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Sutfin EL, Lazard AJ, Jang H, Wagoner KG, Reboussin BA, Suerken CK, Soule EK, Kimes CM, Zizzi AR, Cornacchione Ross J. Waterpipe Tobacco Brands and Flavors Sold Online in the USA. Subst Use Misuse 2024:1-9. [PMID: 38946151 DOI: 10.1080/10826084.2024.2359723] [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: 07/02/2024]
Abstract
INTRODUCTION Flavor additives are commonly used in combustible tobacco products to mask harshness and increase appeal. However, research on the availability of flavored waterpipe tobacco (WT) is lacking, yet is important to support implementation of policies. METHODS We completed a comprehensive online search in 2020 to identify WT brands and flavors sold online in the USA. We conducted a descriptive content analysis categorizing flavors as explicit (i.e., clear taste/flavor) or concept (i.e., no clear taste/flavor); and coded for 23 flavor descriptors (e.g., fruit, mint/menthol, tobacco). Flavor names were double-coded and discrepancies were resolved by a third coder. RESULTS We identified 66 WT brands with 118 product lines (i.e., sub-brands). We found 2953 flavors, including 1871 unique flavors. Brands averaged 45 flavors (range: 1-183). Almost three quarters (73.5%, n = 2171) used explicit flavor names and 26.5% (n = 782) used concept flavor names. Concept flavors varied widely, and included names such as 1001 Nights and California Dream. The most common flavor descriptors were fruit (54.1%) and mint/menthol (12.5%). Tobacco was rarely (0.2%) used as a flavor descriptor. Flavor descriptors also included location (10.7%), color (11.1%), candy (6.3%), cool/ice (5.3%), and alcohol (5.5%). CONCLUSIONS WT is available in 1871 unique flavors, likely contributing to product appeal and use. Like other tobacco products, fruit and mint/menthol are common flavors. Given the significant health consequences associated with WT smoking and the role of flavors in product use, regulatory action specifically targeting WT flavors is urgently needed.
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Affiliation(s)
- Erin L Sutfin
- Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Allison J Lazard
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
- Hussman School of Media and Journalism, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Heesoo Jang
- Hussman School of Media and Journalism, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Kimberly G Wagoner
- Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Beth A Reboussin
- Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Cynthia K Suerken
- Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Eric K Soule
- College of Health and Human Performance, East Carolina University, Greenville, North Carolina, USA
| | - Caroline M Kimes
- Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Alexandra R Zizzi
- Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Jennifer Cornacchione Ross
- Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
- Boston University School of Public Health, Boston, Massachusetts, USA
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Sharma R, Kanaan M, Siddiqi K. The Diversity in Tobacco Use Among Women of Reproductive Age (15-49 Years) in Pakistan: A Secondary Analysis of a Multiple Indicator Cluster Survey 2016-2018. Nicotine Tob Res 2024; 26:931-939. [PMID: 38300742 PMCID: PMC11190045 DOI: 10.1093/ntr/ntae016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 12/04/2023] [Accepted: 01/25/2024] [Indexed: 02/03/2024]
Abstract
INTRODUCTION Tobacco use in women of reproductive age group (15-9 years) may contribute to poor maternal and child health outcomes. We estimated the prevalence of smokeless tobacco (ST), cigarette, and waterpipe use among these women in Pakistan and explored associations with socio-economic differences and birth weights after recent childbirths (past 2 years). AIMS AND METHODS We used the Multiple Indicator Cluster Surveys datasets from three provinces in Pakistan. Prevalence was generated for current use of tobacco among women with recent childbirth (WWRC) and without recent childbirth (WWoRC). We further compared socio-economic status and birth weights between tobacco users and non-users. RESULTS The prevalence of current ST use was 1.4% and 2.5%, and waterpipe smoking was 1.2% and 1.8%, in WWRC and WWoRC, respectively. ST use varied across Pakistan's provinces by 13 percentage points in WWRC and WWoRC while waterpipe smoking by 10 and 15 percentage points, respectively. The odds of using any form of tobacco were significantly lower with higher levels of education or wealth index. Compared to children born to mothers who did not use tobacco, the birth weight of children born to mothers who smoked waterpipe was on average 0.83 kg (95% CI -1.6 to -0.1) lower whereas it was 0.33 kg (95% CI -0.9 to 0.3) higher for ST users. CONCLUSIONS Tobacco use among women of reproductive age in Pakistan varied significantly based on province and tobacco type. Waterpipe smoking was associated with a reduction in birth weight. Raising awareness of the harms of tobacco use among women of reproductive age and targeting interventions in high-burden regions of Pakistan should be prioritized. IMPLICATIONS The prevalence of current smokeless tobacco use and waterpipe smoking varied significantly in Pakistan (~13 and ~15 percentage points, respectively) among women of reproductive age, and there seems to be little change in tobacco use behavior around pregnancy and early motherhood. The study highlights a need to better understand the prevalence of tobacco use in Pakistan, and further contextual research is warranted to understand the reasons for such high tobacco use in certain areas. This information highlights the need for improving current tobacco control interventions and policies, including measures that could help reduce its use and prevent its uptake. Furthermore, compared to children born to mothers who did not use any form of tobacco, we found a statistically significant difference (830 g) in birth weight for babies born to mothers who at the time of the interview smoked waterpipe and a non-statistically significant difference of about 330 g for children born to mothers who at the time of the interview used smokeless tobacco. In addition to our findings, some literature suggests the association of waterpipe smoking with low birth weight. A possible explanation could be the exposure to smoke that contains toxicants from the tobacco product itself in addition to the burning of charcoal, which is required when using waterpipe. Waterpipe smoking also results in high exposures to carbon monoxide and polycyclic aromatic hydrocarbons, which are known to be carcinogenic and teratogenic. In terms of smokeless tobacco use, further research is warranted to understand its impact on birth outcomes through longitudinal studies accounting for diverse products, its constituents and the amount of consumption.
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Affiliation(s)
- Radha Sharma
- Department of Health Sciences, University of York, York, UK
- ConnectHEOR Canada Limited, Edmonton, Alberta, Canada
| | - Mona Kanaan
- Department of Health Sciences, University of York, York, UK
| | - Kamran Siddiqi
- Department of Health Sciences, University of York, York, UK
- Hull York Medical School, University of York, York, UK
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Rashidian H, Hadji M, Ansari-Moghaddam A, Bakhshi M, Nejatizadeh A, Marzban M, Rezaianzadeh A, Seyyedsalehi MS, Moradi A, Gholipour M, Alizadeh-Navaei R, Freedman ND, Malekzadeh R, Etemadi A, Kamangar F, Weiderpass E, Pukkala E, Boffetta P, Zendehdel K. Association between waterpipe smoking and lung cancer: a multicentre case-control study in Iran. Public Health 2024; 231:166-172. [PMID: 38701659 DOI: 10.1016/j.puhe.2024.03.008] [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: 10/22/2023] [Revised: 02/06/2024] [Accepted: 03/05/2024] [Indexed: 05/05/2024]
Abstract
OBJECTIVES This study investigated the association between lung cancer and waterpipe smoking, which is an emerging global public health concern. STUDY DESIGN Multicentre case-control study. METHODS This study included 627 cases and 3477 controls from the Iranian Study of Opium and Cancer (IROPICAN) study, which was conducted between 2017 and 2020. One frequency-matched control for each lung cancer patient was selected by age, gender and residential place; however, this study used controls of four cancer types in the analyses. The multivariable logistic regression model estimated the odds ratio (OR) and 95% confidence intervals (CIs). Additional analyses were performed among 181 lung cancer cases and 2141 controls who were not cigarette smokers or opium or nass/pipe users. RESULTS The odds of lung cancer were higher among waterpipe smokers than never-smokers (OR = 1.3, 95% CI: 1.0-1.7). Results showed a higher OR of lung cancer for those who smoked the waterpipe daily (OR = 2.1, 95% CI: 1.4-3.0), smoked more than two heads per day (OR = 2.7, 95% CI: 1.8-4.0), had smoked for >20 years (OR = 1.9, 95% CI: 1.3-2.7), smoked more than 20 head-years (OR = 2.8, 95% CI: 1.9-4.1) and initiated smoking before the age of 30 years (OR = 1.7, 95% CI: 1.1-2.5). The association was only statistically significant for squamous cell carcinomas (OR = 1.8, 95% CI 1.2-2.7). Furthermore, this study observed a higher OR of lung cancer among exclusive waterpipe smokers (OR = 2.3, 95% CI: 1.6, 3.5). CONCLUSIONS Waterpipe smoking was associated with an increased risk of lung cancer. The association was stronger with higher frequency, duration and intensity of exposure to waterpipe smoking. The association increases in exclusive waterpipe smokers, which is likely due to controlling for residual confounding by cigarette smoking and opium consumption, and higher exposure levels in this subpopulation.
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Affiliation(s)
- H Rashidian
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - M Hadji
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland; Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - A Ansari-Moghaddam
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - M Bakhshi
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - A Nejatizadeh
- Tobacco and Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - M Marzban
- Statistical Genetics Lab, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia; Department of Public Health, School of Public Health, Bushehr University of Medical Science, Bushehr, Iran
| | - A Rezaianzadeh
- Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - M S Seyyedsalehi
- Department of Medical and Surgical Sciences, University of Bologna, Italy; Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - A Moradi
- Golestan University of Medical Sciences, Gorgan, Iran
| | - M Gholipour
- Metabolic Disorders Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - R Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - N D Freedman
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - R Malekzadeh
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - A Etemadi
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA; Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - F Kamangar
- Department of Biology, School of Computer, Mathematical, and Natural Sciences, Morgan State University, Baltimore, MD, USA
| | - E Weiderpass
- International Agency for Research on Cancer, Lyon, France
| | - E Pukkala
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland; Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
| | - P Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, Italy; Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY, USA.
| | - K Zendehdel
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Medical and Surgical Sciences, University of Bologna, Italy.
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Liu H, Xie Y, Huang Y, Luo K, Gu Y, Zhang H, Xu Y, Chen X. The association between blood eosinophils and clinical outcome of acute exacerbations of chronic obstructive pulmonary disease: A systematic review and meta-analysis. Respir Med 2024; 222:107501. [PMID: 38104787 DOI: 10.1016/j.rmed.2023.107501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 11/30/2023] [Accepted: 12/13/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVES Studies have shown an association between eosinophilia and clinical outcomes in acute exacerbation of chronic obstructive pulmonary disease (AECOPD). However, contradictory findings exist. Our study aims to systematically evaluate the association between elevated peripheral blood eosinophils and clinical outcome of patients with AECOPD. METHODS An electronic search was conducted for relevant studies published from database inception to February 28, 2023, on PubMed, EMBASE, Cochrane Library, and Web of Science. The analysis covered studies on the correlation between EOS AECOPD and mortality, hospital stay duration, readmission and hospitalization rates, and invasive mechanical ventilation. Where applicable, relative risk (RR) and weighted mean difference (WMD) were extracted, pooled, and assessed using meta-analysis. Sensitivity analysis was performed to explore the source of heterogeneity. RESULTS Fifteen high-quality studies including 14 cohort studies and one case-control study were included in the meta-analysis. Compared with non-eosinophilic AECOPD patients, those with eosinophilic AECOPD had a lower risk of mortality (RR = 0.65, 95 % confidence interval [CI] 0.54, 0.77, P < 0.001), shorter length of hospital stay (WMD = -1.56, 95%CI -2.16, -0.96, P < 0.001), and higher readmission rate (RR = 1.07, 95%CI 1.01,1.13, P = 0.029). No difference was found concerning the rate of hospitalization and invasive mechanical ventilation between the two groups. CONCLUSION Individuals diagnosed with eosinophilic AECOPD had a reduced mortality rate, a truncated period of hospitalization, and an insubstantial increase in the probability of readmission relative to their non-eosinophilic AECOPD counterparts. The level of eosinophils in blood has been shown to serve as a potential predictive biomarker for AECOPD patients.
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Affiliation(s)
- Hai Liu
- Department of Nursing, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, China
| | - Yongpeng Xie
- Department of Emergency and Critical Care Medicine, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, China
| | - Yuanyuan Huang
- Department of Emergency Medicine, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, China
| | - Kangle Luo
- Department of Emergency Medicine, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, China
| | - Yongli Gu
- Department of Pharmacy, Lianyungang Clinical College of Nanjing Medical University, China
| | - Huan Zhang
- Department of Humanities and Management, Kangda College of Nanjing Medical University, Lianyungang, China
| | - Yi Xu
- Department of Pharmacy, Lianyungang Clinical College of Nanjing Medical University, China.
| | - Xuefeng Chen
- Department of Emergency and Critical Care Medicine, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, China.
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Al-Awaida W, Goh KW, Al-Ameer HJ, Gushchina YS, Torshin VI, Severin AE, Al Bawareed O, Srour B, Al Farraj J, Hamad I. Assessing the Protective Role of Epigallocatechin Gallate (EGCG) against Water-Pipe Smoke-Induced Toxicity: A Comparative Study on Gene Expression and Histopathology. Molecules 2023; 28:7502. [PMID: 38005223 PMCID: PMC10673035 DOI: 10.3390/molecules28227502] [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: 09/05/2023] [Revised: 11/04/2023] [Accepted: 11/05/2023] [Indexed: 11/26/2023] Open
Abstract
Exposure to water-pipe smoking, whether flavored or unflavored, has been shown to instigate inflammation and oxidative stress in BALB/c mice. This consequently results in alterations in the expression of inflammatory markers and antioxidant genes. This study aimed to scrutinize the impact of Epigallocatechin gallate (EGCG)-a key active component of green tea-on inflammation and oxidative stress in BALB/c mice exposed to water-pipe smoke. The experimental setup included a control group, a flavored water-pipe smoke (FWP) group, an unflavored water-pipe smoke (UFWP) group, and EGCG-treated flavored and unflavored groups (FWP + EGCG and UFWP + EGCG). Expression levels of IL-6, IL1B, TNF-α, CAT, GPXI, MT-I, MT-II, SOD-I, SOD-II, and SOD-III were evaluated in lung, liver, and kidney tissues. Histopathological changes were also assessed. The findings revealed that the EGCG-treated groups manifested a significant decline in the expression of inflammatory markers and antioxidant genes compared to the FWP and UFWP groups. This insinuates that EGCG holds the capacity to alleviate the damaging effects of water-pipe smoke-induced inflammation and oxidative stress. Moreover, enhancements in histopathological features were observed in the EGCG-treated groups, signifying a protective effect against tissue damage induced by water-pipe smoking. These results underscore the potential of EGCG as a protective agent against the adverse effects of water-pipe smoking. By curbing inflammation and oxidative stress, EGCG may aid in the prevention or mitigation of smoking-associated diseases.
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Affiliation(s)
- Wajdy Al-Awaida
- Department of Biology and Biotechnology, American University of Madaba, Madaba 11821, Jordan; (B.S.); (J.A.F.)
| | - Khang Wen Goh
- Faculty of Data Science and Information Technology, INTI International University, Nilai 71800, Malaysia;
| | - Hamzeh J. Al-Ameer
- Department of Biotechnology, Faculty of Allied Medical Sciences, Al-Ahliyya Amman University (AAU), Amman 19328, Jordan;
| | - Yulia Sh. Gushchina
- Department of General and Clinical Pharmacology, Medical Institute, Peoples’ Friendship University of Russia (RUDN University), 6 Miklukho-Maklaya Street, 117198 Moscow, Russia;
| | - Vladimir I. Torshin
- Department of Normal Physiology, Medical Institute, Peoples’ Friendship University of Russia (RUDN University), 6 Miklukho-Maklaya Street, 117198 Moscow, Russia; (V.I.T.); (A.E.S.); (O.A.B.)
| | - Alexandr E. Severin
- Department of Normal Physiology, Medical Institute, Peoples’ Friendship University of Russia (RUDN University), 6 Miklukho-Maklaya Street, 117198 Moscow, Russia; (V.I.T.); (A.E.S.); (O.A.B.)
| | - Omar Al Bawareed
- Department of Normal Physiology, Medical Institute, Peoples’ Friendship University of Russia (RUDN University), 6 Miklukho-Maklaya Street, 117198 Moscow, Russia; (V.I.T.); (A.E.S.); (O.A.B.)
| | - Besan Srour
- Department of Biology and Biotechnology, American University of Madaba, Madaba 11821, Jordan; (B.S.); (J.A.F.)
| | - Jude Al Farraj
- Department of Biology and Biotechnology, American University of Madaba, Madaba 11821, Jordan; (B.S.); (J.A.F.)
| | - Islam Hamad
- Department of Pharmacy, Faculty of Health Sciences, American University of Madaba, Madaba 11821, Jordan;
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Mattingly DT, Cook S, Hirschtick JL, Patel A, Arenberg DA, Barnes GD, Levy DT, Meza R, Fleischer NL. Longitudinal associations between exclusive, dual, and polytobacco use and asthma among US youth. Prev Med 2023; 171:107512. [PMID: 37054989 PMCID: PMC11181903 DOI: 10.1016/j.ypmed.2023.107512] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 04/07/2023] [Accepted: 04/10/2023] [Indexed: 04/15/2023]
Abstract
Little is known about the respiratory health effects of dual (two products) and polytobacco (three or more products) use among youth in the United States. Thus, we followed a longitudinal cohort of youth into adulthood using data from Waves 1-5 (2013-2019) of the Population Assessment of Tobacco and Health Study, examining incident asthma at each follow-up (Waves 2-5). We classified past 30-day tobacco use as 1) no products (never/former use), 2) exclusive cigarettes, 3) exclusive electronic nicotine delivery systems (ENDS), 4) exclusive other combustible (OC) tobacco products (cigars, hookah, pipe), 5) dual cigarettes/OC and ENDS, 6) dual cigarettes and OCs, and 7) polytobacco use (cigarettes, OCs, and ENDS). Using discrete time survival models, we analyzed the incidence of asthma across Waves 2-5, predicted by time-varying tobacco use lagged by one wave, and adjusted for potential baseline confounders. Asthma was reported by 574 of the 9141 respondents, with an average annual incidence of 1.44% (range 0.35% to 2.02%, Waves 2-5). In adjusted models, exclusive cigarette use (HR: 1.71, 95% CI: 1.11-2.64) and dual cigarette and OC use (HR: 2.78, 95% CI: 1.65-4.70) were associated with incident asthma compared to never/former use, while exclusive ENDS use (HR: 1.50, 95% CI: 0.92-2.44) and polytobacco use (HR: 1.95, 95% CI: 0.86-4.44) were not. To conclude, youth who use cigarettes with or without OCs had higher risk of incident asthma. Further longitudinal studies on the respiratory health effects of ENDS and dual/polytobacco use are needed as products continue to evolve.
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Affiliation(s)
- Delvon T Mattingly
- University of Michigan School of Public Health, Department of Epidemiology, Ann Arbor, MI 48109, USA.
| | - Steven Cook
- University of Michigan School of Public Health, Department of Epidemiology, Ann Arbor, MI 48109, USA
| | - Jana L Hirschtick
- University of Michigan School of Public Health, Department of Epidemiology, Ann Arbor, MI 48109, USA
| | - Akash Patel
- University of Michigan School of Public Health, Department of Epidemiology, Ann Arbor, MI 48109, USA
| | - Douglas A Arenberg
- University of Michigan Medical School, Division of Pulmonary and Critical Medicine, Department of Internal Medicine, Ann Arbor, MI 48109, USA
| | - Geoffrey D Barnes
- University of Michigan, Center for Bioethics and Social Science in Medicine, Ann Arbor, MI 48109, USA; University of Michigan, Frankel Cardiovascular Center, Ann Arbor, MI 48109, USA
| | - David T Levy
- Georgetown University, Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | - Rafael Meza
- University of Michigan School of Public Health, Department of Epidemiology, Ann Arbor, MI 48109, USA; BC Cancer Research Center, Department of Integrative Oncology, Vancouver, British Columbia, Canada
| | - Nancy L Fleischer
- University of Michigan School of Public Health, Department of Epidemiology, Ann Arbor, MI 48109, USA
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7
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Agustí A, Celli BR, Criner GJ, Halpin D, Anzueto A, Barnes P, Bourbeau J, Han MK, Martinez FJ, Montes de Oca M, Mortimer K, Papi A, Pavord I, Roche N, Salvi S, Sin DD, Singh D, Stockley R, López Varela MV, Wedzicha JA, Vogelmeier CF. Global Initiative for Chronic Obstructive Lung Disease 2023 Report: GOLD Executive Summary. Am J Respir Crit Care Med 2023; 207:819-837. [PMID: 36856433 PMCID: PMC10111975 DOI: 10.1164/rccm.202301-0106pp] [Citation(s) in RCA: 141] [Impact Index Per Article: 141.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 02/28/2023] [Indexed: 03/02/2023] Open
Affiliation(s)
- Alvar Agustí
- Univ. Barcelona, Hospital Clinic, IDIBAPS and CIBERES, Spain
| | - Bartolome R. Celli
- Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Gerard J. Criner
- Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
| | - David Halpin
- University of Exeter Medical School College of Medicine and Health, University of Exeter, Exeter, Devon, UK
| | - Antonio Anzueto
- South Texas Veterans Health Care System, University of Texas Health, San Antonio, Texas, USA
| | - Peter Barnes
- National Heart & Lung Institute, Imperial College London, United Kingdom
| | - Jean Bourbeau
- McGill University Health Centre, McGill University, Montreal, Canada
| | | | - Fernando J. Martinez
- Weill Cornell Medical Center/ New York-Presbyterian Hospital, New York, New York, USA
| | - Maria Montes de Oca
- Hospital Universitario de Caracas Universidad Central de Venezuela Centro Médico de Caracas, Caracas, Venezuela
| | - Kevin Mortimer
- Liverpool University Hospitals NHS Foundation Trust, UK / National Heart and Lung Institute, Imperial College, London, UK / School of Clinical Medicine, College of Health Sciences, University of Kwazulu-Natal, South Africa
| | | | - Ian Pavord
- Respiratory Medicine Unit and Oxford Respiratory NIHR Biomedical Research Centre, Nuffield Department of Medicine, University of Oxford, UK
| | - Nicolas Roche
- Pneumologie, Hôpital Cochin AP-HP.Centre, Université Paris, France
| | - Sundeep Salvi
- Pulmocare Research and Education (PURE) Foundation, Pune, India
| | - Don D. Sin
- St. Paul’s Hospital University of British Columbia, Vancouver, Canada
| | - Dave Singh
- University of Manchester, Manchester, UK
| | | | | | | | - Claus F. Vogelmeier
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University, German Center for Lung Research (DZL), Marburg, Germany
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8
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Najman JM, Bell S, Williams GM, Clavarino AM, Scott JG, McGee TR, Mamun AA. Do tobacco and cannabis use and co-use predict lung function: A longitudinal study. Respir Med 2023; 208:107124. [PMID: 36682602 DOI: 10.1016/j.rmed.2023.107124] [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: 12/12/2022] [Revised: 01/16/2023] [Accepted: 01/18/2023] [Indexed: 01/20/2023]
Abstract
BACKGROUND Use of tobacco and cannabis is common and has been reported to predict lung function. Less is known about co-use of tobacco and cannabis and their impact on changes in lung function to early adulthood. RESEARCH QUESTION The study examines whether cigarette smoking or cannabis use and co-use are each associated with lung function in a population sample of young adults. STUDY DESIGN AND METHODS Data are from a prospective cohort study of cigarette smoking, cannabis use and co-use at 21 and 30 years of age and lung function (FVC, FEV1, FEV1/FVC) measured at 30 years. Lung function results are transformed using Global Lung Function Formulae. Subjects are the children of pregnant women who were recruited into the cohort study over the period 1981-3. Respondents were administered a spirometry assessment at 21 and 30 years of age. These respondents completed a smoking and cannabis use questionnaire at 21- and 30-year follow-ups. RESULTS Cigarette smoking (with or without cannabis use) is associated with reduced airflow. There is no consistent association between cannabis use and measures of lung function. The co-use of tobacco and cannabis appears to entail no additional risk to lung function beyond the risks associated with tobacco use alone. INTERPRETATION Persistent cigarette smoking is associated with reduced airflow even in young adults. Cannabis use does not appear to be related to lung function even after years of use.
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Affiliation(s)
- Jake M Najman
- School of Public Health, Faculty of Medicine, The University of Queensland, 266 Herston Road, Herston, Qld, 4006, Australia.
| | - Scott Bell
- Children's Health Research Centre, Faculty of Medicine, University of Queensland, Graham Road, South Brisbane, Qld, 4101, Australia
| | - Gail M Williams
- School of Public Health, Faculty of Medicine, The University of Queensland, 266 Herston Road, Herston, Qld, 4006, Australia
| | - Alexandra M Clavarino
- School of Public Health, Faculty of Medicine, The University of Queensland, 266 Herston Road, Herston, Qld, 4006, Australia
| | - James G Scott
- Child & Youth Mental Health, QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, Qld, 4006, Australia
| | - Tara R McGee
- School of Criminology and Criminal Justice, Griffith University, 176 Messines Ridge Road, Mount Gravatt, Qld, 4122, Australia
| | - Abdullah A Mamun
- UQ Poche Centre for Indigenous Health, The University of Queensland, 74 High Street, Toowong, Qld, 4066, Australia
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Agustí A, Celli BR, Criner GJ, Halpin D, Anzueto A, Barnes P, Bourbeau J, Han MK, Martinez FJ, Montes de Oca M, Mortimer K, Papi A, Pavord I, Roche N, Salvi S, Sin DD, Singh D, Stockley R, López Varela MV, Wedzicha JA, Vogelmeier CF. Global Initiative for Chronic Obstructive Lung Disease 2023 Report: GOLD Executive Summary. Arch Bronconeumol 2023; 59:232-248. [PMID: 36933949 DOI: 10.1016/j.arbres.2023.02.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 02/06/2023] [Indexed: 03/05/2023]
Affiliation(s)
- Alvar Agustí
- University of Barcelona, Hospital Clinic, IDIBAPS and CIBERES, Spain.
| | - Bartolome R Celli
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Gerard J Criner
- Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
| | - David Halpin
- University of Exeter Medical School, College of Medicine and Health, University of Exeter, Exeter, Devon, UK
| | - Antonio Anzueto
- South Texas Veterans Health Care System, University of Texas, Health San Antonio, Texas, USA
| | - Peter Barnes
- National Heart & Lung Institute, Imperial College London, United Kingdom
| | - Jean Bourbeau
- McGill University Health Centre, McGill University, Montreal, Canada
| | | | - Fernando J Martinez
- Weill Cornell Medical Center/New York-Presbyterian Hospital, New York, NY, USA
| | - Maria Montes de Oca
- Hospital Universitario de Caracas, Universidad Central de Venezuela, Centro Médico de Caracas, Caracas, Venezuela
| | - Kevin Mortimer
- Liverpool University Hospitals NHS Foundation Trust, UK; National Heart and Lung Institute, Imperial College London, UK; School of Clinical Medicine, College of Health Sciences, University of Kwazulu-Natal, South Africa
| | | | - Ian Pavord
- Respiratory Medicine Unit and Oxford Respiratory NIHR Biomedical Research Centre, Nuffield Department of Medicine, University of Oxford, UK
| | - Nicolas Roche
- Pneumologie, Hôpital Cochin AP-HP.Centre, Université Paris, France
| | - Sundeep Salvi
- Pulmocare Research and Education (PURE) Foundation, Pune, India
| | - Don D Sin
- St. Paul's Hospital, University of British Columbia, Vancouver, Canada
| | - Dave Singh
- University of Manchester, Manchester, UK
| | | | | | - Jadwiga A Wedzicha
- National Heart & Lung Institute, Imperial College London, United Kingdom
| | - Claus F Vogelmeier
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University, German Center for Lung Research (DZL), Marburg, Germany
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10
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Agustí A, Celli BR, Criner GJ, Halpin D, Anzueto A, Barnes P, Bourbeau J, Han MK, Martinez FJ, de Oca MM, Mortimer K, Papi A, Pavord I, Roche N, Salvi S, Sin DD, Singh D, Stockley R, Varela MVL, Wedzicha JA, Vogelmeier CF. Global Initiative for Chronic Obstructive Lung Disease 2023 Report: GOLD Executive Summary. Respirology 2023; 28:316-338. [PMID: 36856440 DOI: 10.1111/resp.14486] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 02/09/2023] [Indexed: 03/02/2023]
Affiliation(s)
- Alvar Agustí
- University of Barcelona, Hospital Clinic, IDIBAPS and CIBERES, Spain
| | - Bartolome R Celli
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Gerard J Criner
- Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
| | - David Halpin
- University of Exeter Medical School College of Medicine and Health University of Exeter, Exeter, Devon, UK
| | - Antonio Anzueto
- South Texas Veterans Health Care System University of Texas, Health San Antonio, Texas, USA
| | - Peter Barnes
- National Heart & Lung Institute Imperial College London, UK
| | - Jean Bourbeau
- McGill University Health Centre McGill University Montreal, Canada
| | - MeiLan K Han
- University of Michigan, Ann Arbor, Michigan, USA
| | - Fernando J Martinez
- Weill Cornell Medical Center/ New York-Presbyterian Hospital New York, New York, USA
| | - Maria Montes de Oca
- Hospital Universitario de Caracas Universidad Central de Venezuela Centro Médico de Caracas, Caracas, Venezuela
| | - Kevin Mortimer
- Liverpool University Hospitals NHS Foundation Trust, UK / National Heart and Lung Institute, Imperial College, London, UK / School of Clinical Medicine, College of Health Sciences, University of Kwazulu-Natal, South Africa
| | | | - Ian Pavord
- Respiratory Medicine Unit and Oxford Respiratory NIHR Biomedical Research Centre, Nuffield Department of Medicine University of Oxford, UK
| | - Nicolas Roche
- Pneumologie, Hôpital Cochin AP-HP.Centre, Université Paris, France
| | - Sundeep Salvi
- Pulmocare Research and Education (PURE) Foundation, Pune, India
| | - Don D Sin
- St. Paul's Hospital University of British Columbia, Vancouver, Canada
| | - Dave Singh
- University of Manchester, Manchester, UK
| | | | | | | | - Claus F Vogelmeier
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University, German Center for Lung Research (DZL), Marburg, Germany
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11
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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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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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13
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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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14
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Lipkus IM, Cobb CO. Effects of Educational Materials About Harms of Waterpipe Tobacco Charcoal use on Adult Smokers' Risk Perceptions. JOURNAL OF DRUG EDUCATION 2022:472379221138052. [PMID: 36514271 DOI: 10.1177/00472379221138052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
A prospective online study, consisting of 203 participants ages 18 and older who smoked waterpipe (hookah) within the last 30 days, examined how brief messaging about harms of burning charcoal to heat waterpipe tobacco (shisha) influenced knowledge of toxicants released by using charcoal and perceived harms of using charcoal. Participants were randomized to either a control or to an educational arm that reviewed toxicants released by burning charcoal and the health consequences. Participants in the educational relative to the control arm perceived charcoal as more harmful, were more knowledgeable of toxicants released by burning charcoal, and expressed a stronger desire to quit. Effects were sustained a week later. Brief messages about the harms of burning charcoal were effective and may be used to educate the public about the harms of waterpipe tobacco smoking.
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Affiliation(s)
| | - Caroline O Cobb
- Center for the Study of Tobacco Products, 6889Virginia Commonwealth University, Richmond, VA, USA
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15
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Exploring motivation to quit and risk appraisals of hookah tobacco smoking for self and partner among a member of single and dual smoker couples. J Behav Med 2022:10.1007/s10865-022-00369-4. [DOI: 10.1007/s10865-022-00369-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 10/04/2022] [Indexed: 11/07/2022]
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16
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Sargent JD, Halenar MJ, Edwards KC, Woloshin S, Schwartz L, Emond J, Tanski S, Taylor KA, Pierce JP, Liu J, Goniewicz ML, Niaura R, Anic G, Chen Y, Callahan-Lyon P, Gardner LD, Thekkudan T, Borek N, Kimmel HL, Cummings KM, Hyland A, Brunette M. Tobacco Use and Respiratory Symptoms Among Adults: Findings From the Longitudinal Population Assessment of Tobacco and Health (PATH) Study 2014-2016. Nicotine Tob Res 2022; 24:1607-1618. [PMID: 35366322 PMCID: PMC9575972 DOI: 10.1093/ntr/ntac080] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 01/17/2022] [Accepted: 03/31/2022] [Indexed: 12/21/2022]
Abstract
INTRODUCTION We examined the relationship between current tobacco use and functionally important respiratory symptoms. METHODS Longitudinal cohort study of 16 295 US adults without COPD in Waves 2-3 (W2-3, 2014-2016) of the Population Assessment of Tobacco and Health Study. Exposure-Ten mutually exclusive categories of tobacco use including single product, multiple product, former, and never use (reference). Outcome-Seven questions assessing wheezing/cough were summed to create a respiratory symptom index; cutoffs of ≥2 and ≥3 were associated with functional limitations and poorer health. Multivariable regressions examined both cutoffs cross-sectionally and change over approximately 12 months, adjusting for confounders. RESULTS All tobacco use categories featuring cigarettes (>2/3's of users) were associated with higher risk (vs. never users) for functionally important respiratory symptoms at W2, for example, at symptom severity ≥ 3, risk ratio for exclusive cigarette use was 2.34 [95% CI, 1.92, 2.85] and for worsening symptoms at W3 was 2.80 [2.08, 3.76]. There was largely no increased symptom risk for exclusive use of cigars, smokeless tobacco, hookah, or e-cigarettes (adjustment for pack-years and marijuana attenuated the cross-sectional e-cigarette association from 1.53(95% CI 0.98, 2.40) to 1.05 (0.67, 1.63); RRs for these products were also significantly lower compared to exclusive use of cigarettes. The longitudinal e-cigarette-respiratory symptom association was sensitive to the respiratory index cutoff level; exclusive e-cigarette use was associated with worsening symptoms at an index cutoff ≥ 2 (RR = 1.63 [1.02, 2.59]) and with symptom improvement at an index cutoff of ≥ 3 (RR = 1.64 [1.04, 2.58]). CONCLUSIONS Past and current cigarette smoking drove functionally important respiratory symptoms, while exclusive use of other tobacco products was largely not associated. However, the relationship between e-cigarette use and symptoms was sensitive to adjustment for pack-years and symptom severity. IMPLICATIONS How noncigarette tobacco products affect respiratory symptoms is not clear; some studies implicate e-cigarettes. We examined functionally important respiratory symptoms (wheezing/nighttime cough) among US adults without COPD. The majority of adult tobacco users smoke cigarettes and have higher risk of respiratory symptoms and worsening of symptoms, regardless of other products used with them. Exclusive use of other tobacco products (e-cigarettes, cigars, smokeless, hookah) was largely not associated with functionally important respiratory symptoms and risks associated with their use was significantly lower than for cigarettes. The association for e-cigarettes was greatly attenuated by adjustment for cigarette pack-years and sensitive to how symptoms were defined.
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Affiliation(s)
- James D Sargent
- Geisel School of Medicine at Dartmouth, The C. Everett Koop Institute at Dartmouth, Lebanon, NH, USA
| | | | | | - Steven Woloshin
- Dartmouth Institute for Health Policy and Clinical Practice, The C. Everett Koop Institute at Dartmouth, The Lisa Schwartz Foundation, Lebanon, NH, USA
| | - Lisa Schwartz
- Dartmouth Institute for Health Policy and Clinical Practice, The C. Everett Koop Institute at Dartmouth, The Lisa Schwartz Foundation, Lebanon, NH, USA
| | - Jennifer Emond
- Geisel School of Medicine at Dartmouth, The C. Everett Koop Institute at Dartmouth, Lebanon, NH, USA
| | - Susanne Tanski
- Geisel School of Medicine at Dartmouth, The C. Everett Koop Institute at Dartmouth, Lebanon, NH, USA
| | | | - John P Pierce
- Moore’s Cancer Center, University of California at San Diego, San Diego, CA, USA
| | | | | | | | - Gabriella Anic
- U.S. Food and Drug Administration, Center for Tobacco Products, Bethesda, MD, USA
| | - Yanling Chen
- U.S. Food and Drug Administration, Center for Tobacco Products, Bethesda, MD, USA
| | | | - Lisa D Gardner
- U.S. Food and Drug Administration, Center for Tobacco Products, Bethesda, MD, USA
| | - Theresa Thekkudan
- U.S. Food and Drug Administration, Center for Tobacco Products, Bethesda, MD, USA
| | - Nicolette Borek
- U.S. Food and Drug Administration, Center for Tobacco Products, Bethesda, MD, USA
| | - Heather L Kimmel
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | | | - Andrew Hyland
- Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Mary Brunette
- Geisel School of Medicine at Dartmouth, The C. Everett Koop Institute at Dartmouth, Lebanon, NH, USA
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17
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Bacterial communities of hookah tobacco products are diverse and differ across brands and flavors. Appl Microbiol Biotechnol 2022; 106:5785-5795. [PMID: 35927334 PMCID: PMC9361917 DOI: 10.1007/s00253-022-12079-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 06/22/2022] [Accepted: 07/11/2022] [Indexed: 12/02/2022]
Abstract
Abstract Young adults are increasingly using non-cigarette products, such as hookahs, since they are perceived as healthier alternatives to cigarette smoking. However, hookah users are exposed to not only carcinogenic compounds but also microorganisms that may play an active role in the development of both infectious and chronic diseases among users. Nevertheless, existing hookah research in this area has focused only on microorganisms that may be transferred to users through the smoking apparatus and not on bacterial communities associated with hookah tobacco. To address this knowledge gap, we conducted time-series experiments on commercially available hookah brands (Al Fakher (flavors: two apple, mint, and watermelon) and Fumari (flavors: white gummy bear, ambrosia, and mint chocolate chill)) stored under three different temperature and relative humidity conditions over 14 days. To characterize bacterial communities, the total DNA was extracted on days 0, 5, 9, and 14, PCR-amplified for the V3V4 region of the bacterial 16S rRNA gene, sequenced on the Illumina HiSeq platform, and analyzed using R. Diversity (alpha and beta) analyses revealed that the microbiotas of Fumari and Al Fakher products differed significantly and that flavor had a significant effect on the hookah microbiota. Overall, Pseudomonas, Bacillus, Sphingomonas, and Methylobacterium were the predominant bacterial taxa across all products. Additionally, we observed compositional differences between hookah brands across the 14-day incubation. These data suggest that the bacterial communities of hookah tobacco are diverse and differ across brands and flavors, which may have critical implications regarding exposures to specific bacteria among hookah users. Key points • Commercial hookah products harbor diverse bacterial communities. • Brands and flavors impact the diversity of these communities. • Research on their viability and transmission to users’ respiratory tracts is needed. Graphical abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1007/s00253-022-12079-7.
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18
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AlMulla A, Kouyoumjian S, Maisonneuve P, Cheema S, Mamtani R. Waterpipe smoking: Results from a population-based study in
Qatar. Tob Induc Dis 2022; 20:61. [PMID: 35836909 PMCID: PMC9227603 DOI: 10.18332/tid/149907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 04/06/2022] [Accepted: 05/09/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Waterpipe smoking is common in the Eastern Mediterranean Region and is becoming more prevalent in Qatar. To better plan waterpipe smoking control strategies we aimed to: 1) determine the prevalence of waterpipe smoking and explore its patterns in Qatar; 2) describe the knowledge, attitudes, and practices related to smoking behaviors; 3) recognize locations of waterpipe smoking and symptoms experienced during waterpipe sessions; and 4) evaluate the frequency of waterpipe smoking and the initiation age. METHODS We analyzed the data of a 7921 population-based survey of adults aged ≥18 years (nationals and expatriates), conducted in Qatar between March and December 2019. Out of 7105 surveys collected, 6904 were complete and included in the analysis. RESULTS Of the 6904, 570 (8.3%; 95% CI: 7.7–9.0) were waterpipe tobacco smokers, 425 (10.6%) males and 145 (5.1%) females. The highest prevalence of waterpipe smoking was reported among people aged 18–24 years (10.6%). Of the 575 waterpipe smokers, 56.3% (n=324) were exclusive waterpipe smokers. Use of other tobacco products among waterpipe smokers was higher among Qataris (52.3%) than expatriates (37.7%). Waterpipe cafés were the most common location for waterpipe smoking, however, females preferred restaurants; 83.3% reported that waterpipe smoking is harmful, while 39.3% considered that it is less harmful than cigarette smoking. CONCLUSIONS Waterpipe smoking prevalence is considerably high in Qatar, the second form of tobacco used. The formulation of new policies and enforcement of regulatory restrictions on waterpipe smoking are essential to reduce its uptake. Expansion in tobacco cessation services for women and poly-tobacco users is needed.
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Affiliation(s)
- Ahmad AlMulla
- Tobacco Control Center, WHO Collaborating Center for Treating Tobacco Dependence, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Silva Kouyoumjian
- Tobacco Control Center, WHO Collaborating Center for Treating Tobacco Dependence, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Patrick Maisonneuve
- Unit of Clinical Epidemiology, Division of Epidemiology and Biostatistics, European Institute of Oncology, Scientific Institute for Research, Hospitalization and Healthcare, Milan, Italy
| | - Sohaila Cheema
- Institute for Population Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Ravinder Mamtani
- Institute for Population Health, Weill Cornell Medicine-Qatar, Doha, Qatar
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19
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Drapkina OM, Kontsevaya AV, Kalinina AM, Avdeev SM, Agaltsov MV, Alexandrova LM, Antsiferova AA, Aronov DM, Akhmedzhanov NM, Balanova YA, Balakhonova TV, Berns SA, Bochkarev MV, Bochkareva EV, Bubnova MV, Budnevsky AV, Gambaryan MG, Gorbunov VM, Gorny BE, Gorshkov AY, Gumanova NG, Dadaeva VA, Drozdova LY, Egorov VA, Eliashevich SO, Ershova AI, Ivanova ES, Imaeva AE, Ipatov PV, Kaprin AD, Karamnova NS, Kobalava ZD, Konradi AO, Kopylova OV, Korostovtseva LS, Kotova MB, Kulikova MS, Lavrenova EA, Lischenko OV, Lopatina MV, Lukina YV, Lukyanov MM, Mayev IV, Mamedov MN, Markelova SV, Martsevich SY, Metelskaya VA, Meshkov AN, Milushkina OY, Mukaneeva DK, Myrzamatova AO, Nebieridze DV, Orlov DO, Poddubskaya EA, Popovich MV, Popovkina OE, Potievskaya VI, Prozorova GG, Rakovskaya YS, Rotar OP, Rybakov IA, Sviryaev YV, Skripnikova IA, Skoblina NA, Smirnova MI, Starinsky VV, Tolpygina SN, Usova EV, Khailova ZV, Shalnova SA, Shepel RN, Shishkova VN, Yavelov IS. 2022 Prevention of chronic non-communicable diseases in Of the Russian Federation. National guidelines. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2022. [DOI: 10.15829/1728-8800-2022-3235] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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20
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Karey E, Hess J, Farrell K, Rebuli ME, Shearston JA, Lee L, Reed TA, Eazor J, Edid A, Shetty A, Khan S, Gibbon G, Jaspers I, Weitzman M, Gordon T. The Nose Knows: Sniffing out the Unique Immunological Risk of Alternative Tobacco Products. Am J Respir Cell Mol Biol 2022; 66:461-464. [PMID: 35361069 PMCID: PMC8990119 DOI: 10.1165/rcmb.2021-0368le] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Emma Karey
- New York University Grossman School of Medicine New York, New York
| | - Jade Hess
- New York University Grossman School of Medicine New York, New York
| | - Kayla Farrell
- New York University Grossman School of Medicine New York, New York
| | - Meghan E Rebuli
- University of North Carolina at Chapel Hill Chapel Hill, North Carolina
| | - Jenni A Shearston
- New York University Grossman School of Medicine New York, New York.,Columbia University New York, New York
| | - Lily Lee
- New York University Grossman School of Medicine New York, New York.,State University of New York Downstate College of Medicine Brooklyn, New York
| | - Taylor A Reed
- New York University Grossman School of Medicine New York, New York.,University of California at Los Angeles Los Angeles, California
| | - James Eazor
- New York University Grossman School of Medicine New York, New York
| | - Alec Edid
- New York University Grossman School of Medicine New York, New York
| | - Anuradha Shetty
- New York University Grossman School of Medicine New York, New York
| | - Sarah Khan
- New York University Grossman School of Medicine New York, New York
| | - Grace Gibbon
- New York University College of Global Public Health New York, New York
| | - Ilona Jaspers
- University of North Carolina at Chapel Hill Chapel Hill, North Carolina
| | - Michael Weitzman
- New York University Grossman School of Medicine New York, New York.,New York University College of Global Public Health New York, New York
| | - Terry Gordon
- New York University Grossman School of Medicine New York, New York.,New York University College of Global Public Health New York, New York
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21
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Lipkus IM, Mays D, Sheeran P, Pan W, Cameron LD, De Brigard F. Effects of mental simulation of future waterpipe tobacco smoking on attitudes, perceived harms and intended use among young adults. J Behav Med 2022; 45:76-89. [PMID: 34406549 PMCID: PMC8821143 DOI: 10.1007/s10865-021-00245-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 07/09/2021] [Indexed: 02/03/2023]
Abstract
The desire to engage in waterpipe tobacco smoking (WTS) may occur when smokers and nonsmokers conjure positive mental simulations of WTS. However, effects of these simulations on desire to smoke waterpipe tobacco and potential mediators are unexplored. This research addressed these effects among young adult waterpipe tobacco smokers and nonsmokers. Two online studies were conducted with adults ages 18-30. In Study 1, 200 smokers, 190 susceptible nonsmokers, and 182 nonsusceptible nonsmokers were randomized to mentally simulate or not WTS in the future. In Study 2, 234 smokers and 241 susceptible nonsmokers were randomized to four arms: no simulation or simulations that varied valence of experience (positive, negative or no valence provided). Main outcomes were immediate desire to smoke waterpipe tobacco, cognitive and affective attitudes, and perceived harms. In Study 1, mental simulations increased the desire to smoke waterpipe tobacco among smokers. In Study 2, asking participants to simulate WTS positively or with no valence instruction increased desire to smoke relative to negative valence instruction or no simulation. Negative simulations reduced perceived probability of smoking within a month compared to positive simulations. Effects on desire to engage in WTS were mediated by cognitive and affective attitudes among susceptible nonsmokers and by cognitive attitudes among smokers. These findings suggest that exploring when and how often mental simulations about WTS are evoked and their potency for promoting prevention and cessation of WTS merit further attention.
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Affiliation(s)
| | - Darren Mays
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, USA
| | | | - Wei Pan
- Duke University School of Nursing
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22
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Lipkus IM, Sanders C, Mays D. Influencing Perceptions of Harm of Waterpipe Tobacco Smoking Among One Member of Couples Who Use Waterpipe. Nicotine Tob Res 2021; 24:1071-1078. [PMID: 34953166 PMCID: PMC9199946 DOI: 10.1093/ntr/ntab261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/11/2021] [Accepted: 12/24/2021] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Waterpipe tobacco smoking (WTS) often occurs socially, increasing health risks for the smoker and others through secondhand smoke effects. While messages on WTS harms enhance perceived risks for self, whether these messages elevate perceived risks for others, such as one's romantic partner who engages in WTS, is unclear. We tested this idea by surveying one member of dual-smoking couples who engages in WTS. AIMS AND METHODS As part of an online study, we enrolled adults ages 18-30 who engaged in WTS and were in a committed relationship of at least 6 months whose partner engaged in WTS. Participants were randomized to a control arm or to one of two arms consisting of watching a brief video on health harms or overcoming myths about WTS, respectively. Outcomes were perceived harms and measures of desire and probability of quitting for self and partner. RESULTS Participants (N = 238) who watched either video, compared with participants who did not watch a video, reported greater perceived health risks for self and partner and that their own WTS harmed their partner. Participants who watched either video reported a greater desire to quit for themselves, perceived that their partner had a greater desire to quit, and reported a higher likelihood of quitting together in the next 6 months. CONCLUSIONS Brief videos containing risk-based messaging increase young adult waterpipe tobacco smokers' perceived harms and desire to quit for self and partner. This can be a useful strategy to motivate cessation in couples who engage in WTS. IMPLICATIONS This study shows for the first time that at least among one member of dual-smoking couples who engages in WTS, brief videos on harms of WTS influences perceived harms and motivation to quit for the self and one's partner. This can be a useful strategy to promote cessation.
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Affiliation(s)
- Isaac M Lipkus
- Corresponding Author: Isaac M. Lipkus, PhD, Duke University School of Nursing, 307 Trent Dr., Durham, NC 27710, USA. Telephone: 919-668-2348; Fax: (919)-681-8899;
| | | | - Darren Mays
- Center for Tobacco Research, Ohio State University Comprehensive Cancer Center, Department of Internal Medicine, Ohio State University College of Medicine, Columbus, OH, USA
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23
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Bertoni N, Cavalcante TM, Souza MCD, Szklo AS. Prevalence of electronic nicotine delivery systems and waterpipe use in Brazil: where are we going? REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2021; 24:e210007. [PMID: 34910061 DOI: 10.1590/1980-549720210007.supl.2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 07/14/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To describe the prevalence of use of electronic nicotine delivery systems (ENDS) and waterpipe in Brazil, by population subgroups, and to evaluate the trend between 2013 and 2019. METHODS We used data from the 2019 National Health Survey to estimate the prevalence of lifetime and current use of ENDS and current use of waterpipes by socio-behavioral characteristics. Differences in prevalence over time were calculated using data from the III Brazilian Household Survey on Substance Use-2015 and the National Health Survey-2013. RESULTS For 2019, the prevalence of current use of ENDS was estimated at 0.64% (∼1 million people), of which ∼70% were in the age group of 15-24 years old. The highest prevalence was observed in the Midwest region, but the Southeast region concentrates half of these users. Almost 90% are non-smokers, with high prevalence among those who also use waterpipe and abuse alcohol. There was an increase in ENDS use between 2015 and 2019, particularly among younger people. The prevalence of current waterpipe use in 2019 was estimated at 0.47% (∼800,000 individuals), of which ∼80% were 15-24 years old. There was an increase in the prevalence of current waterpipe use between 2013 and 2019, and among young people the increase was ∼300%. CONCLUSIONS In Brazil, ENDS have been used mostly by young people, and by never smokers of manufactured cigarettes. The use of ENDS and waterpipe has been increasing even with the country's regulatory restrictions, which may compromise the successful history of the tobacco control policy.
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Affiliation(s)
- Neilane Bertoni
- National Cancer Institute, Population Research Division - Rio de Janeiro (RJ), Brazil
| | - Tania Maria Cavalcante
- National Cancer Institute, National Commission for Implementation of the Framework Convention in Brazil - Rio de Janeiro (RJ), Brazil
| | | | - Andre Salem Szklo
- National Cancer Institute, Population Research Division - Rio de Janeiro (RJ), Brazil
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24
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Lipkus I, Sanders C. A Pilot Study Assessing Reactions to Educational Videos on Harm of Waterpipe among Young Adults Susceptible to Waterpipe Tobacco Smoking. JOURNAL OF HEALTH COMMUNICATION 2021; 26:743-752. [PMID: 34758698 DOI: 10.1080/10810730.2021.2000522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Young adults who never engaged in waterpipe tobacco smoking (WTS) yet are open to trying it, that is, are susceptible, is a high-risk group for initiation WTS. Very few interventions dissuade this group from WTS. Thus, we explored how four short videos that varied themes of WTS harms influenced susceptible young adults' risk perceptions, risk beliefs, and susceptibility to future WTS. As part of online cross-sectional study, 208 participants aged 18-34 were randomized to watch or not a short video; each video focused on different themes of WTS risks: physical harms, myths about WTS, addiction, and harms to others. The main outcomes were perceived personal risks, risk beliefs, perceived harm of WTS compared to cigarettes, and susceptibility to future WTS. Watching any video increased beliefs of harm of WTS and lowered susceptibility to future WTS compared to not watching a video. The theme of physical harms was most effective at increasing risk beliefs and lowering susceptibility to future WTS. All four videos were rated as credible, engaging, personally relevant, producing negative affect toward WTS, and effective at dissuading WTS. These promising findings suggest further testing is needed to determine if effects persist and prevent WTS among adults susceptible to WTS.
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Affiliation(s)
- Isaac Lipkus
- Duke University School of Nursing, Durham, North Carolina, USA
| | - Camilla Sanders
- Duke University School of Nursing, Durham, North Carolina, USA
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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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26
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Predictors of Renal Function Worsening in Patients with Chronic Obstructive Pulmonary Disease (COPD): A Multicenter Observational Study. Nutrients 2021; 13:nu13082811. [PMID: 34444971 PMCID: PMC8400083 DOI: 10.3390/nu13082811] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 08/14/2021] [Accepted: 08/14/2021] [Indexed: 01/18/2023] Open
Abstract
Background. Chronic obstructive pulmonary disease (COPD) patients have multiple comorbidities which may affect renal function. Chronic kidney disease (CKD) is a risk factor for adverse outcomes in COPD patients. The predictors of CKD in COPD are not well investigated. Methods. A multicenter observational cohort study including patients affected by COPD (GOLD stages 1 and 2) was carried out. Principal endpoints were the incidence of CKD, as defined by an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2, and the rapid decline of eGFR >5 mL/min/1.73 m2/year. Results. We enrolled 707 outpatients. Overall, 157 (22.2%) patients had CKD at baseline. Patients with CKD were older, with higher serum uric acid (UA) levels, and lower FEV1. During a mean follow-up of 52.3 ± 30.2 months, 100 patients developed CKD, and 200 patients showed a rapid reduction of eGFR. Multivariable Cox regression analysis displayed that UA (hazard ratio (HR) 1.148, p < 0.0001) and diabetes (HR 1.050, p < 0.0001) were predictors of incident CKD. The independent predictors of rapidly declining renal function were represented by an increase of 1 mg/dL in UA (odds ratio (OR) 2.158, p < 0.0001)), an increase of 10 mL/min/1.73 m2 in baseline eGFR (OR 1.054, p < 0.0001) and the presence of diabetes (OR 1.100, p < 0.009). Conclusions. This study shows that COPD patients have a significant worsening of renal function over time and that UA and diabetes were the two strongest predictors. Optimal management of these risk factors may reduce the incidence of CKD in this population thus probably improving clinical outcome.
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27
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Darawshy F, Abu Rmeileh A, Kuint R, Berkman N. Waterpipe smoking: a review of pulmonary and health effects. Eur Respir Rev 2021; 30:200374. [PMID: 33980668 PMCID: PMC9488736 DOI: 10.1183/16000617.0374-2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 01/27/2021] [Indexed: 01/19/2023] Open
Abstract
Waterpipe smoking is an old form of tobacco smoking, originating in Persia and the Middle East. The popularity of the waterpipe is increasing worldwide, particularly among young adults, and there are widespread misconceptions regarding its negative health effects. The inhaled smoke of the waterpipe contain several toxic and hazardous materials including nicotine, tar, polyaromatic hydrocarbons and heavy metals, all of which are proven to be related to lung diseases and cancer. Regular waterpipe smoking is associated with respiratory symptoms, a decrease in pulmonary function and increased risk for lung disease such as COPD. Additional negative health effects include increased risk for arterial stiffness, ischaemic heart disease and several cancer types including lung cancer. This review summarises the negative health effects of waterpipe smoking, with emphasis on cardiorespiratory complications. Increased awareness and knowledge amongst healthcare professionals will hopefully help identify waterpipe smokers and promote patient education. Applying World Health Organization (WHO) regulations will provide a synergistic effect in reducing waterpipe use and associated disease.
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Affiliation(s)
- Fares Darawshy
- Institute of Pulmonary Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Ayman Abu Rmeileh
- Institute of Pulmonary Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Rottem Kuint
- Institute of Pulmonary Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Neville Berkman
- Institute of Pulmonary Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
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28
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Sutfin EL, Lazard AJ, Soule EK, Kimes CM, King J, Jenson D, Ross JC. Health Claims, Marketing Appeals, and Warnings on Popular Brands of Waterpipe Tobacco Packaging Sold in the United States. Nicotine Tob Res 2021; 23:1183-1190. [PMID: 33406241 DOI: 10.1093/ntr/ntab002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 01/05/2021] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Waterpipe tobacco (WT) smoking is associated with misperceptions of harm, especially among users. WT packaging contains imagery, flavor descriptors, and text claims that may contribute to misperceptions. The study goal was to characterize visual and text elements of WT packaging. AIMS AND METHODS Using data from the U.S. Population Assessment on Tobacco and Health Study Wave 2 (October 2014-October 2015), we identified the 10 most popular WT brands. For each brand, we identified available flavors, including flavor collections with unique packaging elements. We randomly selected 10 flavors per brand for purchase (March-April 2018). We conducted descriptive content analysis to code all textual and visual design elements of each package. RESULTS Over half (54%) of WT packages had modified risk tobacco product (MRTP) claims prohibited by federal law, including substance-free MRTP claims (43%) and the descriptor "natural" (11%). No MRTP reduced exposure or reduced risk claims were found. Over a quarter (26%) of packaging including one or more of terms that may imply reduced harm including "fresh," "premium," "quality," and "pure." All packages included a text-only warning, yet none appeared on the primary display panel. Almost all packaging (99%) included imagery, with 72% including flavor imagery. The majority of packages (72%) included a smoking cue. The most popular marketing appeals were "well-made" (57%), "enjoyable" (55%), and "patriotic" (47%). CONCLUSIONS Prohibited MRTP claims, other descriptors, and flavor imagery are common on WT packaging, despite federal law. Future research is needed to evaluate if this marketing contributes to misperceptions of reduced harm. IMPLICATIONS Tobacco packaging is used to convey health-related messages, both explicitly and implicitly; however, information about WT packaging is virtually nonexistent. We conducted a content analysis of WT packaging from the 10 most popular US brands. Over half (54%) of packages had prohibited MRTP claims and over a quarter (26%) included one or more descriptors that may be perceived as implying reduced harm. Use of imagery, including smoking cues, was common. The widespread use of prohibited MRTP claims, other descriptors, and imagery on WT packaging may contribute to misperceptions of reduced harm.
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Affiliation(s)
- Erin L Sutfin
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Allison J Lazard
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Eric K Soule
- Department of Health Education and Promotion, East Carolina University, Greenville, NC, USA
| | - Caroline M Kimes
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Jessica King
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, USA
| | - Desmond Jenson
- Mitchell Hamline School of Law, Public Health Law Center, Saint Paul, MN, USA
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Sutfin EL, Lazard AJ, Cornacchione Ross J, Noar SM, Reboussin BA. Waterpipe Tobacco Warnings: An Experimental Study among a Nationally Representative Sample of U.S. Young Adults. Nicotine Tob Res 2021; 23:1855-1860. [PMID: 34077539 DOI: 10.1093/ntr/ntab107] [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] [Received: 11/13/2020] [Accepted: 06/01/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND Waterpipe tobacco (WT) smoking by young adults remains high and misperceptions are common. Product warnings can increase knowledge of harms and reduce use. The goal of this study was to test warning statements, including the FDA-required nicotine warning (prior to implementation), on young adults' thinking about harms of and discouragement from WT smoking. METHODS We conducted a between-subjects experiment in a nationally representative telephone survey of 1,152 young adults ages 18-29. Participants were randomly assigned to hear one of five warning statements and reported how much, on a 4-point scale, the warning made them think about the harms and discouraged them from WT smoking. RESULTS The sample was 36.8% female, 57.8% white, 20.2% Black, 24.1% Hispanic, with a mean age of 23.2 (SE=0.25). Under half (43.5%) had ever smoked WT. There were significant differences among the statements on both thinking about harms (p<.0001) and discouragement (p<.0001). The FDA-required 'nicotine' warning led to the lowest thinking about harms (M=2.85, SE=0.08) and was the least discouraging (M=2.86, SE=0.08), while the '100 cigarettes' warning resulted in the greatest thinking about harms (M=3.62, SE=0.05) and was the most discouraging (M=3.56, SE=0.06). CONCLUSION The nicotine warning resulted in the lowest levels of thinking about harms and discouragement from WT smoking, suggesting limited impact. However, a warning focused on comparing smoke inhalation from WT smoking to cigarettes seems promising. Warnings should cover a broad range of WT health effects, and possibly comparisons to cigarettes. Findings also have implications for the content of international waterpipe warnings. IMPLICATIONS This study indicates that the nicotine warning is the least effective at making young adults think about the harms of and discouraging waterpipe tobacco smoking. The FDA and other countries should consider requiring warnings to cover a broader range of health harms, misperceptions, and possibly comparisons to cigarettes.
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Affiliation(s)
- Erin L Sutfin
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Allison J Lazard
- Hussman School of Journalism and Media and Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, United States
| | - Jennifer Cornacchione Ross
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Seth M Noar
- Hussman School of Journalism and Media and Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, United States
| | - Beth A Reboussin
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC, United States
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30
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Wang C, Zhou J, Wang J, Li S, Fukunaga A, Yodoi J, Tian H. Progress in the mechanism and targeted drug therapy for COPD. Signal Transduct Target Ther 2020; 5:248. [PMID: 33110061 PMCID: PMC7588592 DOI: 10.1038/s41392-020-00345-x] [Citation(s) in RCA: 102] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 09/15/2020] [Accepted: 09/21/2020] [Indexed: 02/07/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is emphysema and/or chronic bronchitis characterised by long-term breathing problems and poor airflow. The prevalence of COPD has increased over the last decade and the drugs most commonly used to treat it, such as glucocorticoids and bronchodilators, have significant therapeutic effects; however, they also cause side effects, including infection and immunosuppression. Here we reviewed the pathogenesis and progression of COPD and elaborated on the effects and mechanisms of newly developed molecular targeted COPD therapeutic drugs. Among these new drugs, we focussed on thioredoxin (Trx). Trx effectively prevents the progression of COPD by regulating redox status and protease/anti-protease balance, blocking the NF-κB and MAPK signalling pathways, suppressing the activation and migration of inflammatory cells and the production of cytokines, inhibiting the synthesis and the activation of adhesion factors and growth factors, and controlling the cAMP-PKA and PI3K/Akt signalling pathways. The mechanism by which Trx affects COPD is different from glucocorticoid-based mechanisms which regulate the inflammatory reaction in association with suppressing immune responses. In addition, Trx also improves the insensitivity of COPD to steroids by inhibiting the production and internalisation of macrophage migration inhibitory factor (MIF). Taken together, these findings suggest that Trx may be the ideal drug for treating COPD.
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Affiliation(s)
- Cuixue Wang
- Department of Basic Medicine, Medical College, Shaoxing University, Shaoxing, 312000, China
| | - Jiedong Zhou
- Department of Basic Medicine, Medical College, Shaoxing University, Shaoxing, 312000, China
| | - Jinquan Wang
- Department of Basic Medicine, Medical College, Shaoxing University, Shaoxing, 312000, China
| | - Shujing Li
- Department of Basic Medicine, Medical College, Shaoxing University, Shaoxing, 312000, China
| | - Atsushi Fukunaga
- Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine, Kobe, 650-0017, Japan
| | - Junji Yodoi
- Laboratory of Infection and Prevention, Department of Biological Response, Institute for Virus Research, Kyoto University, Kyoto, 606-8501, Japan
| | - Hai Tian
- Department of Basic Medicine, Medical College, Shaoxing University, Shaoxing, 312000, China.
- Jiaozhimei Biotechnology (Shaoxing) Co, Ltd, Shaoxing, 312000, China.
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Abstract
Hookah is a single-stemmed or multistemmed instrument for vaporizing and smoking flavored tobacco, whose smoke is passed through a water basin before inhalation. The use of hookah dates back centuries and is believed to have originated in India during the reign of Akbar the Great or the Safavid dynasty of Persia. Outside its native region, hookah smoking has gained popularity throughout the world, especially among younger people. There is generally a misconception among hookah users that it is less addictive than combustible cigarette smoking and that there is little to no nicotine content in hookah, with some even believing that certain additives impart health benefits. Although studies investigating the health hazards of hookah are rather limited, the inhaled smoke contains large quantities of nicotine, tar, carbon monoxide, polyaromatic hydrocarbons, heterocyclic compounds, carboxylic compounds, and various inorganic compounds such as heavy metals, all of which are found in combustible cigarette smoking. Regular hookah use is associated with an increased risk of obstructive lung disease as well as lung cancer and malignancies of the head and neck. This narrative review summarizes the available data on the health hazards of hookah, with an emphasis on pulmonary complications. Increased knowledge and awareness of hookah smoking among healthcare providers can potentially lead to better patient education and identification of at-risk populations.
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Inyang NA, Chang JT, Wang B. National Estimates of hospital emergency department visits due to acute injuries associated with hookah smoking, United States, 2011-2019. Inj Epidemiol 2020; 7:41. [PMID: 32772919 PMCID: PMC7416403 DOI: 10.1186/s40621-020-00267-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 06/16/2020] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Hookah (also known as waterpipe) smoking is associated with acute adverse health effects such as vomiting and fainting, symptoms related to carbon monoxide poisoning, and decreased pulmonary function, however, national estimates of hookah-related acute injuries are not currently available in the scientific literature. This study provides national estimates of United States hospital emergency department visits due to hookah-related acute injuries. METHODS We analyzed 2011-2019 data from the National Electronic Injury Surveillance System to calculate national estimates of emergency department visits due to hookah-related acute injuries. National Electronic Injury Surveillance System data were gathered from approximately 100 United States hospitals selected as a probability sample of approximately 5000 hospitals with emergency departments. Each case contains information abstracted from all emergency department records involving injuries associated with consumer products. All individuals admitted to emergency departments who sustained hookah-related acute injuries were included in the study. RESULTS During 2011-2019, an estimated 1371 (95% confidence interval: 505-2283) United States hospital emergency department visits were related to hookah-related acute injuries. The most common injuries were sustained from dizziness/light-headedness and syncopal episodes (54.8%), followed by burns (41.5%). Young adults aged 18-24 years accounted for 66.8% of hookah-related acute injuries admitted to United States emergency departments. CONCLUSIONS This study provides national estimates of hospital emergency department visits due to hookah-related acute injuries. We found that hookah smoking related AIs mostly occurred among young adults. Study findings may inform public health policy and educational intervention efforts to prevent these events and complement other acute injury surveillance systems, such as the National Poison Data System.
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Affiliation(s)
- Naa A Inyang
- US Food and Drug Administration, Center for Tobacco Products, Office of Science, 10903 New Hampshire Avenue, Silver Spring, MD, 20993-0002, USA.
| | - Joanne T Chang
- US Food and Drug Administration, Center for Tobacco Products, Office of Science, 10903 New Hampshire Avenue, Silver Spring, MD, 20993-0002, USA
| | - Baoguang Wang
- US Food and Drug Administration, Center for Tobacco Products, Office of Science, 10903 New Hampshire Avenue, Silver Spring, MD, 20993-0002, USA
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Xiong H, Huang Q, Shuai T, Zhu L, Zhang C, Zhang M, Wang Y, Liu J. Assessment of comorbidities and prognosis in patients with COPD diagnosed with the fixed ratio and the lower limit of normal: a systematic review and meta-analysis. Respir Res 2020; 21:189. [PMID: 32677946 PMCID: PMC7364614 DOI: 10.1186/s12931-020-01450-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 07/09/2020] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Currently, the diagnosis of chronic obstructive pulmonary disease (COPD) is not uniform, COPD guidelines recommend fixed ratio (FR), whereas ATS and ERS define airflow obstruction based on lower limit of normal (LLN). We aim to determine if there is difference between the two diagnostic criteria for morbidity, mortality, exacerbation. METHODS Four databases and all relevant studies from the references were searched from inception to June 25, 2019, to find studies that described the rate of comorbidity, the exacerbation rates, mortality in COPD patients. Data analysis was performed using STATA/SE 14.0 and followed the standard of Cochrane Collaboration. A sensitivity analysis was performed to find the source of heterogeneity. RESULTS Thirteen studies and 154,447 participants were finally included in this meta-analysis. The 11 cohort studies and 2 cross-sectional studies were all high-quality. Patients with airflow limitation according to either FR or LLN had higher mortality (HRFR+/LLN- = 1.27, 95% CI = 1.14-1.42; HRFR-/LLN+ = 1.83, 95% CI = 1.17-2.86) than those who met neither criteria. When compared with the FR-/LLN- criteria, those who met the FR criteria were more likely to exacerbate (HR FR+/LLN- = 1.64, 95% CI = 1.09-2.46; HR FR-/LLN+ = 1.58, 95% CI = 0.70-3.55). The meta-analysis for comorbidities showed no significant difference between patients who met neither criteria and those who met LLN or FR criteria. CONCLUSION The patients with airflow limitations according to FR were more likely to exacerbate than those with LLN only. Patients that met either FR or LLN were more likely to have higher mortality than FR-/LLN-. There was no difference between the FR+/LLN- and FR-/LLN+ groups for the occurrence of comorbidities.
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Affiliation(s)
- Huaiyu Xiong
- The First Clinical Medical College of the First Hospital of Lanzhou University, Lanzhou, 730000, China.,Department of Intensive Care Unit, The First Hospital of Lanzhou University, No.199 Donggang West Road, Chengguan District, Lanzhou City, 730000, Gansu Province, China.,Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China
| | - Qiangru Huang
- The First Clinical Medical College of the First Hospital of Lanzhou University, Lanzhou, 730000, China.,Department of Intensive Care Unit, The First Hospital of Lanzhou University, No.199 Donggang West Road, Chengguan District, Lanzhou City, 730000, Gansu Province, China.,Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China
| | - Tiankui Shuai
- The First Clinical Medical College of the First Hospital of Lanzhou University, Lanzhou, 730000, China.,Department of Intensive Care Unit, The First Hospital of Lanzhou University, No.199 Donggang West Road, Chengguan District, Lanzhou City, 730000, Gansu Province, China.,Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China
| | - Lei Zhu
- The First Clinical Medical College of the First Hospital of Lanzhou University, Lanzhou, 730000, China.,Department of Intensive Care Unit, The First Hospital of Lanzhou University, No.199 Donggang West Road, Chengguan District, Lanzhou City, 730000, Gansu Province, China
| | - Chuchu Zhang
- The First Clinical Medical College of the First Hospital of Lanzhou University, Lanzhou, 730000, China.,Department of Intensive Care Unit, The First Hospital of Lanzhou University, No.199 Donggang West Road, Chengguan District, Lanzhou City, 730000, Gansu Province, China
| | - Meng Zhang
- The First Clinical Medical College of the First Hospital of Lanzhou University, Lanzhou, 730000, China.,Department of Intensive Care Unit, The First Hospital of Lanzhou University, No.199 Donggang West Road, Chengguan District, Lanzhou City, 730000, Gansu Province, China
| | - Yalei Wang
- The First Clinical Medical College of the First Hospital of Lanzhou University, Lanzhou, 730000, China.,Department of Intensive Care Unit, The First Hospital of Lanzhou University, No.199 Donggang West Road, Chengguan District, Lanzhou City, 730000, Gansu Province, China
| | - Jian Liu
- The First Clinical Medical College of the First Hospital of Lanzhou University, Lanzhou, 730000, China. .,Department of Intensive Care Unit, The First Hospital of Lanzhou University, No.199 Donggang West Road, Chengguan District, Lanzhou City, 730000, Gansu Province, China.
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Sighaldeh SS, Zarghami F, Charkazi A, Negarandeh R. A Qualitative Study of Factors Influencing the Onset of Hookah Smoking among Iranian Men with Turkmen Ethnicity. J Epidemiol Glob Health 2020; 10:135-142. [PMID: 32538029 PMCID: PMC7310776 DOI: 10.2991/jegh.k.191206.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 11/21/2019] [Indexed: 11/30/2022] Open
Abstract
Introduction: Hookah smoking has grown considerably among Iranian Turkmen in the past two decades. The reasons for this increase in the consumption of hookah are unclear. Therefore, this study was conducted with the aim of determining the factors related to the start of hookah smoking in men with Turkmen ethnicity. Methods: This qualitative study was conducted between February 2018 and June 2018 in Turkmen cities of Golestan provinces in Iran. The study participants included 26 male Turkmen water pipe smokers with various ages, occupation, and education level. Study data were collected through semi-structured individual interview and the results were analyzed in August 2018 by content analysis. Data management was done by software, MAXQDA version 10. Results: In this study, 26 hookah smoker men with the age range of 20–45 years were interviewed. The age of the participants at the time of starting hookah consumption varied from 14 to 25 years. On the basis of qualitative data, the reasons for the start of hookah smoking in male Turkmen were classified into three main categories: (1) individual (curiosity and sense of adulthood, fewer perceived risks compared with other substances and hookah’s sensory attractions); (2) interpersonal (hookah-smoking friends and consumption of hookah by family members); and (3) societal (blaming unemployed people in small neighborhoods, cultural influence, more social acceptance compared with other substances, and easy access to hookah). Conclusion: Individual, interpersonal, and societal factors play important role in the start of hookah smoking among male Turkmens. Developing health policies based on the above factors can be effective in adopting hookah prevention and control strategies. Moreover, future studies could be developed with the goal of discovering ways to solve the problem of unemployment and plan for developing recreational activities in this area to prevent initiation of hookah smoking especially among youth.
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Affiliation(s)
- Shirin Shahbazi Sighaldeh
- Reproductive Health Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Zarghami
- Department of Epidemiology and Statistics, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Abdurrahman Charkazi
- Environmental Health Research Center, Faculty of Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Reza Negarandeh
- Nursing & Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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Goding Sauer A, Siegel RL, Jemal A, Fedewa SA. Current Prevalence of Major Cancer Risk Factors and Screening Test Use in the United States: Disparities by Education and Race/Ethnicity. Cancer Epidemiol Biomarkers Prev 2020; 28:629-642. [PMID: 30944145 DOI: 10.1158/1055-9965.epi-18-1169] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 01/11/2019] [Accepted: 02/21/2019] [Indexed: 11/16/2022] Open
Abstract
Overall cancer death rates in the United States have declined since 1990. The decline could be accelerated by eliminating socioeconomic and racial disparities in major risk factors and screening utilization. We provide an updated review of the prevalence of modifiable cancer risk factors, screening, and vaccination for U.S. adults, focusing on differences by educational attainment and race/ethnicity. Individuals with lower educational attainment have higher prevalence of modifiable cancer risk factors and lower prevalence of screening versus their more educated counterparts. Smoking prevalence is 6-fold higher among males without a high school (HS) education than female college graduates. Nearly half of women without a college degree are obese versus about one third of college graduates. Over 50% of black and Hispanic women are obese compared with 38% of whites and 15% of Asians. Breast, cervical, and colorectal cancer screening utilization is 20% to 30% lower among those with <HS education compared with college graduates. Screening for breast, cervical, and colorectal cancers is also lower among Hispanics, Asians, and American Indians/Alaska Natives relative to whites and blacks. Enhanced, multilevel efforts are needed to further reduce the prevalence of modifiable risk factors and improve screening and vaccination, particularly among those with lower socioeconomic status and racial/ethnic minorities.
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Affiliation(s)
- Ann Goding Sauer
- Intramural Research Department, American Cancer Society, Atlanta, Georgia.
| | - Rebecca L Siegel
- Intramural Research Department, American Cancer Society, Atlanta, Georgia
| | - Ahmedin Jemal
- Intramural Research Department, American Cancer Society, Atlanta, Georgia
| | - Stacey A Fedewa
- Intramural Research Department, American Cancer Society, Atlanta, Georgia
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Carina de Oliveira N, Caroline de Oliveira T, Cavassin Klamas V, Anhaia Ventura M, Arana Kamei A, Yukio Naka J, Armando Brancher J, Adilson Soares de Lima A. Salivary flow, amylase, and total protein in hospitalized patients with HIV infection / AIDS complications. Afr Health Sci 2020; 20:597-604. [PMID: 33163020 PMCID: PMC7609095 DOI: 10.4314/ahs.v20i2.7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Saliva is a complex secretion produced daily by the salivary glands. Saliva consists mainly of water, enzymes, ions and amino acids and performs several important functions in oral health. OBJECTIVE The aim of this study was to investigate the flow rate and concentrations of amylase and total proteins in the saliva of hospitalized patients due to AIDS complications. METHODS Ninety-three men and women (20-64 years of age) were divided into two groups (46 HIV-infected patients and 47 controls) and had salivary flow rate and levels of amylase enzyme and total proteins evaluated. RESULT The mean salivary flow rate was lower in individuals with HIV when compared to controls (P < 0.05). No significant difference between amylase enzyme levels and total proteins were observed in the saliva of patients with HIV infection when compared to controls. CONCLUSION Individuals with HIV / AIDS infection (in hospital treatment) suffer no interference in levels of amylase and total salivary proteins, but they have significantly reduced salivary flow.
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Waterpipe Tobacco Smoking and Associated Risk Factors among Bangladeshi University Students: An Exploratory Pilot Study. Int J Ment Health Addict 2020. [DOI: 10.1007/s11469-020-00312-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
AbstractOver the past two decades, there has been a global rise in the prevalence of waterpipe tobacco smoking. Waterpipe tobacco smoking involves the inhalation of heated tobacco smoke after passing through water, and it has been associated with an identified dependence effect similar to that found with cigarette smoking. Despite the popularity of waterpipe tobacco among youth (and in particular, university students) in many countries, detailed data of its usage are lacking in Bangladesh. Therefore, the present study was conducted to explore waterpipe tobacco smoking behavior and normative beliefs among university students in Bangladesh and to assess the factors associated with waterpipe tobacco use. A quantitative cross-sectional survey was carried out among 340 Bangladeshi university students (64.4% male; mean age 21.6 years). Among participants, 13.5% reported they had ever smoked tobacco from a waterpipe and 9.4% had it in past 30 days. Among past 30-day users, 72% were categorized as having waterpipe smoking dependence (n = 23). No females in the sample had ever smoked using a waterpipe. Maternal occupation, monthly expenditure, and regular smoking status were major predominant factors associated with waterpipe smoking behavior of the students. The study is of existential value given that there are no prior studies ever carried out in Bangladesh previously. Recommendations are provided based on the study’s findings, particularly in relation to what action is needed from universities in Bangladesh.
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Nicotine induces resilience to chronic social defeat stress in a mouse model of water pipe tobacco exposure by activating BDNF signaling. Behav Brain Res 2020; 382:112499. [DOI: 10.1016/j.bbr.2020.112499] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 01/16/2020] [Accepted: 01/20/2020] [Indexed: 02/07/2023]
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Lipkus IM, Cobb CO, Eissenberg T. Perceived Harms of Waterpipe Tobacco Heating Sources Among Young Adult Waterpipe Tobacco Smokers. HEALTH EDUCATION & BEHAVIOR 2020; 47:293-301. [PMID: 31997649 DOI: 10.1177/1090198119894964] [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: 11/16/2022]
Abstract
Background. Waterpipe tobacco smoking is associated with many negative health outcomes due to toxicants produced by heating the tobacco using charcoal or electrical heaters. Little is known about how young adult waterpipe tobacco smokers perceive harms of these heating sources. Aims. To examine young adult waterpipe tobacco smokers' perceived harms of electrical heaters and charcoal to heat waterpipe tobacco. Method. This online cross-sectional study enrolled 18- to 32-year-olds who smoked waterpipe tobacco within the past 30 days. Participants completed measures assessing, for each heating source, amount and knowledge of toxicants released (e.g., carbon monoxide, cancer-causing chemicals), perceived safety, worry about inhaling toxicants, perceived health risk, desire to quit, and intention to smoke in the next month. Question order for knowledge of and perceived harms was counterbalanced for each heating source. Results. Analyses were based on responses from 199 participants. Perceived harms for both heating sources were average to low. Despite some question order effects, participants viewed charcoal as more harmful than electrical heaters. Participants knew more about chemicals released from charcoal than electrical heaters. Greater knowledge of chemicals released by both heating sources correlated positively with perceived harms. Perceived harms were associated with a stronger desire to quit, yet unrelated with likelihood of smoking waterpipe during the next month. Discussion. Many young adult waterpipe tobacco smokers view charcoal as more harmful than electrical heaters, although knowledge about harms for each heating source is poor. Conclusion. Interventions are needed to inform the public about harms of waterpipe heating sources in order to curb use.
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Romani M, Jawhar S, Shalak M, Antoun J. Waterpipe smoking cessation: knowledge, barriers, and practices of primary care physicians- a questionnaire-based cross-sectional study. BMC FAMILY PRACTICE 2020; 21:21. [PMID: 32000696 PMCID: PMC6990485 DOI: 10.1186/s12875-020-1095-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 01/23/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND While cigarette smoking has been considered the most relevant tobacco product worldwide, waterpipe tobacco smoking (WTS) has increased in prevalence globally and calls for more considerable attention now. However, little is known about WTS cessation knowledge and clinical practices among physicians, particularly in Lebanon. This study aims to examine the knowledge, barriers, and cessation practices of primary care practitioners towards WTS. METHODS A cross-sectional study where an anonymous self-reported questionnaire was completed by physicians attending the Annual Conference of the Lebanese Society of Family Medicine for family medicine physicians, general practitioners, and internists in Lebanon. RESULTS Out of 180 attendees, 105 primary care practitioners (PCPs) responded to the questionnaire. Only 38.1% of the physicians think similar techniques are used for the cessation of smoking of both cigarette and waterpipe. Similarly, 30.5% of the physicians believe that nicotine replacement therapy works in the cessation of waterpipe smoking. There was a statistically significant difference between the percentage of physicians who counsel for cigarette smoking and those who counsel for waterpipe smoking cessation (p = 0.005) where 30% of the physicians tend to counsel against cigarette smoking more than waterpipe smoking. CONCLUSIONS This study shows a difference in the attitude and behavior of PCPs towards cigarette and waterpipe smoking cessation. Moreover, there is a lack of knowledge about water pipe smoking cessation techniques. There is a great room for continued medical education to PCPs in their private practice to improve their knowledge.
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Affiliation(s)
- Maya Romani
- Department of Family Medicine, American University of Beirut, Riad El Solh, Beirut, 11-0236, Lebanon
| | - Sarah Jawhar
- Department of Family Medicine, American University of Beirut, Riad El Solh, Beirut, 11-0236, Lebanon
| | - Manar Shalak
- Department of Family Medicine, American University of Beirut, Riad El Solh, Beirut, 11-0236, Lebanon
| | - Jumana Antoun
- Department of Family Medicine, American University of Beirut, Riad El Solh, Beirut, 11-0236, Lebanon.
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Qasim H, Alarabi AB, Alzoubi KH, Karim ZA, Alshbool FZ, Khasawneh FT. The effects of hookah/waterpipe smoking on general health and the cardiovascular system. Environ Health Prev Med 2019; 24:58. [PMID: 31521105 PMCID: PMC6745078 DOI: 10.1186/s12199-019-0811-y] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 08/22/2019] [Indexed: 12/13/2022] Open
Abstract
Hookah or waterpipe smoking or use is an emerging trend in the US population, especially among the youth. The misperception of hookah being less harmful than cigarettes and the availability of different but "appealing" flavors are considered among the main reasons for this trend. Hookah users however are exposed to many of the same toxic compounds/by-products as cigarette users, but at dramatically higher levels, which might lead to more severe negative health effects. In fact, hookah users are at risks of infections, cancers, lung disease, and other medical conditions. Moreover, because of the overlapping toxicant/chemical profile to conventional cigarettes, hookah smoke effects on the cardiovascular system are thought to be comparable to those of conventional cigarettes. A major source of tobacco addiction is nicotine, whose levels in hookah are extremely variable as they depend on the type of tobacco used. Taken together, in this review of literature, we will provide insights on the negative health effects of hookah in general, with a focus on what is known regarding its impact on the cardiovascular system.
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Affiliation(s)
- Hanan Qasim
- Department of Pharmaceutical Sciences, School of Pharmacy, The University of Texas at El Paso, El Paso, Texas, 79902, USA
| | - Ahmed B Alarabi
- Department of Pharmaceutical Sciences, School of Pharmacy, The University of Texas at El Paso, El Paso, Texas, 79902, USA
| | - Karem H Alzoubi
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Zubair A Karim
- Department of Pharmaceutical Sciences, School of Pharmacy, The University of Texas at El Paso, El Paso, Texas, 79902, USA
| | - Fatima Z Alshbool
- Department of Pharmaceutical Sciences, School of Pharmacy, The University of Texas at El Paso, El Paso, Texas, 79902, USA.
| | - Fadi T Khasawneh
- Department of Pharmaceutical Sciences, School of Pharmacy, The University of Texas at El Paso, El Paso, Texas, 79902, USA.
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Khan NA, Lawyer G, McDonough S, Wang Q, Kassem NO, Kas-Petrus F, Ye D, Singh KP, Kassem NO, Rahman I. Systemic biomarkers of inflammation, oxidative stress and tissue injury and repair among waterpipe, cigarette and dual tobacco smokers. Tob Control 2019; 29:s102-s109. [PMID: 31494573 DOI: 10.1136/tobaccocontrol-2019-054958] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 06/07/2019] [Accepted: 06/10/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND Waterpipe tobacco (WPT) smoking is associated with deleterious effects on cardio-pulmonary systems which may have adverse repercussions in pathophysiology and progression of chronic lung and cardiovascular diseases. We compared the biomarkers of systemic inflammation, lipid mediators, injury/repair and oxidative stress between groups of non-smokers (NS), exclusive WPT smokers (WPS), exclusive cigarette smokers (CS) and dual WPS and CS (DS). METHODS Two cohorts were recruited. Cohort I consisted of WPS (n=12), CS (n=26), DS (n=10) and NS (n=25). Cohort II consisted of WPS (n=33) and NS (n=24). Plasma and urine samples were collected and analysed for various systemic biomarkers. RESULTS Compared with NS, plasma levels of inflammatory mediators (interleukin (IL)-6, IL-8, IL1β and tumor necrosis factor-α) were significantly higher in WPS and CS, and were further augmented in DS. Endothelial biomarkers (intracellular adhesion molecule-1, prostaglandin E-2 and metalloproteinase-9) were significantly higher in CS. Most notably, pro-resolving lipid mediator (resolvin E1) and biomarkers of immunity, tissue injury, and repair were significantly lower in WPS and CS. Urinary levels of 8-isoprostane were significantly higher in all smoking groups in cohort I, while 8-isoprostane, myeloperoxidase, receptor for advanced glycation end products (RAGE), En-RAGE and matrix metalloproteinase-9 were significantly higher in all smoking groups in cohort II. CONCLUSIONS Biomarkers of inflammation, oxidative stress, immunity, tissue injury and repair were elevated in WPS and CS groups. Furthermore, concurrent use of WPT and cigarettes is more harmful than cigarette or WPT smoking alone. These data may help inform the public and policy-makers about the dangers of WPT smoking and dual use of tobacco products.
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Affiliation(s)
- Naushad Ahmad Khan
- Department of Environmental Medicine, University of Rochester, Rochester, New York, USA
| | - Gina Lawyer
- Department of Environmental Medicine, University of Rochester, Rochester, New York, USA
| | - Samantha McDonough
- Department of Environmental Medicine, University of Rochester, Rochester, New York, USA
| | - Qixin Wang
- Department of Environmental Medicine, University of Rochester, Rochester, New York, USA
| | - Noura O Kassem
- Hookah Studies Division, Center for Behavioral Epidemiology and Community Health, San Diego State University, San Diego, California, USA
| | - Flora Kas-Petrus
- Hookah Studies Division, Center for Behavioral Epidemiology and Community Health, San Diego State University, San Diego, California, USA
| | - Dongxia Ye
- Department of Environmental Medicine, University of Rochester, Rochester, New York, USA
| | - Kameshwar P Singh
- Department of Environmental Medicine, University of Rochester, Rochester, New York, USA
| | - Nada Of Kassem
- Hookah Studies Division, Center for Behavioral Epidemiology and Community Health, San Diego State University, San Diego, California, USA
| | - Irfan Rahman
- Department of Environmental Medicine, University of Rochester, Rochester, New York, USA
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Muzammil, Al Asmari DS, Al Rethaiaa AS, Al Mutairi AS, Al Rashidi TH, Al Rasheedi HA, Al Rasheedi SA. Prevalence and Perception of Shisha Smoking among University Students: A Cross-sectional Study. J Int Soc Prev Community Dent 2019; 9:275-281. [PMID: 31198701 PMCID: PMC6559036 DOI: 10.4103/jispcd.jispcd_407_18] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 03/06/2019] [Indexed: 12/18/2022] Open
Abstract
Aims and Objectives: Understanding perceptions and factors behind the rise in the prevalence of shisha smoking is important for the development of prevention strategies and policies. The aim of this descriptive study was to assess the prevalence and perception of shisha smoking among university students. Materials and Methods: The anonymous, self-structured 12-item questionnaire was administered to 450 male university students, with an overall response rate of 82.44% (n = 371). Prevalence, knowledge, and other associated factors regarding shisha smoking were compared between dental and other specialty students using SPSS software for descriptive statistical analysis. Results: Among 371 university students, 40.43% (n = 150) were nonsmokers, 32.88% (n = 122) were shisha smokers, 12.94% (n = 48) were cigarette smokers, and 13.75% (n = 51) smoked both shisha and cigarette. The overall prevalence of shisha smoking (46.63%, n = 173) was higher than that of cigarette smoking (26.68%, n = 99). The percentage of those knowledgeable about the ill effects of shisha smoking was 44.2% with lesser knowledge among shisha smokers than cigarette smokers. There was no statistically significant difference in the mean total knowledge score between dental (5.65 ± 2.08) and other specialty (5.21 ± 2.3) students. Conclusions: A high prevalence of shisha use among university students is reported in this study as well as a general lack of understanding of the dangers involved with this behavior. Study authors recommend the development of policies targeted at preventing further rise in the prevalence of shisha smoking through the implementation of preventive strategies such as incorporating this topic into the school syllabus and encouraging research on shisha smoking.
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Affiliation(s)
- Muzammil
- Department of Oral and Dental Health, College of Applied Health Sciences in Ar Rass, Qassim University, Buraidah, Al Qassim, Kingdom of Saudi Arabia
| | - Dhafer S Al Asmari
- Department of Periodontology and Oral Medicine, College of Dentistry, Qassim University, Buraidah, Al Qassim, Kingdom of Saudi Arabia
| | - Abdullah Saleh Al Rethaiaa
- Department of Health Sciences Preparation, College of Applied Health Sciences in Ar Rass, Qassim University, Buraidah, Al Qassim, Kingdom of Saudi Arabia
| | - Abdullah Saleh Al Mutairi
- Department of Periodontology and Oral Medicine, College of Dentistry, Qassim University, Buraidah, Al Qassim, Kingdom of Saudi Arabia
| | | | | | - Saad Amer Al Rasheedi
- Department of Periodontology and Oral Medicine, College of Dentistry, Qassim University, Buraidah, Al Qassim, Kingdom of Saudi Arabia
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Khemiss M, Ben Fekih D, Ben Khelifa M, Ben Saad H. Comparison of Periodontal Status Between Male Exclusive Narghile Smokers and Male Exclusive Cigarette Smokers. Am J Mens Health 2019; 13:1557988319839872. [PMID: 30902035 PMCID: PMC6440045 DOI: 10.1177/1557988319839872] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Studies evaluating the effects of narghile use on the periodontium present conflicting conclusions. This study aimed to compare the periodontal status of exclusive narghile smokers (ENSs, n = 74) to that of exclusive cigarette smokers (ECSs, n = 74). Males aged 20-40 years were recruited to participate in this comparative study. Information concerning oral health habits (number of yearly visits to the dentist, daily toothbrushing frequency) and tobacco exposure were obtained. Clinical measurements were performed on all the existing teeth, except the third molars. The number of remaining teeth and decayed/missing/filled teeth (DMFT) were noted. The plaque levels were recorded using the plaque index of Löe and Silness. The gingival index modified by Löe was used to evaluate gingival inflammation. Teeth mobility was measured using bidigital mobility. The probing pocket depth was measured using a periodontal probe. Periodontal disease was defined as the presence of at least 10 sites with a probing depth ≥5 mm. Student's t and chi-square tests were used to compare, respectively, the two groups' quantitative and qualitative data. The two groups were matched for quantities of used tobacco, age, daily toothbrushing frequency, teeth mobility, number of remaining teeth, plaque index, and DMFT. Compared to the ECS group, the ENS group had a significantly lower number of yearly visits to the dentist (mean ± SD: 0.2 ± 0.5 vs. 0.1 ± 0.2), lower probing pocket depth (mean ± SD: 2.33 ± 0.63 vs. 2.02 ± 0.80 mm), and gingival index (median [interquartile]: 0.46 [0.10-0.89] vs. 0.00 [0.00-0.50]), and it included significantly lower percentages of smokers with periodontal disease (24.3% vs. 9.5%). In conclusion, chronic exclusive narghile smoking has fewer adverse effects on the periodontium than chronic exclusive cigarette smoking.
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Affiliation(s)
- Mehdi Khemiss
- Department of Dental Medicine, Fattouma Bourguiba University Hospital of Monastir, Tunisia,Research Laboratory N8 LR12SP10: Maxilla Functional and Aesthetic Rehabilitation, Farhat Hached University Hospital of Sousse, Tunisia
| | - Dalila Ben Fekih
- Department of Dental Medicine, Fattouma Bourguiba University Hospital of Monastir, Tunisia
| | - Mohamed Ben Khelifa
- Department of Dental Medicine, Fattouma Bourguiba University Hospital of Monastir, Tunisia,Research Laboratory N8 LR12SP10: Maxilla Functional and Aesthetic Rehabilitation, Farhat Hached University Hospital of Sousse, Tunisia
| | - Helmi Ben Saad
- Université de Sousse, Hôpital Farhat Hached, Service de Physiologie et Explorations Fonctionnelles, Tunisia,Heart Failure (LR12SP09) Research Laboratory, Farhat Hached Hospital, Sousse, Tunisia,Laboratory of Physiology, Faculty of Medicine of Sousse, University of Sousse, Tunisia,Helmi Ben Saad, Laboratory of Physiology, Faculty of Medicine of Sousse, Rue Mohamed Karoui, Sousse, Tunisia.
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Jawad M, Cheeseman H, Brose LS. Waterpipe tobacco smoking prevalence among young people in Great Britain, 2013-2016. Eur J Public Health 2019; 28:548-552. [PMID: 29272388 DOI: 10.1093/eurpub/ckx223] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Background One percent of adults in Great Britain use waterpipe tobacco at least monthly, however national epidemiological evidence among young people is absent. This study aims to assess waterpipe tobacco prevalence and correlates among young people in Great Britain. Methods Data were analyzed from online surveys conducted annually from 2013 to 2016 with weighted national samples of 11 to 18-year olds in Great Britain (annual n = 1936-2059). Primary outcome measures were at least monthly waterpipe tobacco use and lifetime waterpipe tobacco use. Binary logistic regression models tested the association between these outcomes and age, sex, country of residence and other tobacco consumption. Results Between 2013 and 2016, 1.7% (95% CI 1.5-2.1%) used waterpipe tobacco at least monthly and 9.9% (95% CI 9.2-10.7%) used waterpipe in their lifetime. There were no changes in prevalence over time. At least monthly use was associated with older age groups [16-18 years vs. 11-15 years, adjusted odds ratio (AOR) 2.63, 95% CI 1.55-4.46], male sex (AOR 1.82, 95% CI 1.23-2.71) and other tobacco consumption (e.g. lifetime cigarette use AOR 10.30, 95% CI 5.22-20.29). Lifetime use had similar correlates, but was not associated with male sex (AOR 0.97, 95% CI 0.80-1.17). Conclusions One in 10 young people in Great Britain have tried waterpipe tobacco, though more frequent use appears low. We found no evidence of increasing or decreasing prevalence of waterpipe use between 2013 and 2016. Being male, older and a concurrent user of other tobacco products were correlated with waterpipe tobacco use.
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Affiliation(s)
- Mohammed Jawad
- Public Health Policy Evaluation Unit, Imperial College London, Hammersmith, London, UK
| | | | - Leonie S Brose
- Department of Addictions, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
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Khan NA, Yogeswaran S, Wang Q, Muthumalage T, Sundar IK, Rahman I. Waterpipe smoke and e-cigarette vapor differentially affect circadian molecular clock gene expression in mouse lungs. PLoS One 2019; 14:e0211645. [PMID: 30811401 PMCID: PMC6392409 DOI: 10.1371/journal.pone.0211645] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Accepted: 01/17/2019] [Indexed: 01/10/2023] Open
Abstract
The use of emerging tobacco products, such as waterpipe or hookah and electronic cigarettes (e-cigs), has gained significant popularity and are promoted as safer alternatives to conventional cigarettes. Circadian systems are internal biological oscillations that are considered important regulators of immune functions in mammals. Tobacco induced inflammatory lung diseases frequently exhibit time-of-day/night variation in lung function and symptom severity. We investigated the impact of inhaled e-cig vapor and waterpipe smoke (WPS) on pulmonary circadian molecular clock disruption by determining the changes in expression levels and abundance of core clock component genes (BMAL1, CLOCK) and clock-controlled output genes (Rev-erbα, Per2, Rev-erbβ, Cry2, Rorα) in mouse lungs. We showed that the expression levels of these pulmonary core clock genes and clock-controlled output genes were altered significantly following exposure to WPS (Bmal1, Clock, and Rev-erbα). We further showed a significant yet differential effect on expression levels of core clock and clock-controlled genes (Bmal1, Per2) in the lungs of mice exposed to e-cig vapor containing nicotine. Thus, acute exposure to WPS and e-cig vapor containing nicotine contributes to altered expression of circadian molecular clock genes in mouse lungs, which may have repercussions on lung cellular and biological functions.
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Affiliation(s)
- Naushad Ahmad Khan
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Shaiesh Yogeswaran
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Qixin Wang
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Thivanka Muthumalage
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Isaac K. Sundar
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Irfan Rahman
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, New York, United States of America
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Sadek KW, Haik MY, Ashour AA, Baloch T, Aboulkassim T, Yasmeen A, Vranic S, Zeidan A, Al Moustafa AE. Water-pipe smoking promotes epithelial-mesenchymal transition and invasion of human breast cancer cells via ERK1/ERK2 pathways. Cancer Cell Int 2018; 18:180. [PMID: 30473629 PMCID: PMC6234648 DOI: 10.1186/s12935-018-0678-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 11/06/2018] [Indexed: 12/12/2022] Open
Abstract
Background With the increasing popularity of water-pipe smoking (WPS), it is critical to comprehend how WPS may affect women's health. The main goal of this study is to identify the potential outcome of WPS on human breast cancer progression. Methods Two breast cancer cell lines, MCF7 and BT20, were used in this investigation. We explored the outcome of WPS on cell morphology and cell invasion using inverted microscope and Biocoat Matrigel invasion chambers. On the other hand, Western blot was employed to study the expression patterns of key control genes of cell adhesion and invasion. Results Our data reveal that WPS induces epithelial-mesenchymal transition (EMT) of MCF7 and BT20 breast cancer cell lines; thus, WPS enhances cell invasion ability of both cell lines in comparison with their matched controls. More significantly, WPS provokes a down- and up-regulation of E-cadherin and focal adhesion kinase (FAK), respectively, which are important key regulators of cancer progression genes. Finally, our data point out that WPS incites the activation of Erk1/Erk2, which could be behind the stimulation of EMT and invasion as well as the deregulation of E-cadherin and FAK expression. Conclusion Our data show, for the first time, that WPS initiates EMT and stimulates cell invasion of breast cancer cells, which could incite metastatic development in breast cancer patients. Thus, we believe that further studies, both in vitro and in vivo, are required to elucidate the pathogenic outcome of WPS on cancer progression of several human carcinomas including breast.
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Affiliation(s)
- Khaled W Sadek
- 1College of Medicine, Qatar University, Doha, Qatar.,2Biomedical Research Centre, Qatar University, Doha, Qatar
| | - Mahmoud Y Haik
- 1College of Medicine, Qatar University, Doha, Qatar.,2Biomedical Research Centre, Qatar University, Doha, Qatar
| | - Anas A Ashour
- 1College of Medicine, Qatar University, Doha, Qatar.,2Biomedical Research Centre, Qatar University, Doha, Qatar
| | - Tahira Baloch
- 3Segal Cancer Centre, Lady Davis Institute for Medical Research of the Sir Mortimer B. Davis-Jewish General Hospital, Montreal, QC Canada
| | - Tahar Aboulkassim
- 3Segal Cancer Centre, Lady Davis Institute for Medical Research of the Sir Mortimer B. Davis-Jewish General Hospital, Montreal, QC Canada
| | - Amber Yasmeen
- 3Segal Cancer Centre, Lady Davis Institute for Medical Research of the Sir Mortimer B. Davis-Jewish General Hospital, Montreal, QC Canada
| | - Semir Vranic
- 1College of Medicine, Qatar University, Doha, Qatar
| | - Asad Zeidan
- 1College of Medicine, Qatar University, Doha, Qatar
| | - Ala-Eddin Al Moustafa
- 1College of Medicine, Qatar University, Doha, Qatar.,2Biomedical Research Centre, Qatar University, Doha, Qatar.,4Oncology Department, McGill University, Montreal, QC Canada.,Syrian Research Cancer Centre of the Syrian Society against Cancer, Aleppo, Syria
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Ortiz K, Cuevas AG, Salloum R, Lopez N, LaVeist-Ramos T. Intra-Ethnic Racial Differences in Waterpipe Tobacco Smoking among Latinos? Subst Use Misuse 2018; 54:1-10. [PMID: 30028218 PMCID: PMC10629378 DOI: 10.1080/10826084.2018.1480040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND AND OBJECTIVES This study examined differences in waterpipe smoking (both lifetime and current) by race and ethnicity. More specifically, we evaluated intra-ethnic racial differences among Latinos using a nationally representative sample. METHODS Pooled data from the National Adult Tobacco Survey (NATS) [2012-2014] was used, in which Log-Poisson multivariable regression models were deployed to determine the prevalence of waterpipe smoking behavior. Models were stratified by gender and we further investigated acculturation, controlling for relevant sociodemographic characteristics. RESULTS In fully-adjusted models assessing lifetime WTS, Black Latinos and White Latinos exhibited an increase prevalence of lifetime WTS compared to their non-Hispanic white counterparts. Once stratifying by gender, Black Latino men (PR = 1.49; 95% CI = 1.16, 1.90) exhibited increased prevalence of lifetime WTS compared to their non-Hispanic white men counterparts; although white Latino men (PR = 0.88; 95% CI = 0.80, 0.98) exhibited decreased prevalence compared to their non-Hispanic white male counterparts. Similar trends were found for current WTS among men. In fully adjusted models assessing lifetime WTS, among women, only white Latina's (PR = 1.23; 95% CI = 1.04, 1.46) exhibited increased prevalence compared to their non-Hispanic white women counterparts. When evaluating current WTS, Black Latina's (PR = 2.19; 95% CI = 1.32, 3.65) and white Latinas (PR = 1.28; 95% CI = 1.00, 1.63) exhibited increased prevalence of WTS compared to their non-Hispanic white women counterparts. Conclusions/Importance: Among the U.S. general adult population, intra-ethnic racial differences in WTS behaviors exist among Latinos; and is shaped by gender. Future efforts to eliminate racial disparities in WTS should be attentive intra-ethnic racial differences among Latinos.
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Affiliation(s)
- Kasim Ortiz
- Department of Sociology & Criminology, University of New Mexico, Albuquerque, New Mexico, USA
| | - Adolfo G. Cuevas
- Department of Community Health, Tufts University Community Health Program, Medford, Oregon, USA
| | - Ramzi Salloum
- Department of Health Outcomes & Biomedical Informatics, University of Florida, Tallahasee, Florida, USA
| | - Nancy Lopez
- Department of Sociology & Criminology, University of New Mexico, Albuquerque, New Mexico, USA
| | - Thomas LaVeist-Ramos
- Department of Health Policy and Management, George Washington University Milken Institute of Public Health, Washington, USA
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Omotehinwa OJ, Japheths O, Damascene IJ, Habtu M. Shisha use among students in a private university in Kigali city, Rwanda: prevalence and associated factors. BMC Public Health 2018; 18:713. [PMID: 29884163 PMCID: PMC5994055 DOI: 10.1186/s12889-018-5596-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 05/23/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND All over the globe shisha smoking is fast growing among different age brackets. Shisha use has been reported to be increasing among youths in African major cities. Its use is documented to result in health effects such as lung cancer, cardiovascular and respiratory conditions, periodontal diseases, keratoacanthoma which are also associated with cigarette smoking. In Kigali, Rwanda's capital, reports indicate that shisha use is increasing among the youths, particularly the university students. The study aimed at determining the prevalence, and establishing factors associated with shisha use among students in a university in Kigali Rwanda, which will be a significant step in stemming shisha fame among youths in Rwanda as there was no previously documented evidence-based study. METHODS A total of 427 students were selected for this cross-sectional study using stratified sampling method. A questionnaire was used to collect data on shisha use, knowledge about shisha, attitude towards shisha, and factors associated with use of shisha. The association between the independent variables and shisha use was assessed using chi-square p value < 0.05. Binary logistic regression was used to determine variables that were independently associated with shisha smoking. RESULTS Prevalence of ever smoking shisha among the university students was 26.1% and that of those that smoked in the last month (30 days) was 20.8%. About 40 % (39.9%) of the participants that had heard about shisha before demonstrated low level of knowledge, and 41.6% of these reported shisha use in the last 30 days. Logistic regression revealed that the followings were independently associated with shisha smoking: always drink alcohol (p = 0.003); drink alcohol occasionally (p = 0.045); having friend(s) who smoke shisha (p = 0.001); being aware of shisha's availability in cafes, bars and restaurants in Kigali (p = 0.022); positive attitude towards shisha smoking (p < 0.001) and participants with age < 20 years (p = 0.039). CONCLUSIONS There is a relative high prevalence of shisha smoking and a poor knowledge about its impact on health among these university students. Regular medical education and health promotion targeting the youths could improve knowledge and practices about shisha use. Shisha laws and regulations should be enacted, and fines imposed on individuals or group who flout them.
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Affiliation(s)
- Omoboriowo Joad Omotehinwa
- Department of Public Health, Mount Kenya University, School of Health Sciences, P. O. Box 5826, Kigali Campus, Kigali, Rwanda
| | - Ogendi Japheths
- Department of Public Health, Mount Kenya University, School of Health Sciences, P. O. Box 5826, Kigali Campus, Kigali, Rwanda
| | | | - Michael Habtu
- Department of Public Health, Mount Kenya University, School of Health Sciences, P. O. Box 5826, Kigali Campus, Kigali, Rwanda
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Al-Sawalha NA, Al-Bo'ul HF, Alzoubi KH, Khabour OF, Thanawala VJ. Effect of prenatal waterpipe tobacco smoke on airway inflammation in murine model of asthma of adult offspring mice. Inhal Toxicol 2018; 29:366-373. [PMID: 29039230 DOI: 10.1080/08958378.2017.1385113] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Worldwide popularity of waterpipe tobacco smoking has increased, including in pregnant women. This study investigates the effect of prenatal waterpipe tobacco smoke (WTS) exposure on airway inflammation in a murine model of asthma of adult offspring mice. MATERIALS AND METHODS Pregnant BALB/c mice were exposed to fresh air or WTS, using a whole-body exposure system that mimics human use during WTS. Adult male offspring mice were divided into; (1) control (prenatal fresh air, postnatal ovalbumin sensitization and saline challenge), (2) postnatal Ova S/C (prenatal fresh air, postnatal ovalbumin sensitization and challenge (Ova S/C)), (3) prenatal WTS (prenatal WTS, postnatal ovalbumin sensitization and saline challenge) and (4) prenatal WTS + postnatal Ova S/C. Cells from the bronchoalveolar lavage fluid, cytokines, and oxidative stress markers (superoxide dismutase (SOD), catalase, glutathione peroxidase (GPx) and thiobarbituric acid reactive substances (TBARS)) from lung homogenates were evaluated. RESULTS Prenatal WTS increased recruitment of cells in lungs and levels of SOD and catalase when compared to unexposed offspring's. The levels of cytokines, GPx and TBARS were not affected by prenatal WTS. Prenatal WTS exposure and postnatal Ova S/C increased airway inflammation and activity of SOD compared to control and Ova S/C mice and reduced IL-18 levels compared to Ova S/C mice. DISCUSSION AND CONCLUSIONS Prenatal exposure to WTS induced airway inflammation, further enhanced by a murine model of asthma in adult offspring. Prenatal exposure to WTS adversely affects the lung function of the offspring and careful strategies for increasing public awareness regarding the harmful effects of WTS during pregnancy is important.
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Affiliation(s)
- Nour A Al-Sawalha
- a Faculty of Pharmacy , Jordan University of Science and Technology , Irbid , Jordan
| | - Hanadi F Al-Bo'ul
- a Faculty of Pharmacy , Jordan University of Science and Technology , Irbid , Jordan
| | - Karem H Alzoubi
- a Faculty of Pharmacy , Jordan University of Science and Technology , Irbid , Jordan
| | - Omar F Khabour
- b Faculty of Applied Medical Sciences , Jordan University of Science and Technology , Irbid , Jordan.,c Faculty of Applied Medical Sciences , Taibah University , Medina , Saudi Arabia
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