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Tamim H, Beyhum A, Alzaghoul A, Kesibi D, Alghalyini B, Yunis K. Prevalence and characteristics of smoking cigarette and narghile among Syrian refugee parents in Ontario, Canada. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003176. [PMID: 38701042 PMCID: PMC11068169 DOI: 10.1371/journal.pgph.0003176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 04/08/2024] [Indexed: 05/05/2024]
Abstract
This study aimed to explore the prevalence and associated sociodemographic, migration, and health-related factors of smoking cigarettes and narghile among Syrian refugee parents resettled in Ontario, Canada since 2015. A total of 540 Syrian refugee parents, with at least one child less than 18 years of age, were interviewed. Multivariate logistic regression analysis was performed to assess the independent relationship between each of the associated sociodemographic, migration, and health-related factors and smoking cigarettes and narghile. The overall prevalence of smoking was 43% (cigarette = 22%, narghile = 25.6%). The average number of cigarettes smoked per day was 15.4 (SD = 10.1). With regard to smoking narghile, 18.2% of the sample smoked daily, while 35.5% and 52.9% smoked at least once weekly and occasionally, respectively. Results from multivariate logistic regression analysis showed that more fathers were at increased odds of smoking cigarettes than mothers OR (95% CI) = 6.6 (3.7-11.9), while no such difference was found for narghile smokers OR (95% CI) = 1.5 (0.9-2.6). Results showed that smoking cigarettes was associated with lower education levels and being Muslim, whereas smoking narghile was associated with younger age and alcohol use. Poor perceived mental health was significant/approached significance for both types of smoking. Greater understanding of smoking patterns of resettled refugees is needed to direct healthcare providers to offer targeted interventions for those who are most at risk.
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Affiliation(s)
- Hala Tamim
- Department of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - Aliya Beyhum
- Department of Archeology, University of Cambridge, Cambridge, United Kingdom
| | - Aseel Alzaghoul
- Division of Social and Transcultural Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Durmalouk Kesibi
- Department of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | | | - Khalid Yunis
- Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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2
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Araujo-Silva H, de Souza AM, Mamede JPM, de Medeiros SRB, Luchiari AC. Individual differences in response to alcohol and nicotine in zebrafish: Gene expression and behavior. Dev Growth Differ 2023; 65:434-445. [PMID: 37435714 DOI: 10.1111/dgd.12876] [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: 11/09/2022] [Revised: 06/06/2023] [Accepted: 07/04/2023] [Indexed: 07/13/2023]
Abstract
Alcohol and nicotine are psychoactive substances responsible for serious health consequences. Although the biological mechanisms of alcohol and nicotine have been studied extensively, individual differences in the response to these drugs have received little attention. Here we evaluated gene expression and behavior of bold and shy individuals after acute exposure to alcohol and nicotine. For this, zebrafish were classified as bold and shy individuals based on emergence tests, and then fish were exposed to 0.00, 0.10, and 0.50% alcohol or 0.00, 1.00, and 5.00 mg/L nicotine and their anxiety-like and locomotor behavior was observed. After behavioral assessment, brain mRNA expression (ache, bdnf, gaba1, gad1b, th1, and tph1) was evaluated. Locomotion patterns differed between profiles depending on alcohol and nicotine concentration. Anxiety increased in shy fish and decreased in bold fish after exposure to both drugs. Alcohol exposure induced an increase in tph1 mRNA expression in bold fish, while bdnf mRNA expression was increased in shy fish. Nicotine increased ache, bdnf, and tph1 mRNA levels in both profiles, but at higher levels in bold fish. Based on our research, we found that alcohol induces anxiogenic effects in both bold and shy zebrafish. Additionally, shy individuals exposed to a low concentration of nicotine exhibited stronger anxiety-like responses than their bold counterparts. These findings further support the validity of using zebrafish as a dependable tool for studying the effects of drugs and uncovering the underlying mechanisms associated with individual variations.
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Affiliation(s)
- Heloysa Araujo-Silva
- Department of Physiology and Behavior, Universidade Federal do Rio Grande do Norte, Natal, Brazil
- Graduate Program in Psychobiology, Biosciences Center, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Augusto Monteiro de Souza
- Department of Molecular Biology and Genetics, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - João Paulo Medeiros Mamede
- Department of Physiology and Behavior, Universidade Federal do Rio Grande do Norte, Natal, Brazil
- Graduate Program in Psychobiology, Biosciences Center, Federal University of Rio Grande do Norte, Natal, Brazil
| | | | - Ana Carolina Luchiari
- Department of Physiology and Behavior, Universidade Federal do Rio Grande do Norte, Natal, Brazil
- Graduate Program in Psychobiology, Biosciences Center, Federal University of Rio Grande do Norte, Natal, Brazil
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Ali D, AlAhmari F, Mikami T, Baskaradoss JK. Increased expression of advanced glycation endproducts in the gingival crevicular fluid compromises periodontal status in cigarette-smokers and waterpipe users. BMC Oral Health 2022; 22:206. [PMID: 35614406 PMCID: PMC9131685 DOI: 10.1186/s12903-022-02240-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 05/19/2022] [Indexed: 02/08/2023] Open
Abstract
Background The aim was to assess the association between levels of advanced glycation endproducts (AGEs) in the gingival crevicular fluid (GCF) and periodontal parameters among cigarette-smokers and waterpipe-users. Methods Self-reported cigarette-smokers; waterpipe-users and never-smokers were included. Demographic data was recorded using a questionnaire. Periodontal parameters (plaque index [PI], gingival index [GI], clinical attachment loss [AL], probing depth [PD], and marginal bone loss [MBL]) were assessed in all groups. The GCF samples were collected using standard techniques and assessed for AGEs levels using enzyme-linked immunosorbent assay. Sample-size estimation was done and group-comparisons were done. Correlation between levels of GCF AGEs levels and periodontal parameters was assessed using a logistic regression model. Level of significance was set at P < 0.01. Results Eighty-two individuals (28 cigarette-smokers, 28 waterpipe-users and 26 never-smokers) were included. There was no difference in mean ages of all patients. Cigarette-smokers had a smoking history of 5.1 ± 0.2 pack years and waterpipe-users were using waterpipe for 4.4 ± 0.6 years. There was no statistically significant difference in PI, GI, clinical AL, PD and MBL in all groups. Levels of AGEs were significantly higher among cigarette-smokers (P < 0.001) and waterpipe-users (P < 0.001) than never-smokers. There was no significant correlation between levels of GCF AGEs levels and periodontal parameters in all groups. Conclusion Clinical periodontal status of individuals with a short history of cigarette-smoking and waterpipe-usage may appear similar to never-smokers. On a molecular level, cigarette-smoking and waterpipe-users express raised levels of AGEs than never-smokers that sirens about the ongoing yet latent periodontal inflammatory process.
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Affiliation(s)
- Dena Ali
- Department of General Dental Practice, Kuwait University, P. O. Box 24923, 13110, Safat, Kuwait.
| | - Fatemah AlAhmari
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Toshinari Mikami
- Pax Creation Medical Lab, Morioka, Japan.,Department of Oral Pathology, Oral Lab Central College of Stomatology, China Medical University, Shenyang, China
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Erinoso O, Oyapero A, Osoba M, Amure M, Osibogun O, Wright K, Osibogun A. Association between anxiety, alcohol, poly-tobacco use and waterpipe smoking: A cross-sectional study in Lagos, Nigeria. Niger Postgrad Med J 2021; 28:117-125. [PMID: 34494598 DOI: 10.4103/npmj.npmj_530_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Waterpipe smoking (WPS) has been reported to have a wide range of damaging health effects on pulmonary and cardiovascular systems. Studies suggest that waterpipe tobacco smoking is associated with reduced harm perceptions, mental health problems and the use of psychoactive substances. We investigate the patterns of use and the association of WPS with anxiety, poly-tobacco and alcohol use in Lagos, Nigeria. Materials and Methods A cross-sectional study design was used to assess the data from 818 adolescents and adults in Lagos State, Nigeria. An online questionnaire obtained demographic information, waterpipe, e-cigarette, alcohol and other tobacco product use from respondents. Anxiety was assessed using the validated Generalised Anxiety Disorder 7-point scale. Bivariate and multivariate logistic regression analysis was used to identify the factors associated with waterpipe ever-use. P < 0.05 was considered statistically significant. Results The mean (standard deviation) age of respondents was 23.43 (±3.96), over half were female (55.2%) and a majority had a college diploma or more (88.59%). Among study participants, 18.58% reported waterpipe ever-use. Among ever waterpipe users, 17.33% reported current use (past 30-days), with a majority having smoked waterpipe in a bar or pub. Alcohol use (P < 0.001), e-cigarette ever-use (P: 0.010) and poly-tobacco ever-use (P: 0.030) were significantly associated with higher odds of waterpipe use in the multivariate regression model. Further, there was a lower likelihood of waterpipe ever-use in the bivariate regression model among respondents with mild and moderate to severe anxiety levels than those with normal anxiety levels (P: 0.030); however, this association was no longer significant in the adjusted model. Conclusions Our findings suggest a relatively high prevalence of WPS in Lagos, Nigeria. Concurrent alcohol consumption, e-cigarette and poly-tobacco use are associated with WPS, and most waterpipe smokers have normal anxiety levels. The Nigerian Government should consider surveillance measures for WPS and a more comprehensive smoke-free policy.
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Affiliation(s)
- Olufemi Erinoso
- Department of Oral and Maxillofacial Surgery, Lagos State University Teaching Hospital, Ikeja, Nigeria
| | - Afolabi Oyapero
- Department of Preventive Dentistry, Lagos State University College of Medicine, Ikeja, Nigeria
| | - Moyosoore Osoba
- African Center of Excellence for Genomics of Infectious Diseases, Redeemer's University, Ede, Osun State, Nigeria
| | - Mary Amure
- Department of Preventive Dentistry, Lagos State University Teaching Hospital, Ikeja, Nigeria
| | - Olatokunbo Osibogun
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Kikelomo Wright
- Department of Community Health and Primary Health Care, Lagos State University College of Medicine, Ikeja, Nigeria
| | - Akin Osibogun
- Department of Community Health and Primary Health Care, College of Medicine, University of Lagos, Lagos, Nigeria
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Sáenz-Lussagnet JM, Rico-Villademoros F, Luque-Romero LG. Use of waterpipes and other substances in adolescents: Prevalence and potential associations with mental and behavioral well-being, a cross-sectional study. Tob Prev Cessat 2021; 7:50. [PMID: 34268458 PMCID: PMC8265394 DOI: 10.18332/tpc/137672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 03/29/2021] [Accepted: 05/18/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION This study assess the prevalence and potential determinants (attitudes, behavioral and emotional conditions) associated with waterpipe tobacco smoking (WTS) and cigarette smoking in adolescents in public compulsory secondary schools. METHODS This was a cross-sectional study conducted in October 2017 in three secondary schools from Seville, Spain, among adolescents aged 12-18 years. We administered an ad hoc questionnaire to explore the demographic and clinical characteristics of students; in addition, it included questions on consumption of tobacco (waterpipe and/or cigarette), alcohol (usual consumption and/or drunkenness) and/or cannabis, and attitudes towards waterpipe tobacco smoking. We also administered a validated version of the Strengths and Difficulties Questionnaire (SDQ), which is used to screen children and adolescents with emotional and behavioral problems. An established usage of a substance was defined as weekly or daily use. A multivariate analysis was performed using binary logistic regression methods to determine the probability of established usage. RESULTS Of the 1135 adolescents, 72.1% lived with at least one smoker; the established usage was 13.4% for waterpipe; 9.2% for cigarettes and 3.2% for dual use. Of those with established usage of waterpipe, 38.2% had established alcohol usage, 12.7% were drunk weekly or daily, and 27.4% used cannabis. Students consolidating the consumption of waterpipes were three times more likely to have established cigarette use than those not having an established usage (OR=3.7; p=0.0005). The overall SDQ score increased the likelihood of established usage of both waterpipes and cigarettes (p=0.0005). CONCLUSIONS The probability of established usage of cigarettes (multivariate analysis) is associated with increasing age (course), cohabitation with smokers, established usage of waterpipe, established use of alcohol and a borderline score in the behavioral dimension (SDQ). Addiction to waterpipes among teens is significantly associated with their behavioral and emotional difficulties.
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Affiliation(s)
- Juan M Sáenz-Lussagnet
- Aljarfe - Sevilla North District, Andalusian Health Service, Regional Council of Andalusia, Seville, Spain.,Department of Evolutionary Psychology and Education, Faculty of Psychology, Seville University, Seville, Spain
| | | | - Luis G Luque-Romero
- Aljarfe - Sevilla North District, Andalusian Health Service, Regional Council of Andalusia, Seville, Spain.,Department of Normal and Pathological Cytology and Histology, Faculty of Medicine, Seville University, Seville, Spain
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Alam MM, Ward KD, Bahelah R, Kalan ME, Asfar T, Eissenberg T, Maziak W. The Syrian Center for Tobacco Studies-13 (SCTS-13): Psychometric evaluation of a waterpipe-specific nicotine dependence instrument. Drug Alcohol Depend 2020; 215:108192. [PMID: 32738447 PMCID: PMC7860966 DOI: 10.1016/j.drugalcdep.2020.108192] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/14/2020] [Accepted: 07/09/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Waterpipe tobacco smoking (WTS) has surged globally among young people and causes nicotine dependence (ND). No existing ND instruments are sensitive to waterpipe-specific features of ND and early stages of use. METHODS We conducted a psychometric scale evaluation among 192 current waterpipe smokers, initially averaging 15 years of age, recruited from schools in Beirut, Lebanon, and assessed 4 times, 6 months apart. Twenty eight self-report items tapping multiple features of ND were submitted to exploratory and confirmatory factor analyses (EFA and CFA) to reduce items and verify factor structure. Convergent validity was assessed with the Lebanese Waterpipe Dependence Scale and the Hooked on Nicotine Checklist, and discriminant validity with the Depressive Symptom Scale and Adolescent Life Events Stress Scale. Concurrent and predictive validity measures included smoking status and intensity (amount, frequency, session duration, and change in frequency), quitting interest and success, perceived addiction, and smoking alone. RESULTS The EFA yielded a single factor, 13 item solution (named the Syrian Center for Tobacco Studies [SCTS]-13) that explained 91% of variance in responses, was internally consistent (Cronbach's alpha and McDonald's omega = 0.87), and captured several positive reinforcement, negative reinforcement, and social/sensory-related features of ND. The CFA indicated good model fit. The SCTS-13 showed acceptable convergent and discriminant validity. Higher SCTS-13 scores predicted current waterpipe and dual (waterpipe and cigarette) smoking, greater intensity of use, less interest in quitting, shorter duration of abstinence, greater perceived addiction, and smoking alone (vs. socially). CONCLUSION The SCTS-13 is a promising brief, waterpipe-specific ND instrument.
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Affiliation(s)
- Mohammad Masudul Alam
- Center for the Study of Tobacco, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Kenneth D Ward
- School of Public Health, University of Memphis, Memphis, TN, United States; Syrian Center for Tobacco Studies, Aleppo, Syria.
| | - Raed Bahelah
- Department of Public Health & Prevention Science, School of Health Sciences, Baldwin Wallace University, Berea, OH, United States
| | - Mohammad Ebrahmi Kalan
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, United States
| | - Taghrid Asfar
- Syrian Center for Tobacco Studies, Aleppo, Syria; Department of Public Health Sciences, University of Miami Miller School of Medicine, and Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Thomas Eissenberg
- Syrian Center for Tobacco Studies, Aleppo, Syria; Department of Psychology and Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, United States
| | - 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, FL, United States
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Ibraheem WI, Fageeh HI, Preethanath RS, Alzahrani FA, Al-Zawawi AS, Divakar DD, Al-Kheraif AA. Comparison of RANKL and osteoprotegerin levels in the gingival crevicular fluid of young cigarette- and waterpipe-smokers and individuals using electronic nicotine delivery systems. Arch Oral Biol 2020; 115:104714. [DOI: 10.1016/j.archoralbio.2020.104714] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 03/08/2020] [Accepted: 03/24/2020] [Indexed: 12/19/2022]
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Alomari MA, Alzoubi KH, Khabour OF. Differences in oxidative stress profile in adolescents smoking waterpipe versus cigarettes: The Irbid TRY Project. Physiol Rep 2020. [PMCID: PMC7484827 DOI: 10.14814/phy2.14512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Mahmoud A. Alomari
- Department of Physical Education Qatar University Doha Qatar
- Division of Physical Therapy Department of Rehabilitation Sciences Jordan University of Science and Technology Irbid Jordan
| | - Karem H. Alzoubi
- Department of Clinical Pharmacy Jordan University of Science and Technology Irbid Jordan
| | - Omar F. Khabour
- Department of Medical Laboratory Sciences Jordan University of Science and Technology Irbid Jordan
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Hallit J, Salameh P, Haddad C, Sacre H, Soufia M, Akel M, Obeid S, Hallit R, Hallit S. Validation of the AUDIT scale and factors associated with alcohol use disorder in adolescents: results of a National Lebanese Study. BMC Pediatr 2020; 20:205. [PMID: 32393212 PMCID: PMC7212566 DOI: 10.1186/s12887-020-02116-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 04/30/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND This study objective was to evaluate the prevalence of alcohol use disorder (AUD) and related factors (smoking, internet addiction, social anxiety, child abuse, and bullying) among a representative sample of Lebanese adolescents, and to validate and confirm psychometric properties of the Alcohol Use Disorders Identification Test (AUDIT). METHODS A cross-sectional study, conducted between January and May 2019, enrolled 1810 adolescents aged between 14 and 17 from schools of all Lebanese districts. From the total number of schools, a proportionate number was selected in each district. AUD was defined as a high AUDIT score (≥8; score range 0-40). A principal component analysis technique to confirm the validity of the construct of the AUDIT scale score was done and a confirmatory analysis to assess the structure of the instrument was conducted. Spearman correlation was used for linear correlation between continuous variables. The Mann-Whitney test was used to compare the means of two groups, while the Kruskal-Wallis test was used to compare three groups or more. A stepwise linear regression was conducted, taking the AUDIT total score as the dependent variable and taking child abuse (psychological, sexual, physical and verbal), cigarette and waterpipe smoking dependence, bullying, social phobia, and internet addiction as independent variables. RESULTS The mean AUDIT score was 6.46 ± 8.44 and high risk of AUD was found in 507 (28.0%) adolescents [95% CI 0.259-0.301]. One factor solution of the AUDIT scale was found after running the factor analysis (αCronbach = 0.978). Higher AUDIT scores were significantly associated with higher cigarette (Beta = 0.527; p < 0.001) and waterpipe (Beta = 0.299; p < 0.001) dependence, higher childhood sexual abuse (Beta = 0.656; p < 0.001) and neglect (Beta = 0.126; p < 0.001), higher bullying victimization (Beta = 0.236; p < 0.001). CONCLUSION Alcohol use disorder among Lebanese adolescents seems to be associated with several factors, such as cigarette and waterpipe dependence, parents' divorce, higher internet addiction, bullying victimization, and childhood sexual abuse and neglect. Parents and healthcare professionals could use this data for early interventions.
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Affiliation(s)
- Jennifer Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Pascale Salameh
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
- Faculty of Medicine, Lebanese University, Hadat, Lebanon
| | - Chadia Haddad
- Research and Psychology Departments, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
- Université de Limoges, UMR 1094, Neuroépidémiologie Tropicale, Institut d'Epidémiologie et de Neurologie Tropicale, GEIST, 87000, Limoges, France
| | - Hala Sacre
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon
- Drug Information Center, Order of Pharmacists of Lebanon, Beirut, Lebanon
| | - Michel Soufia
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
- Faculty of Medicine, Lebanese University, Hadat, Lebanon
| | - Marwan Akel
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Sahar Obeid
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon
- Research and Psychology Departments, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
- Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Rabih Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon.
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Reyes-Caballero H, Park B, Loube J, Sanchez I, Vinayachandran V, Choi Y, Woo J, Edwards J, Brinkman MC, Sussan T, Mitzner W, Biswal S. Immune modulation by chronic exposure to waterpipe smoke and immediate-early gene regulation in murine lungs. Tob Control 2019; 29:s80-s89. [PMID: 31852817 DOI: 10.1136/tobaccocontrol-2019-054965] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 08/22/2019] [Accepted: 08/24/2019] [Indexed: 01/02/2023]
Abstract
OBJECTIVE We investigated the effects of chronic waterpipe (WP) smoke on pulmonary function and immune response in a murine model using a research-grade WP and the effects of acute exposure on the regulation of immediate-early genes (IEGs). METHODS WP smoke was generated using three WP smoke puffing regimens based on the Beirut regimen. WP smoke samples generated under these puffing regimens were quantified for nicotine concentration. Mice were chronically exposed for 6 months followed by assessment of pulmonary function and airway inflammation. Transcriptomic analysis using RNAseq was conducted after acute exposure to characterise the IEG response. These biomarkers were then compared with those generated after exposure to dry smoke (without water added to the WP bowl). RESULTS We determined that nicotine composition in WP smoke ranged from 0.4 to 2.5 mg per puffing session. The lung immune response was sensitive to the incremental severity of chronic exposure, with modest decreases in airway inflammatory cells and chemokine levels compared with air-exposed controls. Pulmonary function was unmodified by chronic WP exposure. Acute WP exposure was found to activate the immune response and identified known and novel IEG as potential biomarkers of WP exposure. CONCLUSION Chronic exposure to WP smoke leads to immune suppression without significant changes to pulmonary function. Transcriptomic analysis of the lung after acute exposure to WP smoke showed activation of the immune response and revealed IEGs that are common to WP and dry smoke, as well as pools of IEGs unique to each exposure, identifying potential biomarkers specific to WP exposure.
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Affiliation(s)
- Hermes Reyes-Caballero
- Environmental Health and Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Bongsoo Park
- Environmental Health and Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jeffrey Loube
- Environmental Health and Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Ian Sanchez
- Environmental Health and Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Vinesh Vinayachandran
- Environmental Health and Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Youngshim Choi
- Environmental Health and Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Juhyung Woo
- Environmental Health and Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Justin Edwards
- Environmental Health and Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Thomas Sussan
- Toxicology Directorate, US Army Public Health Command, Aberdeen Proving Ground, Maryland, USA
| | - Wayne Mitzner
- Environmental Health and Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Shyam Biswal
- Environmental Health and Engineering, Johns Hopkins University, Baltimore, Maryland, USA
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Khabour OF, Alzoubi KH, Al-Sheyab NA, Azab MA, Massadeh AM, Alomary AA, Eissenberg TE. Plasma and saliva levels of three metals in waterpipe smokers: a case control study. Inhal Toxicol 2018; 30:224-228. [PMID: 30257114 DOI: 10.1080/08958378.2018.1500663] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
In this case-control study, the influence of waterpipe tobacco smoking on the plasma and saliva levels of cadmium, lead and zinc was examined in participants who were waterpipe tobacco smokers (WS) or never-smokers (NS). The concentration of metals was higher in WS relative to NS. The mean (SEM) cadmium concentration in plasma was 3.3 (0.18) µg/dL in WS versus 0.82 (0.09) µg/L in NS (p < .001) and in saliva was 5.1 (0.36) µg/L in WS versus 0.64 (0.2) µg/L in NS (p < .001). The mean (SEM) lead concentration in plasma was 5.2 (0.25) µg/dL in WS versus 3.4 (0.41) µg/dL in NS (p < .01) and in saliva was 4.8 (0.58) µg/L in WS versus 2.8 (0.27) µg/L in NS (p < .05). Similarly, a significant difference in zinc concentration was observed, with a mean of 2.0 (0.17) µg/mL in WS plasma versus 1.49 (0.16) µg/mL in NS (p < .05) and a mean 0.94 (0.07) µg/mL in WS saliva versus 0.45 (0.06) µg/mL in NS (p < .01). In conclusion, waterpipe tobacco smoking is associated with elevated levels of metals in body fluids. These results provide another demonstration of how waterpipe tobacco smoking exposes smokers to harmful toxicants.
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Affiliation(s)
- Omar F Khabour
- a Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences , Jordan University of Science and Technology , Irbid , Jordan
| | - Karem H Alzoubi
- b Department of Clinical Pharmacy, Faculty of Pharmacy , Jordan University of Science and Technology , Irbid , Jordan
| | - Nihaya A Al-Sheyab
- c Department of Maternal and Child Health Nursing, Faculty of Nursing , Jordan University of Science and Technology , Irbid , Jordan
| | - Mohammad A Azab
- d Department of Basic Medical Sciences, Faculty of Medicine , The Hashemite University , Zarqa , Jordan
| | - Adnan M Massadeh
- e Department of Medicinal Chemistry and Pharmacognosy, Faculty of Pharmacy , Jordan University of Science and Technology , Irbid , Jordan
| | - Ahmed A Alomary
- f Department of Chemistry, Faculty of Sciences , Yarmouk University , Irbid , Jordan
| | - Thomas E Eissenberg
- g Department of Psychology , Center for the Study of Tobacco Products, Virginia Commonwealth University , Richmond , VA , USA
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Nakkash R, Lotfi T, Bteddini D, Haddad P, Najm H, Jbara L, Alaouie H, Al Aridi L, Al Mulla A, Mahfoud Z, Afifi RA. A Randomized Controlled Trial of a Theory-Informed School-Based Intervention to Prevent Waterpipe Tobacco Smoking: Changes in Knowledge, Attitude, and Behaviors in 6th and 7th Graders in Lebanon. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1839. [PMID: 30149668 PMCID: PMC6163698 DOI: 10.3390/ijerph15091839] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 08/16/2018] [Accepted: 08/17/2018] [Indexed: 12/11/2022]
Abstract
Waterpipe tobacco smoking (WTS) is spreading worldwide. Research has indicated health consequences of WTS similar to cigarettes. Prevalence of WTS is high among young people. In Lebanon, current use rates of 35% have been documented among 13⁻15 year olds. We evaluated a school-based intervention. Method: We conducted a randomized-controlled-trial of a theory-informed WTS intervention. The intervention consisted of ten sessions based on social cognitive theory and the social influences approach. Thirty-one schools participated: 14 intervention and 17 control; a total of 1279 students completed pre and post assessments. We measured knowledge, attitudes and self-reported behaviors related to WTS using Chi-square tests and regression analyses to compare results between the two study arms. Results: The intervention increased knowledge of intervention group compared to control group participants-about WTS constituents and health consequences; and shifted attitudes of intervention group participants to be even more unfavorable towards WTS. We found no impact of the intervention on WTS behaviors. Discussion: The effectiveness of the intervention on knowledge and attitudes supports previous research. The lack of intervention effect on behavior is not surprising given the timing of the post assessment immediately after the intervention, and the social context that was supportive of waterpipe use.
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Affiliation(s)
- Rima Nakkash
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut 1107-2020, Lebanon.
| | - Tamara Lotfi
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut 1107-2020, Lebanon.
| | - Dima Bteddini
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut 1107-2020, Lebanon.
| | | | - Hala Najm
- Soins Infirmiers et Développement Communautaire (SIDC), Sin El Fil 1100, Lebanon.
| | - Lina Jbara
- Academic Coordinator, Sorbonne University Abu Dhabi, 38044 Abu Dhabi, United Arab Emirates.
| | - Hala Alaouie
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut 1107-2020, Lebanon.
| | | | - Ahmad Al Mulla
- Department of Medicine, Hamad Medical Corporation, Doha 4147, Qatar.
| | - Ziyad Mahfoud
- Department of Global and Public Health, Weill-Cornell Medicine, Doha 24144, Qatar.
| | - Rima A Afifi
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut 1107-2020, Lebanon.
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, IA 52242, USA.
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