toluene (1.62 ± 0.69 vs. 0.3 ± 0.22 μg/m3), and xylenes (2.9 ± 1.66 vs. 0.31 ± 0.22 μg/m3) were considerably higher in the indoor air of the case houses compared with the control houses (p < 0.05). The Incremental Lifetime Cancer Risk (ILCR) of benzene for non-smoking and smoking houses were estimated 1.8 × 10-6 and 15 × 10-6, respectively, exceeding the recommendations of the World Health Organization (WHO) and the Environmental Protection Agency (EPA) (1 × 10-6). Moreover, Hazard Quotients (HQs) of all BTX compounds were < 1. The indoor benzene concentration was significantly influenced by the floor at which families lived and type of the kitchen. In order to prevent children's exposure to BTX emitted by hookah, banning indoor smoking is the only way to eliminate these compounds in the indoor air.
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Affiliation(s)
- Zeynab Tabatabaei
- Department of Environmental Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Ali Baghapour
- Research Center for Health Sciences, Institute of Health, Department of Environmental Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hoseini
- Research Center for Health Sciences, Institute of Health, Department of Environmental Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Fararouei
- Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fariba Abbasi
- Department of Environmental Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Melika Baghapour
- Department of Biology, Faculty of Science, York University, Toronto, Canada
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40
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Adham D, Kalan ME, Fazlzadeh M, Abbasi-Ghahramanloo A. Latent class analysis of initial nicotine dependence among adult waterpipe smokers. JOURNAL OF ENVIRONMENTAL HEALTH SCIENCE & ENGINEERING 2021; 19:1765-1771. [PMID: 34900305 PMCID: PMC8617218 DOI: 10.1007/s40201-021-00731-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 08/23/2021] [Indexed: 06/14/2023]
Abstract
Waterpipe (WP) tobacco smoking increases the risk of smoking-related health problems. In this study, we sought to identify the unobserved class memberships of WP-associated initial nicotine dependence (ND) symptoms and assess the predictors of each latent class. This cross-sectional study was conducted among a convenience sample of 900 current (past 30-day) WP smokers who were recruited from 94 WP-serving venues surrounding Tehran and Ardebil metropolitans in Iran. All participants completed a self-administrated questionnaire. We performed latent class analysis using PROC LCA in SAS to identify class memberships of initial ND symptoms using 10-item Hooked on Nicotine Checklist. Five latent classes were identified as non-dependent (25.4 %), low dependent (7.1 %), low-moderate dependent (19.6 %), moderate dependent (15.6 %), and high dependent (32.2 %). Using flavored WP tobacco significantly increased the odds of belonging to low-moderate dependent class [adjusted OR (aOR) = 1.89; 95 % confidence interval (CI): 1.07-3.34] compared to non-dependent class. Also, having academic education decreased the odds of belonging to low-moderate dependent (aOR = 0.43; 95 %CI: 0.26-0.67) and moderate dependent (aOR = 0.39; 95 %CI: 0.23-0.67) class in comparison to non-dependent class. Also, WP smoking initiation at an older age was associated with belonging to high dependent (OR = 2.05; 95 %CI: 1.39-3.03) class compared to non-dependent. This study revealed that nearly half of WP smokers fell under moderate and high-dependent classes. Our findings showed that some items of HONC had more role in the clustering of participants based on ND symptoms. The WP-specific cessation programs and targeted clinical trials should consider the diversity of ND levels among smokers to achieve successful quit rates among these smokers. Additionally, limiting flavors would be a strong strategy to limit the rate of ND, especially among young people who are eager to smoke flavored WP tobacco.
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Affiliation(s)
- Davoud Adham
- Department of Public Health, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mohammad Ebrahimi Kalan
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL USA
| | - Mehdi Fazlzadeh
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Tehran, Iran
- Department of Environmental Health, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Abbas Abbasi-Ghahramanloo
- Department of Public Health, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran
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41
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Hsieh JR, Mekoli ML, Edwards RL. Levels of Chemical Toxicants in Waterpipe Tobacco and Waterpipe Charcoal Solid Waste. JOURNAL OF ENVIRONMENTAL PROTECTION 2021; 12:913-938. [PMID: 34881071 PMCID: PMC8649808 DOI: 10.4236/jep.2021.1211054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This work provides insights on waterpipe tobacco and waterpipe charcoal as potential sources of environmental toxicants. Selected harmful and potentially harmful constituents (HPHCs) from ten U.S. commercial waterpipe tobacco filler products (before and after electric heating) and five waterpipe charcoal products (before and after burning) were investigated. The differences in quantities of HPHCs between the evaluated products appear to be affected by raw material properties and/or the manufacturing processes involved in product production. Trace metal quantities in waterpipe tobacco and charcoal products were observed after heating or burning conditions compared to unheated or unburned conditions, which could impact the environment through the generation of toxic tobacco product waste. This study demonstrates that waterpipe tobacco and waterpipe charcoal contain substantial quantities of benzo[a]pyrene (B[a]P) and trace metals (i.e., selenium, arsenic, cadmium, chromium, cobalt, lead, nickel) before use and that extensive and varied changes in trace metal quantities take place as a result of heating, and more studies are needed to estimate the magnitude of the environmental impact of waterpipe tobacco use.
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Affiliation(s)
- Jason R. Hsieh
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Calverton, MD, USA
| | - Megan L. Mekoli
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Calverton, MD, USA
| | - Ronald L. Edwards
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Calverton, MD, USA
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Stevens EM, Villanti AC, Leshner G, Wagener TL, Keller-Hamilton B, Mays D. Integrating Self-Report and Psychophysiological Measures in Waterpipe Tobacco Message Testing: A Novel Application of Multi-Attribute Decision Modeling. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11814. [PMID: 34831571 PMCID: PMC8617707 DOI: 10.3390/ijerph182211814] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 11/05/2021] [Accepted: 11/09/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Waterpipe (i.e., hookah) tobacco smoking (WTS) is one of the most prevalent types of smoking among young people, yet there is little public education communicating the risks of WTS to the population. Using self-report and psychophysiological measures, this study proposes an innovative message testing and data integration approach to choose optimal content for health communication messaging focusing on WTS. METHODS In a two-part study, we tested 12 WTS risk messages. Using crowdsourcing, participants (N = 713) rated WTS messages based on self-reported receptivity, engagement, attitudes, and negative emotions. In an in-lab study, participants (N = 120) viewed the 12 WTS risk messages while being monitored for heart rate and eye-tracking, and then completed a recognition task. Using a multi-attribute decision-making (MADM) model, we integrated data from these two methods with scenarios assigning different weights to the self-report and laboratory data to identify optimal messages. RESULTS We identified different optimal messages when differently weighting the importance of specific attributes or data collection method (self-report, laboratory). Across all scenarios, five messages consistently ranked in the top half: four addressed harms content, both alone and with themes regarding social use and flavors and one addiction alone message. DISCUSSION Results showed that the self-report and psychophysiological data did not always have the same ranking and differed based on weighting of the two methods. These findings highlight the need to formatively test messages using multiple methods and use an integrated approach when selecting content.
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Affiliation(s)
- Elise M. Stevens
- Department of Population and Quantitative Health Sciences, Division of Preventative and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA 01655, USA
| | - Andrea C. Villanti
- Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, VT 05405, USA;
| | - Glenn Leshner
- Gaylord College of Journalism and Mass Communication, University of Oklahoma, Norman, OK 73019, USA;
| | - Theodore L. Wagener
- Center for Tobacco Research, The Ohio State University James Comprehensive Cancer Center, Columbus, OH 43214, USA; (T.L.W.); (B.K.-H.); (D.M.)
- Department of Internal Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Brittney Keller-Hamilton
- Center for Tobacco Research, The Ohio State University James Comprehensive Cancer Center, Columbus, OH 43214, USA; (T.L.W.); (B.K.-H.); (D.M.)
- Department of Internal Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Darren Mays
- Center for Tobacco Research, The Ohio State University James Comprehensive Cancer Center, Columbus, OH 43214, USA; (T.L.W.); (B.K.-H.); (D.M.)
- Department of Internal Medicine, The Ohio State University, Columbus, OH 43210, USA
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Lee JJ, Yeung KCY, Wang MP, Thorne S, Tong HSC, Lai V. Circumventing tobacco control and safety policies to promote waterpipe use in smoking venues: the perspective of staff in waterpipe smoking venues. Tob Control 2021:tobaccocontrol-2021-056692. [PMID: 34753793 DOI: 10.1136/tobaccocontrol-2021-056692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 10/22/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To understand Hong Kong waterpipe smoking (WPS) sales and promotion, including strategies to avoid policy enforcement, from the perspective of WPS venue staff. METHODS Qualitative interviews and observations were guided by interpretive description. 20 WPS venue staff who were responsible for preparing and serving waterpipes to patrons and had worked at the bar for at least 3 months were recruited. In-depth semistructured interviews with WPS venue staff were conducted, in addition to covert and participant observations in 10 WPS venues in Hong Kong. Interpretive description involving constant comparative analysis of qualitative data was adopted to facilitate an inductive analytic approach to generate findings. RESULTS Two primary themes emerged from analyses of interview and observation data: strategies to avoid law enforcement, and perceived health and safety concerns linked to working and smoking in waterpipe venues. The findings suggest that many Hong Kong venues may be failing to comply with tobacco control policies and developing strategies to circumvent law enforcement. Moreover, waterpipe preparation, allowance of WPS and burning of charcoal in indoor areas were perceived as negatively affecting the health and safety of staff and customers. CONCLUSIONS The study provides preliminary evidence indicating the ineffectiveness of current tobacco control policy on WPS. Due to its risks to health and safety, and the need to sustain tobacco control efforts for their intended purpose, waterpipe-specific regulations and stricter surveillance on waterpipe sales and promotion are urgently required.
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Affiliation(s)
- Jung Jae Lee
- School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong
| | | | - Man Ping Wang
- School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong
| | - Sally Thorne
- School of Nursing, The University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Vienna Lai
- Hong Kong Council on Smoking and Health, Wanchai, Hong Kong
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Adetona O, Mok S, Rajczyk J, Brinkman MC, Ferketich AK. The adverse health effects of waterpipe smoking in adolescents and young adults: A narrative review. Tob Induc Dis 2021; 19:81. [PMID: 34720796 PMCID: PMC8534427 DOI: 10.18332/tid/142521] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/25/2021] [Accepted: 09/22/2021] [Indexed: 12/28/2022] Open
Abstract
Waterpipe (WP) smoking has rapidly grown in popularity in the United States and other Western countries with the fastest uptake among younger individuals. This growth has been encouraged by the misperception that WP smoke is harmless or less harmful than cigarette smoke. To better understand how WP affects the health of young people, we conducted a narrative review of the literature focusing on the adverse health effects of WP smoking in adolescents and younger adults. We searched scientific literature databases including PubMed, MEDLINE, EMBASE, and ISI Web and selected papers that met the inclusion criteria. Sixty-three papers met the inclusion criteria and were selected for review. Data were abstracted from the selected papers into a standardized table. The evidence demonstrates that WP smoking can cause acute lung infection and injury, and carbon monoxide (CO) poisoning, in adolescents and young adults. It is also associated with adverse subclinical effects in this sub-population, including oral and systemic genotoxicity, lung function decline, and the alteration of vascular and hemodynamic functions. Limited evidence that is available indicates associations with psychological and neurological effects and asthma. No identified publications examined the association between WP use and type 2 diabetes, a condition that is associated with cigarette smoking among young people. WP smoking by younger individuals can result in their hospitalization due to systemic CO poisoning and acute lung disease, and induce subclinical adverse effects in the oral cavity, pulmonary system, and in circulation, that are involved in the pathogenesis of local and systemic chronic diseases.
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Affiliation(s)
- Olorunfemi Adetona
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, United States
| | - Sarah Mok
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, United States
| | - Jenna Rajczyk
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, United States
| | - Marielle C Brinkman
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, United States
| | - Amy K Ferketich
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, United States
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45
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Ebrahimi Kalan M, Abazari M, Ben Taleb Z, Adham D, Abbasi A, Bursac Z, Ward KD, Cobb CO, Behaleh R, Wipfli HL, Fazlzadeh M. Characteristics of flavored and non-flavored waterpipe tobacco users: a real-world setting study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:57629-57639. [PMID: 34089452 PMCID: PMC8179087 DOI: 10.1007/s11356-021-14706-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 05/31/2021] [Indexed: 05/05/2023]
Abstract
We aimed to compare sociodemographic characteristics, smoking patterns, beliefs and perceptions, nicotine dependence, and psychological indicators between flavored waterpipe (WP) tobacco (FWT) and non-flavored WP tobacco (non-FWT) smokers in Iran. A cross-sectional study was conducted in 94 WP-serving venues surrounding Tehran and Ardabil metropolitans in Iran. Convenience sampling was applied to select 900 current WP smokers [508 (56%) FWT-only and 392 (44%) non-FWT-only smokers] aged 18 years and older. Multivariable logistic regression was used to examine the independent characteristics of FWT and non-FWT smokers. Compared to non-FWT smokers, FWT smokers were younger (adjusted odds ratio [AOR]=0.88, 95% confidence interval [CI]: 0.87-0.90) and more likely to have ≥ 1 sibling who smoked WP (AOR=1.54, 95% CI: 1.06-2.24), share WP with others (AOR=2.52, 95% CI: 1.68-3.77), report current cigarette smoking (AOR=2.05, 95% CI: 1.23-3.42), and report confidence in quitting at any time (AOR=3.64, 95% CI: 2.45-5.39). FWT smokers were less likely to have seen (AOR=0.40, 95% CI: 0.27-0.60) or read (AOR=0.44, 95% CI: 0.24-0.80) warning messages on WP tobacco packages relative to non-FTW smokers. The most common self-reported reason for smoking WP was entertainment for both groups, followed by stress relief for non-FWT smokers and the escape from loneliness for FWT smokers. FWT-only smokers differ from non-FWT-only smokers in several aspects including being younger, having more positive beliefs and perceptions regarding WP use, and having higher cigarette smoking prevalence. These findings will help in developing more effective and targeted policies and cessation interventions for WP smokers according to flavor type they use, especially in the Middle East.
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Affiliation(s)
- Mohammad Ebrahimi Kalan
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | - Malek Abazari
- Department of Public Health, School of Health, Ardabil University of Medical Sciences, Daneshgah St, Ardabil, 5615731567, Iran
| | - Ziyad Ben Taleb
- Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, USA
| | - Davoud Adham
- Department of Public Health, School of Health, Ardabil University of Medical Sciences, Daneshgah St, Ardabil, 5615731567, Iran.
| | - Abbas Abbasi
- Department of Public Health, School of Health, Ardabil University of Medical Sciences, Daneshgah St, Ardabil, 5615731567, Iran
| | - Zoran Bursac
- Department of Biostatistics, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | - Kenneth D Ward
- School of Public Health, University of Memphis, Memphis, TN, USA
| | - Caroline O Cobb
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Raed Behaleh
- School of Health Sciences, Baldwin Wallace University, Berea, OH, USA
| | - Heather Lynn Wipfli
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Mehdi Fazlzadeh
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran.
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Sadeghifar A, Sheibani M, Joukar S, Dabiri S, Alavi S, Azari O, Vosoghi D, Zeynali Y, Zeynali Y, Shahraki M, Torghabe A, Rostamzadeh F, Nasri A. The Effect of Waterpipe Tobacco Smoking on Bone Healing Following Femoral Fractures in Male Rats. Front Surg 2021; 8:722446. [PMID: 34671637 PMCID: PMC8520932 DOI: 10.3389/fsurg.2021.722446] [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: 06/08/2021] [Accepted: 08/30/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Given the increasing use of waterpipe tobacco smoking in the world and its unknown effects on bone healing, this study investigated the repairing of femoral bone fractures in rats exposed to waterpipe tobacco smoking (WTS). Main Methods: This study involved 40 male Wistar rats that were divided into two groups, including the femoral fracture (Fx) and the Fx + WTS groups. Each group was divided into two subgroups that were evaluated for bone healing 28 and 42 days after femoral fracture. After fixing the fractured femur, the healing process was evaluated by radiography, pathological indicators, and a measurement of the blood levels of vascular endothelial growth factor (VEGF), parathyroid hormone (PTH), Ca ++, transforming growth factor-beta (TGF-β), and insulin-like growth factor 1 (IGF-1). Additionally, the density of VEGF and CD34 in fracture tissue was investigated by immunohistochemistry. Key Findings: Radiographic findings showed that factors related to the earlier stages of bone healing had higher scores in the Fx + WTS28 and 42 subgroups in comparison to the Fx groups. The density of VEGF and CD34 showed that the angiogenesis processes were different in the bone fracture area and callus tissue in the Fx +WTS subgroups. The serum levels of VEGF, TGF-β, and IGF-1 were significantly lower in the Fx +WTS42 group, and PTH in the Fx +WTS28 group was higher than that in the other groups. Significance: The findings showed the disturbance and delay in the femoral fracture union in rats exposed to hookah smoke. This is partly due to the reduction of molecular stimuli of bone synthesis and the attenuation of quantitative angiogenesis.
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Affiliation(s)
- Amirreza Sadeghifar
- Orthopedic Department, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohamad Sheibani
- Orthopedic Department, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Siyavash Joukar
- Physiology Research Center, Institute of Basic and Clinical Physiology Sciences, and Department of Physiology and Pharmacology, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Shahriar Dabiri
- Pathology Department and Stem Cell Research Center, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Samanehsadat Alavi
- Cardiovascular Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Omid Azari
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Darioush Vosoghi
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Yas Zeynali
- Physiology Research Center, Institute of Basic and Clinical Physiology Sciences, and Department of Physiology and Pharmacology, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Yasman Zeynali
- Physiology Research Center, Institute of Basic and Clinical Physiology Sciences, and Department of Physiology and Pharmacology, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohamad Shahraki
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Amirhesam Torghabe
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Farzaneh Rostamzadeh
- Cardiovascular Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Alireza Nasri
- Pathology Department and Stem Cell Research Center, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
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47
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Mays D, Johnson AC, Phan L, Sanders C, Shoben A, Tercyak KP, Wagener TL, Brinkman MC, Lipkus IM. Tailored Mobile Messaging Intervention for Waterpipe Tobacco Cessation in Young Adults: A Randomized Trial. Am J Public Health 2021; 111:1686-1695. [PMID: 34436927 PMCID: PMC8589064 DOI: 10.2105/ajph.2021.306389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2021] [Indexed: 11/04/2022]
Abstract
Objectives. To test a tailored mobile health (i.e., mHealth) intervention for waterpipe tobacco cessation in young adults. Methods. From 2018 to 2020 at 2 US sites, we conducted a randomized trial with 349 waterpipe tobacco smokers aged 18 to 30 years randomized to control (no intervention), untailored, or tailored intervention arms. Intervention arms received a 6-week mHealth intervention conveying risks of waterpipe tobacco through text and images and strategies to enhance motivation and support quitting. The tailored intervention was personalized to baseline measures and intervention text message responses. Risk appraisals, motivation to quit, waterpipe smoking frequency, and cessation were assessed at 6 weeks, 3 months, and 6 months. Results. At 6 months, cessation was higher in the tailored (49%) than the control arm (29%; odds ratio = 2.4; 95% confidence interval = 1.3, 4.2) and smoking frequency was lower in the tailored (mean = 3.5 days) than the control arm (mean = 4.3 days; P = .006). At interim follow-ups, significant differences in other outcomes favored the tailored intervention. Conclusions. Tailored mobile messaging can help young adult waterpipe tobacco smokers quit. This scalable intervention is poised for population implementation.
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Affiliation(s)
- Darren Mays
- Darren Mays and Theodore L. Wagener are with the Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus. Andrea C. Johnson is with the Department of Psychiatry and Tobacco Center of Regulatory Science, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Lilianna Phan is with the National Institute of Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD. Camilla Sanders and Isaac M. Lipkus are with the Duke University School of Nursing, Durham, NC. Abigail Shoben and Marielle C. Brinkman are with the College of Public Health, The Ohio State University, Columbus. Kenneth P. Tercyak is with the Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Andrea C Johnson
- Darren Mays and Theodore L. Wagener are with the Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus. Andrea C. Johnson is with the Department of Psychiatry and Tobacco Center of Regulatory Science, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Lilianna Phan is with the National Institute of Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD. Camilla Sanders and Isaac M. Lipkus are with the Duke University School of Nursing, Durham, NC. Abigail Shoben and Marielle C. Brinkman are with the College of Public Health, The Ohio State University, Columbus. Kenneth P. Tercyak is with the Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Lilianna Phan
- Darren Mays and Theodore L. Wagener are with the Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus. Andrea C. Johnson is with the Department of Psychiatry and Tobacco Center of Regulatory Science, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Lilianna Phan is with the National Institute of Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD. Camilla Sanders and Isaac M. Lipkus are with the Duke University School of Nursing, Durham, NC. Abigail Shoben and Marielle C. Brinkman are with the College of Public Health, The Ohio State University, Columbus. Kenneth P. Tercyak is with the Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Camilla Sanders
- Darren Mays and Theodore L. Wagener are with the Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus. Andrea C. Johnson is with the Department of Psychiatry and Tobacco Center of Regulatory Science, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Lilianna Phan is with the National Institute of Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD. Camilla Sanders and Isaac M. Lipkus are with the Duke University School of Nursing, Durham, NC. Abigail Shoben and Marielle C. Brinkman are with the College of Public Health, The Ohio State University, Columbus. Kenneth P. Tercyak is with the Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Abigail Shoben
- Darren Mays and Theodore L. Wagener are with the Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus. Andrea C. Johnson is with the Department of Psychiatry and Tobacco Center of Regulatory Science, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Lilianna Phan is with the National Institute of Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD. Camilla Sanders and Isaac M. Lipkus are with the Duke University School of Nursing, Durham, NC. Abigail Shoben and Marielle C. Brinkman are with the College of Public Health, The Ohio State University, Columbus. Kenneth P. Tercyak is with the Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Kenneth P Tercyak
- Darren Mays and Theodore L. Wagener are with the Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus. Andrea C. Johnson is with the Department of Psychiatry and Tobacco Center of Regulatory Science, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Lilianna Phan is with the National Institute of Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD. Camilla Sanders and Isaac M. Lipkus are with the Duke University School of Nursing, Durham, NC. Abigail Shoben and Marielle C. Brinkman are with the College of Public Health, The Ohio State University, Columbus. Kenneth P. Tercyak is with the Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Theodore L Wagener
- Darren Mays and Theodore L. Wagener are with the Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus. Andrea C. Johnson is with the Department of Psychiatry and Tobacco Center of Regulatory Science, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Lilianna Phan is with the National Institute of Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD. Camilla Sanders and Isaac M. Lipkus are with the Duke University School of Nursing, Durham, NC. Abigail Shoben and Marielle C. Brinkman are with the College of Public Health, The Ohio State University, Columbus. Kenneth P. Tercyak is with the Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Marielle C Brinkman
- Darren Mays and Theodore L. Wagener are with the Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus. Andrea C. Johnson is with the Department of Psychiatry and Tobacco Center of Regulatory Science, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Lilianna Phan is with the National Institute of Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD. Camilla Sanders and Isaac M. Lipkus are with the Duke University School of Nursing, Durham, NC. Abigail Shoben and Marielle C. Brinkman are with the College of Public Health, The Ohio State University, Columbus. Kenneth P. Tercyak is with the Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Isaac M Lipkus
- Darren Mays and Theodore L. Wagener are with the Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus. Andrea C. Johnson is with the Department of Psychiatry and Tobacco Center of Regulatory Science, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Lilianna Phan is with the National Institute of Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD. Camilla Sanders and Isaac M. Lipkus are with the Duke University School of Nursing, Durham, NC. Abigail Shoben and Marielle C. Brinkman are with the College of Public Health, The Ohio State University, Columbus. Kenneth P. Tercyak is with the Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
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Phan L, Mays D, Tercyak KP, Johnson AC, Rehberg K, Lipkus IM. Initial development of the Hookah Smoker Scale: Assessing young adults' mental schemas about hookah "smokers". Transl Behav Med 2021; 11:206-215. [PMID: 31722424 DOI: 10.1093/tbm/ibz155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Many young adult hookah tobacco users do not consider themselves hookah "smokers," but data on this topic are limited. There are no existing measures of young adults' mental schemas of hookah "smokers." We examined the factor structure and reliability of the Hookah Smoker Scale and examined associations with perceived harm and addictiveness and attitudes toward hookah. Two hundred and forty-six young adult (ages 18-30) hookah smokers participated in a cross-sectional online study. Participants completed items assessing schemas characterizing hookah smokers and valid measures of perceived harm and addictiveness of hookah smoking, risk appraisals, and attitudes toward hookah. Exploratory factor analysis using principal axis factoring with oblique rotation extracted a 12-item scale with three dimensions (Regular Use, Social-Enabled Use, and Self-Enabled Use). The scale explained 69.7% of the variance (eigenvalue = 9.2). Cronbach's α for the scale was .89, with Cronbach's α ≥ .80 for four-item subscales. Higher subscale scores indicate stronger beliefs that the dimension characterizes a hookah smoker. Higher Regular Use scores (score variance = 46.9%; eigenvalue = 5.6) were associated with greater perceived harm and addictiveness (β = 0.21, p = .01), greater risk appraisals (β = 0.20, p = .02), and more negative attitudes toward hookah (β = -0.18, p = .03). The Hookah Smoker Scale is a promising measure that can be used to identify targets for preventing and reducing young adults' hookah tobacco use. Findings also suggest young adults associate health risks of hookah with daily smoking, but not with intermittent social smoking patterns.
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Affiliation(s)
- Lilianna Phan
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA
| | - Darren Mays
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA
| | - Kenneth P Tercyak
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA
| | - Andrea C Johnson
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA.,Department of Prevention and Community Health, Milken Institute School of Public Health, Washington, DC, USA
| | - Kathryn Rehberg
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA
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49
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Kjeld SG, Andersen S, Andersen A, Glenstrup S, Lund L, Danielsen D, Bast LS. Who are the young users of tobacco products? Prevalence and characteristics of Danish adolescents who have either smoked cigarettes, used alternative tobacco products, or used both. NORDIC STUDIES ON ALCOHOL AND DRUGS 2021; 38:555-572. [PMID: 35309851 PMCID: PMC8900172 DOI: 10.1177/14550725211027687] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 06/08/2021] [Indexed: 01/16/2023] Open
Abstract
Aims: We examined characteristics (smoking in social relations, binge drinking, and well-being measures) of Danish 13-year-olds in relation to their tobacco use patterns. Ever use of cigarettes exclusively, ever use of alternative tobacco products (ATPs; e-cigarettes, snus, or waterpipe) exclusively, and use of both cigarettes and ATPs were studied. Methods: We used self-reported data from students at 46 Danish schools in 2017 comprising 2,307 students (response rate = 86%). Multi-level logistic regression analyses were used to examine the associations between student characteristics and the odds for having ever used any tobacco products, smoked cigarettes exclusively, used ATPs exclusively, or used both cigarettes and ATPs compared with never use of any tobacco products. Unadjusted estimates and estimates adjusted for gender were reported. Results: A significant minority of youth (13.2%) had used one or more tobacco products. Of these, 2.0% had exclusively smoked cigarettes, 7.2% had exclusively used ATPs, and 4.0% had used both. Findings showed that all included characteristics (families’ and friends’ smoking, binge drinking, and well-being characteristics) were associated with using any tobacco product; however, students with friends who smoked, had been binge drinking, and had low well-being at home had notably higher odds for having both smoked cigarettes and used ATPs compared to the other tobacco use patterns. Conclusion: ATPs were popular among Danish adolescents compared with conventional cigarettes. Thus, prevention efforts among adolescents should not merely focus on the health risks of conventional cigarette smoking but also on ATPs. Students with diverse tobacco use patterns were similar on various characteristics. However, findings indicate that adolescents who had used both conventional cigarettes and ATPs constitute a more risk-averse group in special need of prevention efforts. Gender did not markedly influence the results. These findings may help future strategies aiming at the youngest adolescents at risk of using tobacco products.
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Affiliation(s)
- Simone Gad Kjeld
- Simone Gad Kjeld, National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark.
| | | | | | | | - Lisbeth Lund
- University of Southern Denmark, Copenhagen, Denmark
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50
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Kalan ME, Ghobadi H, Taleb ZB, Adham D, Cobb CO, Ward KD, Behaleh R, Fazlzadeh M. COVID-19 and beliefs about tobacco use: an online cross-sectional study in Iran. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:40346-40354. [PMID: 33029777 PMCID: PMC7541093 DOI: 10.1007/s11356-020-11038-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 09/28/2020] [Indexed: 05/02/2023]
Abstract
There is mixed evidence surrounding the relationship between tobacco use and COVID-19 infection/progression. The current study investigates beliefs and tobacco use behaviors and COVID-19 infection among a sample of smokers and never-smokers. Data were collected using an online survey distributed through Telegram, a cloud-based social media networking application in Iran from April 1 to May 31, 2020. The study participants included never-smokers (n = 511), current (past-month) waterpipe smokers (n = 89), current cigarette smokers (n = 158), and ex-smokers (n = 172). Multinomial logistic regression was used to compare tobacco use groups with never- smokers on beliefs, controlling for potential confounders. The study participants (n = 944) was mostly male (64%), had > high school education (76%), and lived in an urban area (91%), with mean ± SD age of 35.3 ± 10.8. Key findings of this study are that compared with never-smokers: (1) cigarette smokers were less likely to believe that smoking cigarette can lead to spreading COVID-19; (2) waterpipe smokers were more likely to believe that smoking waterpipe at home was a safe practice, that waterpipe protects against COVID-19, and smoking waterpipe may lead to a more rapid recovery from COVID-19; (3) both waterpipe and cigarette smokers believed that using e-cigarettes in public places was a safe practice during the COVID-19 pandemic; and (4) more than half of the ex-smokers stopped smoking due to COVID-19 and most of them planned to continue abstaining from smoking after the pandemic. Our findings underscore the need to raise awareness about the unsupported claims of a lower hazard of using tobacco products or possible protective effects against COVID-19 and to promote cessation programs.
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Affiliation(s)
- Mohammad Ebrahimi Kalan
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | - Hassan Ghobadi
- Department of Internal Medicine, Pulmonary Division, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Ziyad Ben Taleb
- Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, USA
| | - Davoud Adham
- Department of Public Health, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran.
| | - Caroline O Cobb
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Kenneth D Ward
- School of Public Health, University of Memphis, Memphis, TN, USA
| | - Raed Behaleh
- School of Health Sciences, Baldwin Wallace University, Berea, OH, USA
| | - Mehdi Fazlzadeh
- Department of Environmental Health, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran.
- Department of Environmental Health, School of Health, Tehran University of Medical Sciences, Tehran, Iran.
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