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Cham B, Weaver SR, Jones CK, Popova L, Jacques N. Prevalence and associated factors of shisha smoking among students in Senegal: Global Youth Tobacco Survey 2020. Tob Induc Dis 2024; 22:TID-22-77. [PMID: 38745595 PMCID: PMC11091866 DOI: 10.18332/tid/186656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/29/2024] [Accepted: 04/02/2024] [Indexed: 05/16/2024] Open
Abstract
INTRODUCTION Although shisha smoking is banned in Senegal, it has become increasingly popular, especially among youth. Despite the health risks associated with shisha smoking, there are few studies on shisha smoking in West Africa and none in Senegal. Our study assessed the prevalence and factors associated with shisha smoking among students aged 13-15 years in Senegal. METHODS We used the 2020 Global Youth Tobacco Survey (GYTS) Senegal data from 2524 students aged 13-15 years. We calculated the weighted prevalence of ever and current (past 30 days) shisha smoking. Multivariable logistic regression analyses identified factors associated with ever and current shisha smoking among students. RESULTS The prevalences of ever and current shisha smoking were 9.8% (95% CI: 7.7-12.3) and 2.2% (95% CI: 1.5-3.1), respectively. Ever shisha smoking was significantly associated with being male (AOR=1.97; 95% CI: 1.33-2.92), current cigarette smoking (AOR=7.54; 95% CI: 2.95-19.29), higher class grade (AOR=2.27; 95% CI:1.10-4.67), more weekly pocket money (AOR=3.29; 95% CI:1.36-7.95), current use of smokeless tobacco (AOR=11.53; 95% CI: 4.98- 26.72), and exposure to secondhand cigarette smoke in public (AOR=1.55; 95% CI: 1.00-2.41). Current shisha smoking was significantly associated with current cigarette smoking (AOR=21.75; 95% CI: 6.08-77.78), more weekly pocket money (AOR=8.91; 95% CI: 1.75-45.40), current use of smokeless tobacco (AOR=8.26; 95% CI: 2.07-33.04), and fathers' smoking (AOR=3.34; 95% CI: 1.24-8.96). CONCLUSIONS One in 10 students aged 13-15 years have ever smoked shisha and 2.2% were currently smoking it, suggesting that shisha smoking is a public health concern in Senegal. Senegal might consider offering students more education on the harms of shisha, both in schools and through comprehensive media campaigns that address all tobacco products.
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Affiliation(s)
- Bai Cham
- School of Public Health, Georgia State University, Atlanta, United States
- Disease Control and Elimination Theme, Medical Research Council Unit The Gambia, London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Scott R. Weaver
- School of Public Health, Georgia State University, Atlanta, United States
| | - Candace K. Jones
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, United States
- Research Triangle Institute (RTI) International, Research Triangle Park, United States
| | - Lucy Popova
- School of Public Health, Georgia State University, Atlanta, United States
| | - Nerline Jacques
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, United States
- CyberData Technologies, Herndon, United States
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Talih S, Hanna E, Salman R, Salam S, El-Hage R, Karaoghlanian N, Talih F, Baldassari S, Saliba N, Elbejjani M, Eissenberg T, El-Hellani A, Shihadeh A. Influence of nicotine form and nicotine flux on puffing behavior and mouth-level exposure to nicotine from electronic nicotine delivery systems. Drug Alcohol Depend 2024; 254:111052. [PMID: 38103538 PMCID: PMC10872307 DOI: 10.1016/j.drugalcdep.2023.111052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 11/28/2023] [Accepted: 11/28/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Nicotine form (freebase/protonated) and nicotine flux (rate at which nicotine is emitted) are two factors that can affect the dose of nicotine inhaled by individuals using electronic nicotine delivery systems (ENDS) because they can influence puffing behavior. The nicotine dose for each puff also is directly proportional to nicotine flux (i.e., dose/puff=nicotine flux*puff duration). This study examines the effect of nicotine form and flux on puffing parameters and mouth-level nicotine exposure. METHODS Thirty-two dual ENDS and combustible cigarette participants completed five visits that differed by nicotine form (freebase or protonated) and nicotine flux (14 or 35µg/sec); a zero-nicotine condition was a negative control. Participants used a Subox Mini C ENDS, powered at 20W, during a 10-puff directed bout (B1) followed by a one-hour ad libitum bout (B2). Puffing parameters and mouth-level nicotine exposure were assessed using the American University of Beirut REALTIME instrument. RESULTS Relative to protonated nicotine, freebase nicotine was associated with lower total puff duration (puff duration*number of puffs), lower flow rate in B1, lower liquid consumption, and lower mouth-level nicotine exposure. Increasing nicotine flux from 14 to 35µg/sec was associated with lower total puff duration in both bouts, as well as lower liquid consumption. Increasing nicotine flux was associated with higher mouth-level nicotine exposure in B1 only. CONCLUSION ENDS with protonated nicotine may enhance nicotine exposure by promoting longer puffing and thus greater dose delivered. This work highlights the importance of accounting for interactions between nicotine form and flux when considering nicotine regulation for ENDS.
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Affiliation(s)
- Soha Talih
- Mechanical Engineering Department, Maroun Semaan Faculty of Engineering and Architecture, American University of Beirut, Bliss Street, P.O. Box 11-0236, Beirut, Lebanon; Center for the Study of Tobacco Products, Virginia Commonwealth University, Suite 200, 100 West Franklin Street, Richmond, VA 23220, USA.
| | - Eliana Hanna
- Mechanical Engineering Department, Maroun Semaan Faculty of Engineering and Architecture, American University of Beirut, Bliss Street, P.O. Box 11-0236, Beirut, Lebanon; Center for the Study of Tobacco Products, Virginia Commonwealth University, Suite 200, 100 West Franklin Street, Richmond, VA 23220, USA
| | - Rola Salman
- Mechanical Engineering Department, Maroun Semaan Faculty of Engineering and Architecture, American University of Beirut, Bliss Street, P.O. Box 11-0236, Beirut, Lebanon; Center for the Study of Tobacco Products, Virginia Commonwealth University, Suite 200, 100 West Franklin Street, Richmond, VA 23220, USA
| | - Sally Salam
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Suite 200, 100 West Franklin Street, Richmond, VA 23220, USA; Chemistry Department, Faculty of Arts and Sciences, American University of Beirut, Bliss Street, P.O. Box 11-0236, Beirut, Lebanon
| | - Rachel El-Hage
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Suite 200, 100 West Franklin Street, Richmond, VA 23220, USA; Chemistry Department, Faculty of Arts and Sciences, American University of Beirut, Bliss Street, P.O. Box 11-0236, Beirut, Lebanon
| | - Nareg Karaoghlanian
- Mechanical Engineering Department, Maroun Semaan Faculty of Engineering and Architecture, American University of Beirut, Bliss Street, P.O. Box 11-0236, Beirut, Lebanon; Center for the Study of Tobacco Products, Virginia Commonwealth University, Suite 200, 100 West Franklin Street, Richmond, VA 23220, USA
| | - Farid Talih
- Department of Psychiatry, Faculty of Medicine, American University of Beirut, Bliss Street, PO. Box 11-0236, Beirut, Lebanon
| | - Stephen Baldassari
- Program in Addiction Medicine, Yale Center for the Study of Tobacco Product Use and Addiction, Yale School of Medicine, New Haven, CT, USA
| | - Najat Saliba
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Suite 200, 100 West Franklin Street, Richmond, VA 23220, USA; Chemistry Department, Faculty of Arts and Sciences, American University of Beirut, Bliss Street, P.O. Box 11-0236, Beirut, Lebanon
| | - Martine Elbejjani
- Clinical Research Institute and Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Bliss Street, P.O. Box 11-0236, Beirut, Lebanon
| | - Thomas Eissenberg
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Suite 200, 100 West Franklin Street, Richmond, VA 23220, USA
| | - Ahmad El-Hellani
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, 3650 Olentangy River Rd, Columbus, OH 43214, USA
| | - Alan Shihadeh
- Mechanical Engineering Department, Maroun Semaan Faculty of Engineering and Architecture, American University of Beirut, Bliss Street, P.O. Box 11-0236, Beirut, Lebanon; Center for the Study of Tobacco Products, Virginia Commonwealth University, Suite 200, 100 West Franklin Street, Richmond, VA 23220, USA
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3
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Badejo PO, Umphres SS, Ali HEA, Alarabi AB, Qadri S, Alshbool FZ, Khasawneh FT. Exposure to Electronic Waterpipes Increases the Risk of Occlusive Cardiovascular Disease in C57BL/6J Mice. J Cardiovasc Pharmacol Ther 2024; 29:10742484241242702. [PMID: 38592084 DOI: 10.1177/10742484241242702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
INTRODUCTION It is well documented that cardiovascular disease (CVD) is the leading cause of death in the US and worldwide, with smoking being the most preventable cause. Additionally, most smokers die from thrombotic-based diseases, in which platelets play a major role. To this end, because of the proven harm of smoking, several novel tobacco products such as electronic(e)-waterpipe have been gaining popularity among different sectors of the population, partly due to their "false" safety claims. While many investigators have focused on the negative health effects of traditional cigarettes and e-cigarettes on the cardiovascular system, virtually little or nothing is known about e-waterpipes, which we investigated herein. METHODS AND MATERIALS To investigate their occlusive CVD effects, we employed a whole-body mouse exposure model of e-waterpipe vape/smoke and exposed C57BL/6J male mice (starting at 7 weeks of age) for 1 month, with the controls exposed to clean air. Exposures took place seven times a week, according to the well-known Beirut protocol, which has been employed in many studies, as it mimics real-life waterpipe exposure scenarios; specifically, 171 puffs of 530 ml volume of the e-liquid at 2.6 s puff duration and 17 s puff interval. RESULTS The e-waterpipe exposed mice had shortened bleeding and occlusion times, when compared to the clean air controls, indicating a prothrombotic phenotype. As for the mechanism underlying this phenotype, we found that e-waterpipe exposed platelets exhibited enhanced agonist-triggered aggregation and dense granule secretion. Also, flow cytometry analysis of surface markers of platelet activation showed that both P-selectin and integrin GPIIb-IIIa activation were enhanced in the e-waterpipe exposed platelets, relative to the controls. Finally, platelet spreading and Akt phosphorylation were also more pronounced in the exposed mice. CONCLUSION We document that e-waterpipe exposure does exert untoward effects in the context of thrombosis-based CVD, in part, via promoting platelet hyperreactivity.
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Affiliation(s)
- Precious O Badejo
- Department of Pharmaceutical Sciences, Irma Lerma Rangel School of Pharmacy, Texas A&M University, Kingsville, TX, USA
| | - Shelby S Umphres
- Department of Pharmaceutical Sciences, Irma Lerma Rangel School of Pharmacy, Texas A&M University, Kingsville, TX, USA
| | - Hamdy E A Ali
- Department of Pharmaceutical Sciences, Irma Lerma Rangel School of Pharmacy, Texas A&M University, Kingsville, TX, USA
| | - Ahmed B Alarabi
- Department of Pharmaceutical Sciences, Irma Lerma Rangel School of Pharmacy, Texas A&M University, Kingsville, TX, USA
| | - Shahnaz Qadri
- Department of Pharmaceutical Sciences, Irma Lerma Rangel School of Pharmacy, Texas A&M University, Kingsville, TX, USA
| | - Fatima Z Alshbool
- Department of Pharmacy Practice, Irma Lerma Rangel School of Pharmacy, Texas A&M University, Kingsville, TX, USA
| | - Fadi T Khasawneh
- Department of Pharmaceutical Sciences, Irma Lerma Rangel School of Pharmacy, Texas A&M University, Kingsville, TX, USA
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Hassane M, Rahal Z, Karaoghlanian N, Zhang J, Sinjab A, Wong JW, Lu W, Scheet P, Lee JJ, Raso MG, Solis LM, Fujimoto J, Chami H, Shihadeh AL, Kadara H. Chronic Exposure to Waterpipe Smoke Elicits Immunomodulatory and Carcinogenic Effects in the Lung. Cancer Prev Res (Phila) 2022; 15:423-434. [PMID: 35468191 PMCID: PMC9256796 DOI: 10.1158/1940-6207.capr-21-0610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 03/23/2022] [Accepted: 04/21/2022] [Indexed: 01/07/2023]
Abstract
Effects of waterpipe smoking on lung pathobiology and carcinogenesis remain sparse despite the worldwide emergence of this tobacco vector. To address this gap, we investigated the effects of chronic waterpipe smoke (WPS) exposure on lung pathobiology, host immunity, and tumorigenesis using an experimental animal model that is prone to tobacco carcinogens and an exploratory observational analysis of human waterpipe smokers and nonsmokers. Mice exhibited elevated incidence of lung tumors following heavy WPS exposure (5 days/week for 20 weeks) compared to littermates with light WPS (once/week for 20 weeks) or control air. Lungs of mice exposed to heavy WPS showed augmented CD8+ and CD4+ T cell counts along with elevated protumor immune phenotypes including increased IL17A in T/B cells, PD-L1 on tumor and immune cells, and the proinflammatory cytokine IL1β in myeloid cells. RNA-sequencing (RNA-seq) analysis showed reduced antitumor immune gene signatures in animals exposed to heavy WPS relative to control air. We also performed RNA-seq analysis of airway epithelia from bronchial brushings of cancer-free waterpipe smokers and nonsmokers undergoing diagnostic bronchoscopy. Transcriptomes of normal airway cells in waterpipe smokers, relative to waterpipe nonsmokers, harbored gene programs that were associated with poor clinical outcomes in patients with lung adenocarcinoma, alluding to a WPS-associated molecular injury, like that established in response to cigarette smoking. Our findings support the notion that WPS exhibits carcinogenic effects and constitutes a possible risk factor for lung cancer as well as warrant future studies that can guide evidence-based policies for mitigating waterpipe smoking. PREVENTION RELEVANCE Potential carcinogenic effects of waterpipe smoking are very poorly understood despite its emergence as a socially acceptable form of smoking. Our work highlights carcinogenic effects of waterpipe smoking in the lung and, thus, accentuate the need for inclusion of individuals with exclusive waterpipe smoking in prevention and smoking cessation studies.
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Affiliation(s)
- Maya Hassane
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Zahraa Rahal
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | | - Jiexin Zhang
- Department of Biostatistics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Ansam Sinjab
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Justin W. Wong
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Wei Lu
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Paul Scheet
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - J. Jack Lee
- Department of Biostatistics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Maria Gabriela Raso
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Luisa M Solis
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Junya Fujimoto
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Hassan Chami
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon.,School of Medicine, John Hopkins University, Baltimore, Maryland, USA
| | - Alan L. Shihadeh
- Faculty of Engineering, American University of Beirut, Beirut, Lebanon
| | - Humam Kadara
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.,Correspondence to Humam Kadara, PhD, Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA, Telephone: 713-745-9396,
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5
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Hammad AM, Meknas SJ, Hall FS, Hikmat S, Sari Y, Al-Qirim TM, Alfaraj M, Amawi H. Effects of waterpipe tobacco smoke and ceftriaxone treatment on the expression of endocannabinoid receptors in mesocorticolimbic brain regions. Brain Res Bull 2022; 185:56-63. [PMID: 35490908 DOI: 10.1016/j.brainresbull.2022.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 04/15/2022] [Accepted: 04/26/2022] [Indexed: 11/17/2022]
Abstract
Chronic tobacco exposure can alter the endocannabinoid (eCB) system, consequently leading to an anxiety state. In this study, we investigated the effects of waterpipe tobacco smoke (WTS) on cannabinoid receptor 1 and 2 (CBR1 and CBR2) gene and protein expression in mesocorticolimbic brain regions. Using elevated plus maze (EPM) and open field (OF) tests, the effects of WTS exposure on withdrawal-induced anxiety-like behavior were examined. The effect of ceftriaxone (CEF), a β-lactam known to upregulate glutamate transporter 1 (GLT-1), on anxiety and the expression of cannabinoid receptors was also determined. Male Sprague-Dawley rats were randomly assigned to four groups: 1) the Control group was exposed only to standard room air; 2) the WTS group was exposed to tobacco smoke and treated with saline vehicle; 3) the WTS-CEF group was exposed to WTS and treated with ceftriaxone; and 4) the CEF group was exposed only to standard room air and treated with ceftriaxone. Rats were exposed to WTS (or room air) for two hours per day, five days per week for a period of four weeks. Behavioral tests (EPM and OF) were conducted weekly during acute withdrawal, 24 h following WTS exposure. Rats were given either saline or ceftriaxone (200 mg/kg i.p.) for five days during Week 4, 30 min prior to WTS exposure. Withdrawal-induced anxiety was induced by WTS exposure but was reduced by ceftriaxone treatment. WTS exposure decreased CBR1 mRNA and protein expression in the NAc and VTA, but not PFC, and ceftriaxone treatment attenuated these effects. WTS exposure did not change CBR2 mRNA expression in the NAc, VTA, or PFC. These findings demonstrate that WTS exposure dysregulated the endocannabinoid system and increased anxiety-like behavior, and these effects were reversed by ceftriaxone treatment, which suggest the involvement of glutamate transporter 1 in these effects.
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Affiliation(s)
- Alaa M Hammad
- Department of Pharmacy, College of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan.
| | - Sara Jamal Meknas
- Department of Pharmacy, College of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - F Scott Hall
- Department of Pharmacology and Experimental Therapeutics, College of Pharmacy and Pharmaceutical Sciences, University of Toledo, Toledo, OH, USA
| | - Suhair Hikmat
- Department of Pharmacy, College of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Youssef Sari
- Department of Pharmacology and Experimental Therapeutics, College of Pharmacy and Pharmaceutical Sciences, University of Toledo, Toledo, OH, USA
| | - T M Al-Qirim
- Department of Pharmacy, College of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Malek Alfaraj
- Department of Pharmacy, College of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Haneen Amawi
- Department of Clinical Pharmacy and Pharmacy Practice, College of Pharmacy, Yarmouk University, Irbid 21163, Jordan
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Hsieh JR, Mekoli ML, Edwards RL. Levels of Chemical Toxicants in Waterpipe Tobacco and Waterpipe Charcoal Solid Waste. JOURNAL OF ENVIRONMENTAL PROTECTION 2021; 12:913-938. [PMID: 34881071 PMCID: PMC8649808 DOI: 10.4236/jep.2021.1211054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This work provides insights on waterpipe tobacco and waterpipe charcoal as potential sources of environmental toxicants. Selected harmful and potentially harmful constituents (HPHCs) from ten U.S. commercial waterpipe tobacco filler products (before and after electric heating) and five waterpipe charcoal products (before and after burning) were investigated. The differences in quantities of HPHCs between the evaluated products appear to be affected by raw material properties and/or the manufacturing processes involved in product production. Trace metal quantities in waterpipe tobacco and charcoal products were observed after heating or burning conditions compared to unheated or unburned conditions, which could impact the environment through the generation of toxic tobacco product waste. This study demonstrates that waterpipe tobacco and waterpipe charcoal contain substantial quantities of benzo[a]pyrene (B[a]P) and trace metals (i.e., selenium, arsenic, cadmium, chromium, cobalt, lead, nickel) before use and that extensive and varied changes in trace metal quantities take place as a result of heating, and more studies are needed to estimate the magnitude of the environmental impact of waterpipe tobacco use.
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Affiliation(s)
- Jason R. Hsieh
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Calverton, MD, USA
| | - Megan L. Mekoli
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Calverton, MD, USA
| | - Ronald L. Edwards
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Calverton, MD, USA
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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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8
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Al-Sawalha NA, Pokkunuri ID, Alzoubi KH, Khabour OF, Almomani BN. Waterpipe Tobacco Smoke Exposure during Lactation-Susceptibility of Reproductive Hormones and Oxidative Stress Parameters in Male Progeny Rats. Reprod Sci 2021; 28:37-42. [PMID: 32748221 DOI: 10.1007/s43032-020-00282-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 07/29/2020] [Indexed: 11/24/2022]
Abstract
There is a growing evidence for the public health hazards associated with waterpipe tobacco smoking (WTS). While the adverse effects of WTS exposure during pregnancy on the offspring are widely reported, its impact during breastfeeding remains less understood. The effects of WTS exposure during lactation on the reproductive hormones and oxidative stress biomarkers of adult male progeny were examined. Lactating rats received either fresh air (controls) or mainstream WTS for 1 h twice/day from day 4 to day 21 of lactation. The offspring was then followed up until week 20. The data indicated that WTS exposure in the lactating animals reduced the levels of follicle-stimulating hormone (FSH), prolactin (P < 0.05), luteinizing hormone (LH) (P = 0.1146), and estradiol (P = 0.0773) in the blood in male progeny. While the activities of testicular superoxide dismutase (SOD), glutathione peroxidase (GPx) and the levels of thiobarbituric acid reactive substances (TBARS) and blood levels of testosterone (P >0.05) remained unaltered, the activity of catalase increased significantly indicating an increased oxidant load in the WTS exposed rats compared to the controls. WTS exposure during lactation impairs male reproductive hormonal profile, augments oxidative damage, and potentially affects male fertility in male offspring rats.
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Affiliation(s)
- Nour A Al-Sawalha
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, P.O. Box 3030, Irbid, 22110, Jordan.
| | | | - Karem H Alzoubi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, P.O. Box 3030, Irbid, 22110, Jordan
| | - Omar F Khabour
- Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Bashar N Almomani
- Ministry of Health, National Institute of Forensic Medicine, Amman, Jordan
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9
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Rehder Silinski MA, Uenoyama T, Coleman DP, Blake JC, Thomas BF, Marusich JA, Jackson KJ, Meredith SE, Gahl RF. Analysis of Nicotine and Non-nicotine Tobacco Constituents in Aqueous Smoke/Aerosol Extracts by UHPLC and Ultraperformance Convergence Chromatography-Tandem Mass Spectrometry. Chem Res Toxicol 2020; 33:2988-3000. [PMID: 33226218 DOI: 10.1021/acs.chemrestox.0c00312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The non-nicotine constituents of tobacco may alter the reinforcing effects of nicotine, but the quantitative and qualitative profiles of these chemicals in tobacco products such as electronic cigarettes (e-cigarettes), cigars, and waterpipe tobacco are not well characterized. The objective of this work was to develop and validate analytical methods to utilize saline both as an extraction solvent for smoke condensates from cigarettes, little cigars, and waterpipe tobacco and aerosols from e-cigarettes and as a delivery vehicle of nicotine and non-nicotine constitents for nonclinical pharmacological studies. Ultrahigh-performance liquid chromatography was used to analyze nicotine and acetaldehyde, and a novel ultraperformance convergence chromatography-tandem mass spectrometry method was developed to analyze anabasine, anatabine, cotinine, myosmine, nornicotine, harmane, and norharmane. Linearity was confirmed for each standard curve with correlation coefficients (r) ≥ 0.99, and relative errors (RE) for the standards were ≤±10% over the calibration ranges. Method validation was performed by preparing triplicate samples in saline to mimic the composition and concentration of each analyte in the smoke or aerosol condensate and were used to determine method accuracy and precision. Relative standard deviation values were ≤15% and mean RE ≤15% for each analyte at each concentration level. Selectivity of the methods was demonstrated by the absence of peaks in blank vehicle or diluent samples. Storage stability was assessed over ∼45 days. Precision (%RSD ≤ 13) and recovery (percent of day 0 ≥ 80%) indicated that the saline formulations of all four products could be considered stable for up to ∼45 days at 4-8 °C. Therefore, the use of saline both as an extraction solvent and as a delivery vehicle adds versatility and improved performance in the study of the pharmacological effects of constituents from mainstream smoke and aerosols generated from cigarettes, little cigars, waterpipes, and e-cigarettes.
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Affiliation(s)
| | - Teruyo Uenoyama
- RTI International, P. O. Box 12194, Research Triangle Park, North Carolina 27709, United States
| | - Donna P Coleman
- RTI International, P. O. Box 12194, Research Triangle Park, North Carolina 27709, United States
| | - James C Blake
- RTI International, P. O. Box 12194, Research Triangle Park, North Carolina 27709, United States
| | - Brian F Thomas
- RTI International, P. O. Box 12194, Research Triangle Park, North Carolina 27709, United States
| | - Julie A Marusich
- RTI International, P. O. Box 12194, Research Triangle Park, North Carolina 27709, United States
| | - Kia J Jackson
- U. S. Food and Drug Administration, Center for Tobacco Products, Silver Spring, Maryland 20993, United States
| | - Steven E Meredith
- U. S. Food and Drug Administration, Center for Tobacco Products, Silver Spring, Maryland 20993, United States
| | - Robert F Gahl
- U. S. Food and Drug Administration, Center for Tobacco Products, Silver Spring, Maryland 20993, United States
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Taati B, Arazi H, Suzuki K. Oxidative Stress and Inflammation Induced by Waterpipe Tobacco Smoking Despite Possible Protective Effects of Exercise Training: A Review of the Literature. Antioxidants (Basel) 2020; 9:antiox9090777. [PMID: 32825755 PMCID: PMC7555522 DOI: 10.3390/antiox9090777] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/18/2020] [Accepted: 08/19/2020] [Indexed: 12/16/2022] Open
Abstract
The prevalence of waterpipe tobacco smoking (WTS), which is also known as ghalyan, shisha or hookah, is increasing rapidly around the world, especially among youth. Growing interest in this form of tobacco smoking can be traced, in part, to the use of flavored tobacco products, social acceptability as a safer option than cigarettes, and its consideration as a relaxation method or entertainment. However, there is a well-established association between WTS and oxidative stress that causes irreversible chronic pathological conditions such as cardiovascular and respiratory problems, as well as different types of cancers, and thus increases the risk of mortality. Clearly, induction of inflammation status through increased reactive oxygen species (ROS), which in turn leads to oxidative stress and harm to lipids, DNA, and proteins, is the most plausible mechanism to explain the potential harmful effects of WTS. Unlike WTS, well-designed exercise training programs increase ROS to the extent that it is beneficial to the body. In this study, we aimed to review available evidence on the impact of exercise training on oxidative stress and inflammation status. We also summarize the effect of acute and chronic WTS on different exercise capacities.
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Affiliation(s)
- Behzad Taati
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Guilan, Rasht 4199843653, Iran;
| | - Hamid Arazi
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Guilan, Rasht 4199843653, Iran;
- Correspondence: ; Tel.: +98-911-139-9207
| | - Katsuhiko Suzuki
- Faculty of Sport Sciences, Waseda University, Tokorozawa 359-1192, Japan;
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Abi-Gerges A, Dagher-Hamalian C, Abou-Khalil P, Chahine JB, Hachem P, Khalil C. Evaluation of waterpipe smoke toxicity in C57BL/6 mice model. Pulm Pharmacol Ther 2020; 63:101940. [PMID: 32889155 DOI: 10.1016/j.pupt.2020.101940] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 08/20/2020] [Accepted: 08/24/2020] [Indexed: 01/05/2023]
Abstract
Waterpipe smoking is a popular pastime worldwide with statistics pointing to an alarming increase in consumption. In the current paper, the evaluation of sub-chronic waterpipe smoke exposure was undertaken using C57BL/6 female mice using a dynamic exposure setting to emulate smoke exposure. Mice were daily subjected to either one (single exposure, SE) or two sessions (double exposure, DE) of waterpipe-generated smoke (two-apple flavor) for a period of two months. Although lungs histopathological examination pointed to a minor inflammation in smoke-exposed mice compared to control air-exposed (CON) group, the lung weights of the waterpipe-exposed mice were significantly higher (+72% in SE and +39% in DE) (p < 0.01) when compared to CON group. Moreover, changes in the protein expression of several proteins such as iNOS and JNK were noted in the lungs of smoke-exposed mice. However, no changes in p38 and EGFR protein levels were noted between the three groups of mice. Our results mainly showed a significant increase in urea serum levels (+28%) in SE mice along with renal pathological damage in both SE and DE mice compared to CON. Additionally, severe significant DNA damages (p < 0.05) were reported in the lungs, kidneys, bone marrow and liver of waterpipe-exposed animals, using MTS and COMET assays. These findings highlighted the significant risks posed by sub-chronic waterpipe smoke exposure in the selected animal model and the pressing need for future better management of waterpipe indoor consumption.
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Affiliation(s)
- Aniella Abi-Gerges
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Carole Dagher-Hamalian
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Pamela Abou-Khalil
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Joe Braham Chahine
- School of Arts and Sciences, Department of Natural Sciences, Lebanese American University, Byblos, Lebanon
| | - Pia Hachem
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Christian Khalil
- School of Arts and Sciences, Department of Natural Sciences, Lebanese American University, Byblos, Lebanon.
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Alarabi AB, Karim ZA, Ramirez JEM, Hernandez KR, Lozano PA, Rivera JO, Alshbool FZ, Khasawneh FT. Short-Term Exposure to Waterpipe/Hookah Smoke Triggers a Hyperactive Platelet Activation State and Increases the Risk of Thrombogenesis. Arterioscler Thromb Vasc Biol 2020; 40:335-349. [PMID: 31941383 DOI: 10.1161/atvbaha.119.313435] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Cardiovascular disease is a major public health problem. Among cardiovascular disease's risk factors, tobacco smoking is considered the single most preventable cause of death, with thrombosis being the main mechanism of cardiovascular disease mortality in smokers. While tobacco smoking has been on the decline, the use of waterpipes/hookah has been rising, mainly due to the perception that they are less harmful than regular cigarettes. Strikingly, there are few studies on the negative effects of waterpipes on the cardiovascular system, and none regarding their direct contribution to thrombus formation. Approach and Results: We used a waterpipe whole-body exposure protocol that mimics real-life human exposure scenarios and investigated its effects, relative to clean air, on platelet function, hemostasis, and thrombogenesis. We found that waterpipe smoke (WPS)-exposed mice exhibited both shortened thrombus occlusion and bleeding times. Further, our results show that platelets from WPS-exposed mice are hyperactive, with enhanced agonist-induced aggregation, dense and α-granule secretion, αIIbβ3 integrin activation, phosphatidylserine expression, and platelet spreading, when compared with clean air-exposed platelets. Finally, at the molecular level, it was found that Akt (protein kinase B) and ERK (extracellular signal-regulated kinases) phosphorylation are enhanced in the WPS and in nicotine-treated platelets. CONCLUSIONS Our findings demonstrate that WPS exposure directly modulates hemostasis and increases the risk of thrombosis and that this is mediated, in part, via a state of platelet hyperactivity. The negative health impact of WPS/hookah, therefore, should not be underestimated. Moreover, this study should also help in raising public awareness of the toxic effects of waterpipe/hookah.
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Affiliation(s)
- Ahmed B Alarabi
- From the Pharmaceutical Sciences, School of Pharmacy, The University of Texas at El Paso
| | - Zubair A Karim
- From the Pharmaceutical Sciences, School of Pharmacy, The University of Texas at El Paso
| | - Jean E Montes Ramirez
- From the Pharmaceutical Sciences, School of Pharmacy, The University of Texas at El Paso
| | - Keziah R Hernandez
- From the Pharmaceutical Sciences, School of Pharmacy, The University of Texas at El Paso
| | - Patricia A Lozano
- From the Pharmaceutical Sciences, School of Pharmacy, The University of Texas at El Paso
| | - José O Rivera
- From the Pharmaceutical Sciences, School of Pharmacy, The University of Texas at El Paso
| | - Fatima Z Alshbool
- From the Pharmaceutical Sciences, School of Pharmacy, The University of Texas at El Paso
| | - Fadi T Khasawneh
- From the Pharmaceutical Sciences, School of Pharmacy, The University of Texas at El Paso
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Hensel EC, Sarles SE, al-Olayan A, DiFrancesco AG, Jayasekera S, Eddingsaas NC, Robinson RJ. A Proposed Waterpipe Emissions Topography Protocol Reflecting Natural Environment User Behaviour. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010092. [PMID: 31877722 PMCID: PMC6981362 DOI: 10.3390/ijerph17010092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 12/18/2019] [Accepted: 12/19/2019] [Indexed: 11/20/2022]
Abstract
Usage of waterpipes is growing in popularity around the world. Limited waterpipe natural environment topography data reduces the ability of the research community to accurately assess emissions and user exposure to toxicants. A portable ergonomic waterpipe monitor was provided to study participants to use every time they smoked their own waterpipe during a one-week monitoring period in conjunction with their own choice shisha tobacco. Users provided demographic information and logged their product use to supplement electronic monitor data. A total of 44 prospective study participants were invited to an intake appointment following an on-line pre-screening survey. Of these, 34 individuals were invited to participate in the study and data for 24 individuals who completed all aspects of the 1-week monitoring protocol is presented. 7493 puffs were observed during 74 waterpipe sessions accumulating over 48 h of waterpipe usage. The 95% CI on mean puff flow rate, duration, volume and interval are presented, yielding grand means of 243 [mL/s], 3.5 [s], 850 [mL], and 28 [s] respectively. The middle 95% of puff flow rates ranged between 62 to 408 [mL/s], durations from 0.8 to 6.8 [s], and puff volumes from 87 to 1762 [mL]. A waterpipe emissions topography protocol consisting of 13 flow conditions is proposed to reflect 93% of the observed range of puff flow rate, puff duration and puff volume with representative inter-puff interval, cumulative session time and aerosol volumes.
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Affiliation(s)
- Edward C. Hensel
- Department of Mechanical Engineering, Rochester Institute of Technology, Rochester, NY 14623, USA; (S.E.S.); (A.G.D.); (S.J.); (R.J.R.)
- Correspondence: ; Tel.: +1-585-475-7684
| | - Samantha Emma Sarles
- Department of Mechanical Engineering, Rochester Institute of Technology, Rochester, NY 14623, USA; (S.E.S.); (A.G.D.); (S.J.); (R.J.R.)
| | - Abdulaziz al-Olayan
- Department of Industrial and Systems Engineering, Rochester Institute of Technology, Rochester, NY 14623, USA;
| | - A. Gary DiFrancesco
- Department of Mechanical Engineering, Rochester Institute of Technology, Rochester, NY 14623, USA; (S.E.S.); (A.G.D.); (S.J.); (R.J.R.)
| | - Shehan Jayasekera
- Department of Mechanical Engineering, Rochester Institute of Technology, Rochester, NY 14623, USA; (S.E.S.); (A.G.D.); (S.J.); (R.J.R.)
| | - Nathan C. Eddingsaas
- Rochester Institute of Technology, School of Chemistry and Materials Science, Rochester, NY 14623, USA;
| | - Risa J. Robinson
- Department of Mechanical Engineering, Rochester Institute of Technology, Rochester, NY 14623, USA; (S.E.S.); (A.G.D.); (S.J.); (R.J.R.)
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Eddingsaas NC, Hensel EC, O'Dea S, Kunselman P, DiFrancesco AG, Robinson RJ. Effect of user puffing topography on total particulate matter, nicotine and volatile carbonyl emissions from narghile waterpipes. Tob Control 2019; 29:s117-s122. [DOI: 10.1136/tobaccocontrol-2019-054966] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 07/07/2019] [Accepted: 07/09/2019] [Indexed: 11/03/2022]
Abstract
ObjectivesPuffing topographies of waterpipe users vary widely as does the puff-to-puff topography of an individual user. The aim of this study was to determine if puff duration and flow rate have an effect on the characteristics of the mainstream emission from waterpipes, including total particulate matter (TPM), mass ratio of nicotine and mass concentration of volatile carbonyls.MethodsPuffing parameters were chosen to encompass a significant portion of the perimeter space observed from a natural environment study. Tested conditions were 150, 200 and 250 mL sec-1; each run at 2, 3.5 and 5 s durations; 25 s interpuff duration and ~100 puffs per session. Each session was run in quadruplicate using the Programmable Emissions System-2 (PES-2) emissions capture system under identical conditions. Particulate matter, for quantification of TPM and nicotine, was collected on filter pads every ~5 L of aerosol resulting in 6 to 25 samples per session. Volatile carbonyls were sampled using 2,4-Dinitrophenylhydrazine (DNPH)-coated silica.ResultsMass concentration of TPM linearly decreased with increased flow rate, with no dependency on puff duration. Nicotine mass ratio was independent of topography, with average mass ratio of nicotine to TPM of 0.0027±0.0002 (mg/mg). The main carbonyls observed were acetaldehyde and formaldehyde. Puff duration increased emissions of some carbonyls (eg, formaldehyde) but not others (eg, acetaldehyde).ConclusionsThe results presented here highlight that topographies influence the emissions generated from waterpipes including TPM, total nicotine and volatile carbonyls. For laboratory studies to be representative of user exposure, a range of topographies must be studied. Using a range of topographies within a controlled laboratory environment will better inform regulatory policy.
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15
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Al-Sawalha NA, AlSari RR, Khabour OF, Alzoubi KH. Influence of prenatal waterpipe tobacco smoke exposure on renal biomarkers in adult offspring rats. Inhal Toxicol 2019; 31:171-179. [DOI: 10.1080/08958378.2019.1624897] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Nour A. Al-Sawalha
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Riham R. AlSari
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Omar F. Khabour
- Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Karem H. Alzoubi
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
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16
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Al‐Sawalha NA, Almahmmod YM, Alzoubi KH, Khabour OF, Alyacoub WN. Influence of prenatal waterpipe tobacco smoke exposure on reproductive hormones and oxidative stress of adult male offspring rats. Andrologia 2019; 51:e13318. [DOI: 10.1111/and.13318] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 04/25/2019] [Accepted: 04/28/2019] [Indexed: 12/13/2022] Open
Affiliation(s)
- Nour A. Al‐Sawalha
- Faculty of Pharmacy Jordan University of Science and Technology Irbid Jordan
| | - Yehya M. Almahmmod
- Faculty of Pharmacy Jordan University of Science and Technology Irbid Jordan
| | - Karem H. Alzoubi
- Faculty of Pharmacy Jordan University of Science and Technology Irbid Jordan
| | - Omar F. Khabour
- Faculty of Applied Medical Sciences Jordan University of Science and Technology Irbid Jordan
| | - Weam N. Alyacoub
- Faculty of Pharmacy Jordan University of Science and Technology Irbid Jordan
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17
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Al-Sawalha NA, Al-Filali MS, Alzoubi KH, Khabour OF. Effect of Prenatal Waterpipe Tobacco Smoke Exposure on Cardiac Biomarkers in Adult Offspring Rats. J Cardiovasc Pharmacol Ther 2019; 24:567-574. [DOI: 10.1177/1074248419849424] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Introduction: The prevalence of waterpipe tobacco smoke (WTS) consumption is increased among pregnant woman. Prenatal cigarette smoke exposure increased the risk of developing cardiovascular diseases in offspring. The current study examined the effect of prenatal WTS exposure on inflammatory profile, oxidative stress, and cardiac biomarkers in adult offspring rats. Methods: Female rats received WTS (2 hours per day) or fresh air 1 day prior to mating and throughout the pregnancy period. The body and heart masses were measured in male offspring rats. The level of oxidative stress biomarkers, nitrate, inflammatory mediators (interleukin 6 [IL-6], tumor necrosis factor alpha [TNF-α]), and gene expression of protein kinase C epsilon, angiotensin 2 receptor one, and transforming growth factor beta1 were measured in cardiac tissue homogenates of 13-week-old male offspring rats. Results: Prenatal WTS exposure reduced body weight and increased heart to body weight ratio ( P < .05). Prenatal WTS exposure did not affect oxidative stress biomarkers (superoxide dismutase, glutathione peroxidase, and thiobarbituric acid reactive substances) but significantly increased catalase activity and nitrate level ( P < .05) in cardiac tissue of adult male offspring rats. In addition, prenatal exposure to WTS did not affect cardiac level of TNF-α and IL-6 as well as the gene expression of different cardiac modulators in adult male offspring rats ( P > .05). Conclusion: Prenatal WTS exposure has detrimental consequences on adult offspring rats by increasing the ratio of heart to body mass, increasing the catalase activity and nitrate level in cardiac tissue of adult male offspring rats.
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Affiliation(s)
- Nour A. Al-Sawalha
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Maria S. Al-Filali
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Karem H. Alzoubi
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Omar F. Khabour
- Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
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18
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Rababa’h AM, Bsoul RW, Alkhatatbeh MJ, Alzoubi KH, Khabour OF. Waterpipe tobacco smoke distresses cardiovascular biomarkers in mice: alterations in protein expression of metalloproteinases, endothelin and myeloperoxidase. Inhal Toxicol 2019; 31:99-106. [DOI: 10.1080/08958378.2019.1606366] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Abeer M. Rababa’h
- Department of Clinical Pharmacy Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Raghad W. Bsoul
- Department of Clinical Pharmacy Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammad J. Alkhatatbeh
- Department of Clinical Pharmacy Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Karem H. Alzoubi
- Department of Clinical Pharmacy Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Omar F. Khabour
- Department of Medical Laboratory Sciences Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
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Gentzke AS, Wang B, Robinson JN, Phillips E, King BA. Curiosity About and Susceptibility Toward Hookah Smoking Among Middle and High School Students. Prev Chronic Dis 2019; 16:E04. [PMID: 30629485 PMCID: PMC6341822 DOI: 10.5888/pcd16.180288] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction Hookah smoking has increased among young people. Curiosity and susceptibility may be associated with experimentation or established use. Because tobacco use behaviors are established primarily during adolescence, our objective was to examine factors that may increase the risk of future tobacco product use among youth. Methods We analyzed data from the 2016 National Youth Tobacco Survey, a nationally representative survey of US students. Analyses were restricted to youth who had never smoked a hookah and stratified by their ever having used other tobacco products. The prevalence of hookah curiosity and susceptibility was assessed by sociodemographic characteristics, perceptions of harmfulness and addictiveness of hookahs, and peer use of hookahs. Associations between covariates and curiosity and susceptibility were assessed by using multivariable-adjusted regression. Results Overall, 29.1% of students reported any hookah curiosity or susceptibility. Curiosity was reported by 14.6% of those who never used tobacco products and by 45.9% of those who ever used tobacco products. Hookah susceptibility was reported by 15.6% of never-users and 52.5% of ever-users. Regardless of ever having used other tobacco products, odds of curiosity and susceptibility were higher among students with perceptions of reduced hookah harmfulness and addictiveness and among those who perceived high levels of hookah use among peers. Conclusion Nearly 3 in 10 youth who never smoked a hookah (6.9 million) reported hookah curiosity or susceptibility, and prevalence was highest among those who had ever used other tobacco products. These findings reinforce the importance of educating youth about the dangers of all tobacco products and dispel misperceptions about the harmfulness and addictiveness of hookah smoking. Continued surveillance of youth curiosity, susceptibility, and use of hookahs can inform public health policy and practice.
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Affiliation(s)
- Andrea S Gentzke
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS S107-7, Atlanta, GA 30341. E-mail:
| | - Baoguang Wang
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland
| | - Joelle N Robinson
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland
| | - Elyse Phillips
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Brian A King
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Perraud V, Lawler MJ, Malecha KT, Johnson RM, Herman D, Staimer N, Kleinman MT, Nizkorodov SA, Smith JN. Chemical Characterization of Nanoparticles and Volatiles Present in Mainstream Hookah Smoke. AEROSOL SCIENCE AND TECHNOLOGY : THE JOURNAL OF THE AMERICAN ASSOCIATION FOR AEROSOL RESEARCH 2019; 53:1023-1039. [PMID: 33041429 PMCID: PMC7546025 DOI: 10.1080/02786826.2019.1628342] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Waterpipe smoking is becoming more popular worldwide and there is a pressing need to better characterize the exposure of smokers to chemical compounds present in the mainstream smoke. We report real-time measurements of mainstream smoke for carbon monoxide, volatile organic compounds and nanoparticle size distribution and chemical composition using a custom dilution flow tube. A conventional tobacco mixture, a dark leaf unwashed tobacco and a nicotine-free herbal tobacco were studied. Results show that carbon monoxide is present in the mainstream smoke and originates primarily from the charcoal used to heat the tobacco. Online measurements of volatile organic compounds in mainstream smoke showed an overwhelming contribution from glycerol. Gas phase analysis also showed that very little filtration of the gas phase products is provided by the percolation of mainstream smoke through water. Waterpipe smoking generated high concentrations of 4-100 nm nanoparticles, which were mainly composed of sugar derivatives and especially abundant in the first 10 min of the smoking session. These measured emissions of volatiles and particles are compared with those from a reference cigarette (3R4F) and represent the equivalent of the emission of one or more entire cigarettes for a single puff of hookah smoke. Considerations related to the health impacts of waterpipe smoking are discussed.
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Affiliation(s)
- Véronique Perraud
- Department of Chemistry, University of California, Irvine, California, USA
| | - Michael J. Lawler
- Department of Chemistry, University of California, Irvine, California, USA
| | - Kurtis T. Malecha
- Department of Chemistry, University of California, Irvine, California, USA
| | | | - David Herman
- School of Medicine, University of California, Irvine, California, USA
| | - Norbert Staimer
- Department of Epidemiology, University of California, Irvine, California, USA
| | | | | | - James N. Smith
- Department of Chemistry, University of California, Irvine, California, USA
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Alshogran OY, Magarbeh LS, Alzoubi KH, Saleh MI, Khabour OF. Evaluation of the impact of waterpipe tobacco smoke exposure on the activity and expression of rat hepatic CYP450: a pharmacokinetic study. Inhal Toxicol 2018; 30:519-526. [PMID: 30734611 DOI: 10.1080/08958378.2019.1569182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 12/23/2018] [Accepted: 01/09/2019] [Indexed: 10/27/2022]
Abstract
Waterpipe smoke contains many toxic constituents that can alter drug pharmacokinetics. This study assessed the effect of waterpipe smoke exposure on the activity and expression of CYP450 enzymes in rats. Animals (n = 10/group) were exposed to either waterpipe smoke or side-stream cigarette smoke for 1 h/day (6 days/week) for 31 days, or fresh air (control). An intragastric cocktail solution containing three probe drugs, phenacetin, chlorzoxazone and testosterone was administered to assess the activity of CYP1A2, CYP2E1 and CYP3A, respectively. Serum concentrations were determined using LC-MS/MS and the pharmacokinetic parameters were calculated. The mRNA expression of hepatic enzymes was also quantified. Waterpipe and cigarette smoke exposure did not significantly alter the pharmacokinetics of phenacetin, chlorzoxazone and testosterone. For example, the clearance and drug exposure values were comparable among groups for all probe drugs. Additionally, there was no significant effect of waterpipe and cigarette smoke on mRNA expression of hepatic CYP1A2, CYP2E1 and CYP3A2. The results demonstrate that waterpipe smoke exposure had no effect on the functional expression of three key CYP450 isoforms in rats. Future research is required with longer exposure periods to waterpipe smoke. Such work serves to enhance current understanding of effect of waterpipe smoke exposure on pharmacokinetics.
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Affiliation(s)
- Osama Y Alshogran
- a Department of Clinical Pharmacy Faculty of Pharmacy , Jordan University of Science and Technology , Irbid , Jordan
| | - Leen S Magarbeh
- a Department of Clinical Pharmacy Faculty of Pharmacy , Jordan University of Science and Technology , Irbid , Jordan
| | - Karem H Alzoubi
- a Department of Clinical Pharmacy Faculty of Pharmacy , Jordan University of Science and Technology , Irbid , Jordan
| | - Mohammad I Saleh
- b Department of Biopharmaceutics and Clinical Pharmacy , The University of Jordan , Amman , Jordan
| | - Omar F Khabour
- c Department of Medical Laboratory Sciences Faculty of Applied Medical Sciences , Jordan University of Science and Technology , Irbid , Jordan
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Getachew B, Payne JB, Vu M, Pillai D, Shah J, Levine H, Berg CJ. Perceptions of Alternative Tobacco Products, Anti-tobacco Media, and Tobacco Regulation among Young Adults: A Qualitative Study. Am J Health Behav 2018; 42:118-130. [PMID: 29973316 DOI: 10.5993/ajhb.42.4.11] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objectives With increased alternative tobacco product (ATP) use and lagging public health action, we explored perceptions of ATPs, anti-tobacco messaging, and tobacco regulation among young adults. Methods Semi-structured interviews were conducted with 60 Georgia college students aged 18-25 using: (1) cigarettes, little cigars/cigarillos (LCCs), smokeless tobacco, or e-cigarettes ≥15 days of the past 30; or (2) hookah ≥10 of the past 30 days (due to lower frequency of use). Of 99 participants recruited, 80 consented, and 60 participated. Results Participants were on average 21.01 years old (SD = 2.07), 56.7% women, and 65.0% black; 56.7% reported current use of cigarettes, 43.3% LCCs, 26.7% smokeless tobacco, 45.0% e-cigarettes, and 41.7% hookah. Cigarettes were perceived as most harmful to health and most addictive. E-cigarettes and hookah were generally regarded as lowest risk. Many indicated that ATP risk information was limited or inaccessible and that most anti-tobacco campaigns were irrelevant to ATPs. Participants requested more research and dissemination of evidence regarding ATP risks and need for ATP regulation. Conclusions In light of low risk perceptions regarding ATPs among young adults, research, anti-tobacco campaigns, and regulation must address their known and potential risks.
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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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Jawad M, Eissenberg T, Salman R, Soule E, Alzoubi KH, Khabour OF, Karaoghlanian N, Baalbaki R, El Hage R, Saliba NA, Shihadeh A. Toxicant inhalation among singleton waterpipe tobacco users in natural settings. Tob Control 2018; 28:181-188. [PMID: 29807946 DOI: 10.1136/tobaccocontrol-2017-054230] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 04/23/2018] [Accepted: 04/25/2018] [Indexed: 11/03/2022]
Abstract
BACKGROUND Studies that assess waterpipe tobacco smoking behaviour and toxicant exposure generally use controlled laboratory environments with small samples that may not fully capture real-world variability in human behaviour and waterpipe products. This study aimed to conduct real-time sampling of waterpipe tobacco use in natural environments using an in situ device. METHODS We used the REALTIME sampling instrument: a validated, portable, self-powered device designed to sample automatically a fixed percentage of the aerosol flowing through the waterpipe mouthpiece during every puff. We recruited participants at café and home settings in Jordan and measured puffing behaviour in addition to inhalation exposure of total particulate matter (TPM), carbon monoxide (CO), nicotine, polycyclic aromatic hydrocarbons and volatile aldehydes. We correlated total inhaled volume with five selected toxicants and calculated the regression line of this relationship. RESULTS Averaged across 79 singleton sessions (52% male, mean age 27.0, 95% home sessions), sessions lasted 46.9 min and participants drew 290 puffs and inhaled 214 L per session. Mean quantities of inhaled toxicants per session were 1910 mg TPM, 259 mg CO, 5.0 mg nicotine, 117 ng benzo[a]pyrene and 198 ng formaldehyde. We found positive correlations between total inhaled volume and TPM (r=0.472; p<0.001), CO (r=0.751; p<0.001), nicotine (r=0.301, p=0.035) and formaldehyde (r=0.526; p<0.001), but a non-significant correlation for benzo[a]pyrene (r=0.289; p=0.056). CONCLUSIONS In the natural environment, waterpipe tobacco users inhale large quantities of toxicants that induce tobacco-related disease, including cancer. Toxicant content per waterpipe session is at least equal, but for many toxicants several magnitudes of order higher, than that of a cigarette. Health warnings based on early controlled laboratory studies were well founded; if anything our findings suggest a greater exposure risk.
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Affiliation(s)
- Mohammed Jawad
- Public Health Policy Evaluation Unit, Imperial College London, Hammersmith, UK
| | - Thomas Eissenberg
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA.,Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Rola Salman
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA.,Mechanical Engineering Department, American University of Beirut, Beirut, Lebanon
| | - Eric Soule
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA.,Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Karem H Alzoubi
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Omar F Khabour
- Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid, Jordan.,Faculty of Applied Medical Sciences, Taibah University, Medina, Saudi Arabia
| | - Nareg Karaoghlanian
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA.,Mechanical Engineering Department, American University of Beirut, Beirut, Lebanon
| | - Rima Baalbaki
- Department of Chemistry, American University of Beirut, Beirut, Lebanon
| | - Rachel El Hage
- Department of Chemistry, American University of Beirut, Beirut, Lebanon
| | - Najat A Saliba
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA.,Mechanical Engineering Department, American University of Beirut, Beirut, Lebanon
| | - Alan Shihadeh
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA.,Mechanical Engineering Department, American University of Beirut, Beirut, Lebanon
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Khabour OF, Alzoubi KH, Al-Sawalha N, Ahmad MB, Shihadeh A, Eissenberg T. The effect of chronic exposure to waterpipe tobacco smoke on airway inflammation in mice. Life Sci 2018; 200:110-114. [PMID: 29555589 DOI: 10.1016/j.lfs.2018.03.034] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 03/08/2018] [Accepted: 03/16/2018] [Indexed: 12/14/2022]
Abstract
PURPOSE Acute exposure of experimental animals to waterpipe tobacco smoke has been shown to induce lung inflammation and injury. The aim of this study was to investigate the effect of chronic exposure to waterpipe smoke on inflammatory markers and oxidative stress in the mouse lung. METHOD Using a whole-body exposure system, animals were exposed to waterpipe smoke for 6 weeks with a one-hour daily exposure for 5 days a week. RESULTS Exposure to waterpipe tobacco smoke induced the recruitment of inflammatory cells to the airway. Significant elevation in macrophages, lymphocytes and neutrophils was detected in the bronchoalveolar lavage fluid of exposed animals (P < 0.01). Furthermore, levels of catalase, glutathione peroxidase (GPx) and superoxide dismutase (SOD) in the lung homogenates were elevated (P < 0.05). Finally, waterpipe smoking altered the levels of a panel of inflammatory cytokines including TNFα, IL-1 β, IL-6, IL-10 and IL-12 biomarkers in the lung of exposed animals (P < 0.05). CONCLUSION These results support the notion that waterpipe tobacco smoking exerts harmful respiratory health effects.
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Affiliation(s)
- Omar F Khabour
- Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan.
| | - Karem H Alzoubi
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Nour Al-Sawalha
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Mohammad Bani Ahmad
- Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Alan Shihadeh
- Mechanical Engineering Department, American University of Beirut, Beirut, Lebanon; Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, United States
| | - Thomas Eissenberg
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, United States; Department of Psychology and Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, United States
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Abstract
Objectives We examined the receptivity of non-college young adult hookah users to health warning labels. Methods We conducted in-person qualitative interviews with 23 hookah users, aged 18-29 in Austin, Texas, who were not currently enrolled in college/university. Data were transcribed, coded, and thematically analyzed using NVivo Pro, version 11. Results Gaps in knowledge were evident regarding the level of chemical exposure, cancer risks, and negative health consequences of hookah use. Respondents preferred warning labels that factually listed health consequences rather than labels that used "sensationalistic" wording (eg, "kills") or technical terms. Participants thought placement of hookah warning labels would be most effective on product packaging or on the door of establishments selling hookah. Respondents thought most of the warning labels would be effective in deterring hookah use; however, the majority stated they would likely continue to use hookah over the next year. Conclusions Non-college-attending young adult hookah users preferred hookah health warning labels that are simple, factual, informative, and non-sensationalistic. These results may inform regulations regarding the packaging of tobacco products, specifically in the design and placement of warning labels, which may result in better user message receptivity.
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Talio MC, Alesso M, Acosta M, Wills VS, Fernández LP. Sequential determination of nickel and cadmium in tobacco, molasses and refill solutions for e-cigarettes samples by molecular fluorescence. Talanta 2017; 174:221-227. [PMID: 28738572 DOI: 10.1016/j.talanta.2017.06.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 06/01/2017] [Accepted: 06/03/2017] [Indexed: 12/31/2022]
Abstract
In this work, a new procedure was developed for separation and preconcentration of nickel(II) and cadmium(II) in several and varied tobacco samples. Tobacco samples were selected considering the main products consumed by segments of the population, in particular the age (youth) and lifestyle of the consumer. To guarantee representative samples, a randomized strategy of sampling was used. In the first step, a chemofiltration on nylon membrane is carried out employing eosin (Eo) and carbon nanotubes dispersed in sodium dodecylsulfate (SDS) solution (phosphate buffer pH 7). In this condition, Ni(II) was selectively retained on the solid support. After that, the filtrate liquid with Cd(II) was re-conditioned with acetic acid /acetate buffer solution (pH 5) and followed by detection. A spectrofluorimetric determination of both metals was carried out, on the solid support and the filtered aqueous solution, for Ni(II) and Cd(II), respectively. The solid surface fluorescence (SSF) determination was performed at λem = 545nm (λex = 515nm) for Ni(II)-Eo complex and the fluorescence of Cd(II)-Eo was quantified in aqueous solution using λem = 565nm (λex = 540nm). The calibration graphs resulted linear in a range of 0.058-29.35μgL-1 for Ni(II) and 0.124-56.20μgL-1 for Cd(II), with detection limits of 0.019 and 0.041μgL-1 (S/N = 3). The developed methodology shows good sensitivity and adequate selectivity, and it was successfully applied to the determination of trace amounts of nickel and cadmium present in tobacco samples (refill solutions for e-cigarettes, snuff used in narguille (molasses) and traditional tobacco) with satisfactory results. The new methodology was validated by ICP-MS with adequate agreement. The proposed methodology represents a novel fluorescence application to Ni(II) and Cd(II) quantification with sensitivity and accuracy similar to atomic spectroscopies, introducing for the first time the quenching effect on SSF.
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Affiliation(s)
- María Carolina Talio
- Instituto de Química de San Luis (INQUISAL-CONICET), Chacabuco y Pedernera, 5700 San Luis, Argentina
| | - Magdalena Alesso
- Área de Química Analítica, Facultad de Química, Bioquímica y Farmacia, Universidad Nacional de San Luis, San Luis, Argentina
| | - Mariano Acosta
- Instituto de Química de San Luis (INQUISAL-CONICET), Chacabuco y Pedernera, 5700 San Luis, Argentina
| | | | - Liliana P Fernández
- Área de Química Analítica, Facultad de Química, Bioquímica y Farmacia, Universidad Nacional de San Luis, San Luis, Argentina; Instituto de Química de San Luis (INQUISAL-CONICET), Chacabuco y Pedernera, 5700 San Luis, Argentina.
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Park SH, Duncan DT, Shahawy OE, Shearston JA, Lee L, Tamura K, Sherman SE, Weitzman M. Analysis of State-Specific Prevalence, Regional Differences, and Correlates of Hookah Use in U.S. Adults, 2012-2013. Nicotine Tob Res 2017; 19:1365-1374. [PMID: 27613949 PMCID: PMC5896515 DOI: 10.1093/ntr/ntw229] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 09/02/2016] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To investigate the state-specific prevalence, regional differences, and correlates of hookah use among U.S. adults. METHODS We analyzed the most recent nationally representative data of adults from the National Adult Tobacco Survey (NATS) 2012-2013 (n = 60192). State-specific prevalence of lifetime and current hookah use was calculated and mapped. Multivariate logistic regression was performed to determine the association between sociodemographic characteristics, regional differences, and hookah use. RESULTS Among U.S. adults (≥18 years), overall prevalence of lifetime hookah use was 12.3%, while current use was 3.9%. Mapping of state-specific prevalence revealed that the West tended to have higher rates of use, while the South tended to have lower ones. In the adjusted model, we observed that current hookah use was positively associated with younger adults, males, non-Hispanic adults, those with higher education and income statuses, being single, those living in the West, and current cigarette use. CONCLUSION The prevalence of hookah use varies by state, region, and sociodemographic characteristics among adults. Future research, including longitudinal studies, are needed to identify geographic and sociodemographic characteristics and trends among hookah users, investigate hookah-related health outcomes, and evaluate targeted public health efforts aimed at this emerging threat. IMPLICATIONS This study investigates state-level prevalence, regional differences, and sociodemographic characteristics of hookah use among U.S. adults, using the most recent NATS. Hookah use was positively associated with younger adults and those living in the West. This study adds to the understanding of the geographic and sociodemographic factors underlying hookah use, which can be used to develop much needed evidence-based regulations and programs that are responsive to the needs of different risk groups.
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Affiliation(s)
- Su Hyun Park
- Department of Pediatrics, New York University School of Medicine, New York, NY
| | - Dustin T Duncan
- Department of Population Health, New York University School of Medicine, New York, NY
- College of Global Public Health, New York University, New York, NY
| | - Omar El Shahawy
- Department of Population Health, New York University School of Medicine, New York, NY
- New York University in Abu Dhabi, Public Health Research Center, Abu Dhabi, UAE
| | - Jenni A Shearston
- Department of Population Health, New York University School of Medicine, New York, NY
- College of Global Public Health, New York University, New York, NY
- New York University in Abu Dhabi, Public Health Research Center, Abu Dhabi, UAE
| | - Lily Lee
- Department of Pediatrics, New York University School of Medicine, New York, NY
- Brooklyn College, New York, NY
| | - Kosuke Tamura
- Department of Population Health, New York University School of Medicine, New York, NY
| | - Scott E Sherman
- Department of Population Health, New York University School of Medicine, New York, NY
- College of Global Public Health, New York University, New York, NY
- New York University in Abu Dhabi, Public Health Research Center, Abu Dhabi, UAE
| | - Michael Weitzman
- Department of Pediatrics, New York University School of Medicine, New York, NY
- College of Global Public Health, New York University, New York, NY
- New York University in Abu Dhabi, Public Health Research Center, Abu Dhabi, UAE
- Department of Environmental Medicine, New York University, New York, NY
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Eichhorn L, Michaelis D, Kemmerer M, Jüttner B, Tetzlaff K. Carbon monoxide poisoning from waterpipe smoking: a retrospective cohort study. Clin Toxicol (Phila) 2017; 56:264-272. [PMID: 28906147 DOI: 10.1080/15563650.2017.1375115] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Waterpipe smoking may increasingly account for unintentional carbon monoxide poisoning, a serious health hazard with high morbidity and mortality. We aimed at identifying waterpipe smoking as a cause for carbon monoxide poisoning in a large critical care database of a specialty care referral center. METHODS This retrospective cohort study included patients with a history of exposure to waterpipe smoking and carbon monoxide blood gas levels >10% or presence of clinical symptoms compatible with CO poisoning admitted between January 2013 and December 2016. Patients' initial symptoms and carbon monoxide blood levels were retrieved from records and neurologic status was assessed before and after hyperbaric oxygen treatment. RESULTS Sixty-one subjects with carbon monoxide poisoning were included [41 males, 20 females; mean age 23 (SD ± 6) years; range 13-45] with an initial mean carboxyhemoglobin of 26.93% (SD ± 9.72). Most common symptoms included syncope, dizziness, headache, and nausea; 75% had temporary syncope. Symptoms were not closely associated with blood COHb levels. CONCLUSION CO poisoning after waterpipe smoking may present in young adults with a wide variability of symptoms from none to unconsciousness. Therefore diagnosis should be suspected even in the absence of symptoms.
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Affiliation(s)
- Lars Eichhorn
- a Department of Anesthesiology and Intensive Care Medicine , University Hospital of Bonn , Bonn , North Rhine-Westphalia , Germany
| | - Dirk Michaelis
- b Asklepios Paulinen Klinik Wiesbaden , Wiesbaden , Hessen , Germany.,c Druckkammerzentrum RMT GmbH , Wiesbaden , Hessen , Germany
| | | | - Björn Jüttner
- d Department of Anesthesiology , Hanover Medical School , Hannover , Niedersachsen , Germany
| | - Kay Tetzlaff
- e Department of Sports Medicine , University of Tübingen , Tübingen , Baden-Württemberg , Germany
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Ozouni Davaji RB, Dadban Shahamat Y, Hajili Davaji F, Mirkarimi K, Charkazi A, Pahlavanzadeh B, Seydghasemi NS, Sharifirad G, Moodi M, Elahi A. Patterns, Beliefs, Norms and Perceived Harms of Hookah Smoking in North Iran. Asian Pac J Cancer Prev 2017; 18:823-830. [PMID: 28441793 PMCID: PMC5464506 DOI: 10.22034/apjcp.2017.18.3.823] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Introduction: Hookah smoking is considered as a public health threat around the globe. The aim of this study was to investigatethe hookah smoking patterns, beliefs, norms and perceived harms in Golestan province of Iran. Methods: A cross-sectional study was conducted on 395 hookah smokers using convenience sampling method in 2015. To collect data, Heinz’s hookah patternwas utilized. Ordinal regression models were used to exploring of covariates related to the odds of life time, last-30-day, and current hookah use. Results: In general, 357 (90.4%) subjects were male smokers. Most of subjects smoked hookah in café (62.2%) and with friends (75.6%). The majority of them (71.1%) did not consider themselves as a hooked person. Cigarette smoking (OR =.65, 95 % CI. 42-.98), low perceived addictiveness of hookah than cigarettes (OR =2.33, 95 % CI 1.45-3.73), Social context of hookah smoking with friends in café (OR =1.14, 95 % CI 1.08-1.2), and number of close friends who smoked hookah (OR =1.38, 95 % CI 1.18-1.61) were effective variables affected the past month use of hookah. Conclusion Development, implementation and assessment of interventions particularly adapted to hookah smoking regarding increase of perceived harm of hookah than cigarette and its probable addiction focusing on close friends appeared to be beneficial.
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Affiliation(s)
- Rahman Berdi Ozouni Davaji
- Health Management and Social Development Research Center, Golbarg Aval St, South Motahhari Av, Karimi Sq, Gorgan, Iran.
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Al-Sawalha NA, Migdadi AM, Alzoubi KH, Khabour OF, Qinna NA. Effect of waterpipe tobacco smoking on airway inflammation in murine model of asthma. Inhal Toxicol 2017; 29:46-52. [PMID: 28330430 DOI: 10.1080/08958378.2017.1280105] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE There has been an increase in the popularity of waterpipe tobacco smoking (WTS) worldwide, especially in the younger population, including asthma patients. In this study, we investigated the effects of waterpipe smoking on airway inflammation, cytokine levels and oxidative stress markers in an antigen-driven murine model of asthma. MATERIALS AND METHODS Balb/c mice were divided into four groups; (1) control (received fresh air, ovalbumin sensitization and saline challenge), (2) WTS (received WTS, ovalbumin sensitization and saline challenge), (3) Ova S/C (received fresh air, ovalbumin sensitization and ovalbumin challenge) and (4) simultaneous WTS and Ova S/C (received WTS, ovalbumin sensitization and ovalbumin challenge). Airway inflammatory cells were evaluated in the broncho-alveolar lavage fluid. Cytokines [interleukin (IL)-13, 10 and 18] and oxidative stress markers [superoxide dismutase (SOD), catalase and glutathione peroxidase (GPx)] were evaluated in the lung homogenates. RESULTS Chronic exposure to WTS significantly increased the number of airway inflammatory cells in mice, specifically: eosinophils, neutrophils, macrophages and lymphocytes. The level of IL-13 in the lungs was increased and the level of IL-10 was reduced (p < 0.05) by WTS. Chronic WTS potentiated the increase in inflammatory cells induced by Ova S/C (p < 0.05). The level of IL-13 in the lungs was increased by simultaneous WTS and Ova S/C (p < 0.05) while, levels of IL-10, IL-18, SOD, catalase and GPx in the lungs were not affected. CONCLUSIONS Chronic WTS exposure induced airway inflammation in control mice and enhanced airway inflammation in murine model of asthma.
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Affiliation(s)
- Nour A Al-Sawalha
- a Faculty of Pharmacy , Jordan University of Science and Technology , Irbid , Jordan
| | - Ala'a M Migdadi
- 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
| | - Nidal A Qinna
- d Faculty of Pharmacy and Biomedical Sciences , University of Petra , Amman , Jordan
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Abstract
BACKGROUND Despite the dangers associated with hookah tobacco smoking, use and popularity in the United States among young adults continue to increase. While quantitative studies have assessed users' attitudes toward hookah, qualitative research can provide a more in-depth description of positive and negative attitudes and beliefs associated with hookah use. OBJECTIVES To determine outcome expectancies associated with hookah use among young adults. METHODS We conducted six focus groups in 2013 to identify outcome expectancies associated with hookah use. Participants (N = 40) were young adults aged 18-23 who reported hookah use in the past three months. Using Outcome Expectancy Theory perspective, we posed the question "Hookah smoking is _______?" to elicit words or phrases that users associate with hookah use. RESULTS Over 75% of the users' hookah use outcome expectancies were positive, including associating hookah smoking with relaxation and a social experience. Content analysis of the words engendered six themes. These themes included Social Appeal, Physical Attractiveness, Pleasant Smoke, Comparison to Cigarettes, Relaxation, and Deterrents. Fewer negative hookah use expectancy words and phrases were identified, but included "tar" and "cough." CONCLUSIONS The findings suggest that participants lacked basic knowledge about hookah tobacco smoking, had misconceptions about its danger, and had many positive associations with hookah use. Incorporating components addressing positive hookah expectancies may improve the efficacy of established and new hookah use prevention and cessation interventions and policies.
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Affiliation(s)
- Tracey E Barnett
- a Epidemiology, University of Florida , Gainesville , Florida , USA
| | - Felix E Lorenzo
- b Social & Behavioral Sciences Program , University of Florida , Gainesville , Florida , USA
| | - Eric K Soule
- c Department of Psychology , Virginia Commonwealth University , Richmond , Virginia , USA
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Kim KH, Kabir E, Jahan SA. Waterpipe tobacco smoking and its human health impacts. JOURNAL OF HAZARDOUS MATERIALS 2016; 317:229-236. [PMID: 27285594 DOI: 10.1016/j.jhazmat.2016.05.075] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 01/23/2016] [Accepted: 05/25/2016] [Indexed: 05/12/2023]
Abstract
Waterpipe tobacco smoking (WTS, also known as hookah, shisha, narghile, and many other names) involves passing tobacco smoke through water prior to inhalation by the consumer. As the number of waterpipe smokers is rising rapidly, there is growing concern over the use of WTS, particularly as there has been a widely held misconception that WTS is free from health hazards. In reality, it is associated with a variety of adverse health outcomes on both a short- and long-term basis. Hence, it is desirable to develop advanced techniques for surveillance, intervention, and regulatory/policy frameworks specific to the production and use of waterpipe tobacco. This review is written to survey the types and extent of pollutants released from its use and their potential health risks. A review of the present regulation guidelines is also included.
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Affiliation(s)
- Ki-Hyun Kim
- Department of Civil and Environmental Engineering, Hanyang University, Seoul 04763, Republic of Korea.
| | - Ehsanul Kabir
- Department of Farm, Power, and Machinery, Bangladesh Agricultural University, Mymensingh, Bangladesh
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Primack BA, Carroll MV, Weiss PM, Shihadeh AL, Shensa A, Farley ST, Fine MJ, Eissenberg T, Nayak S. Systematic Review and Meta-Analysis of Inhaled Toxicants from Waterpipe and Cigarette Smoking. Public Health Rep 2016; 131:76-85. [PMID: 26843673 PMCID: PMC4716475 DOI: 10.1177/003335491613100114] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Waterpipe tobacco smoking (WTS) is an emerging trend worldwide. To inform public health policy and educational programming, we systematically reviewed the biomedical literature to compute the inhaled smoke volume, nicotine, tar, and carbon monoxide (CO) associated with a single WTS session and a single cigarette. METHODS We searched seven biomedical bibliographic databases for controlled laboratory or natural environment studies designed to mimic human tobacco consumption. Included studies quantified the mainstream smoke of a single cigarette and/or single WTS session for smoke volume, nicotine, tar, and/or CO. We conducted meta-analyses to calculate summary estimates for the inhalation of each unique substance for each mode of tobacco consumption. We assessed between-study heterogeneity using chi-squared and I-squared statistics. RESULTS Sufficient data from 17 studies were available to derive pooled estimates for inhalation of each exposure via each smoking method. Two researchers working independently abstracted measurement of smoke volume in liters, and nicotine, tar, and CO in milligrams. All numbers included in meta-analyses matched precisely between the two researchers (100% agreement, Cohen's k=1.00). Whereas one WTS session was associated with 74.1 liters of smoke inhalation (95% confidence interval [CI] 38.2, 110.0), one cigarette was associated with 0.6 liters of smoke (95% CI 0.5, 0.7). One WTS session was also associated with higher levels of nicotine, tar, and CO. CONCLUSIONS One WTS session consistently exposed users to larger smoke volumes and higher levels of tobacco toxicants compared with one cigarette. These computed estimates may be valuable to emphasize in prevention programming.
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Affiliation(s)
| | | | - Patricia M. Weiss
- University of Pittsburgh Health Sciences Library System, Pittsburgh, PA
| | | | - Ariel Shensa
- University of Pittsburgh School of Medicine, Pittsburgh, PA
| | | | | | | | - Smita Nayak
- Swedish Center for Research and Innovation, Swedish Health Services, Seattle, WA
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Sustained Waterpipe Tobacco Smoking and Trends Over Time. Am J Prev Med 2015; 49:859-67. [PMID: 26385163 PMCID: PMC4780332 DOI: 10.1016/j.amepre.2015.06.030] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 05/26/2015] [Accepted: 06/29/2015] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Use of waterpipe tobacco smoking (WTS) is now prevalent among U.S. adolescents. However, the more clinically relevant questions are whether users exhibit sustained patterns of use and whether use is increasing over time relative to other tobacco products. We aimed to examine factors associated with sustained WTS among U.S. adolescents and to compare prevalence trends between WTS and other tobacco products. METHODS The Monitoring the Future project began assessing WTS among 12th-grade students in 2010. In 2014, we conducted multivariable regression analyses to examine correlates of sustained WTS, which we defined as use at least six times in the past 12 months. We used trend analysis to compare use of WTS and other types of tobacco. RESULTS Of the 8,737 participants queried from 2010 to 2013, 18.8% (1,639) reported past-year WTS, whereas 7.2% (627) reported sustained use. Sustained WTS was inversely associated with female sex (versus male, OR=0.78, 95% CI=0.63, 0.96); African American race (versus Caucasian, OR=0.26, 95% CI=0.14, 0.48); and increased number of parents in the home (p<0.001). Sustained WTS was positively associated with increased school-level parental education (p=0.002); lower grades (p=0.005); truancy (p<0.001); lower religiosity (p<0.001); more evenings out per week (p<0.001); and dating (p=0.03). Visual inspection and non-overlapping CIs suggest that both past-year and sustained WTS are significantly increasing relative to cigarette use but not small cigar use. CONCLUSIONS Given the prevalence of sustained WTS and indications of its increase over time, it should be included in efforts related to tobacco surveillance and intervention.
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Khabour O, Alzoubi KH, Abu Thiab TM, Al-Husein BA, Eissenberg T, Shihadeh A. Changes in the expression and protein level of matrix metalloproteinases after exposure to waterpipe tobacco smoke. Inhal Toxicol 2015; 27:689-93. [PMID: 26484568 PMCID: PMC4890709 DOI: 10.3109/08958378.2015.1085471] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Waterpipe smoking has become a worldwide epidemic with health consequences that only now are beginning to be understood fully. Because waterpipe use involves inhaling a large volume of toxicant-laden smoke that can cause inflammation, some health consequences may include inflammation-mediated lung injury. Excess matrix metalloproteinase expression is a key step in the etiology of toxicant exposure-driven inflammation and injury. In this study, changes in the level and mRNA of major matrix metalloproteinases (MMP-1, -9, and -12) in the lungs of mice following exposure to waterpipe smoke were investigated. Balb/c mice were exposed to waterpipe smoke for one hour daily, over a period of 2 or 8 weeks. Control mice were exposed to fresh air only. ELISA and real-time PCR techniques were used to determine the protein and mRNA levels of MMP-1, -9, and -12 in the lungs. Our findings showed that MMP-1, -9, and -12 levels in the lung significantly increased after both 2 (p < 0.05) and 8 weeks (p < 0.01) exposures. Similarly, RT-PCR findings showed that mRNA of those proteinases significantly increased following 2 (p < 0.01) and 8 weeks (p < 0.001) exposures. In conclusion, waterpipe smoking is associated strongly with lung injury as measured by elevation in the expression of MMPs in the lung tissue.
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Affiliation(s)
- Omar Khabour
- Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Karem H. Alzoubi
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Tuqa M. Abu Thiab
- Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Belal A. Al-Husein
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Thomas Eissenberg
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
| | - Alan Shihadeh
- Mechanical Engineering Department, American University of Beirut, Beirut, Lebanon
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
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Zhou S, Weitzman M, Vilcassim R, Wilson J, Legrand N, Saunders E, Travers M, Chen LC, Peltier R, Gordon T. Air quality in New York City hookah bars. Tob Control 2015; 24:e193-8. [PMID: 25232045 PMCID: PMC4390442 DOI: 10.1136/tobaccocontrol-2014-051763] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 08/26/2014] [Indexed: 11/03/2022]
Abstract
BACKGROUND Hookahs are increasingly being used in the USA and elsewhere. Despite the popularity of hookah bars, there is a paucity of research assessing the health effects of hookah smoke, and although New York City (NYC) bans indoor tobacco smoking, hookah lounges claim that they only use herbal products without tobacco. This study investigated levels of multiple indices of indoor air pollution in hookah bars in NYC. METHODS Air samples were collected in 8 hookah bars in NYC. Along with venue characteristics, real-time measurements of fine particulate matter (PM2.5), black carbon (BC), and carbon monoxide (CO), and total gravimetric PM, elemental carbon (EC), organic carbon (OC), and nicotine were collected in 1-2 hour sessions. RESULTS Overall, levels of indoor air pollution increased with increasing numbers of active hookahs smoked. The mean (SD) real time PM2.5 level was 1179.9 (939.4) µg/m(3), whereas the filter-based total PM mean was 691.3 (592.6) µg/m(3). The mean real time BC level was 4.1 (2.3) µg/m(3), OC was 237.9 (112.3) µg/m(3), and CO was 32 (16) ppm. Airborne nicotine was present in all studied hookah bars (4.2 (1.5) µg/m(3)). CONCLUSIONS These results demonstrate that despite the ban on smoking tobacco products, at the very least, some NYC hookah bars are serving tobacco-based hookahs, and have elevated concentrations of indoor air pollutants that may present a health threat to visitors and employees. Therefore, there is an urgent need for better air quality monitoring in such establishments and policies to combat this emerging public health threat.
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Affiliation(s)
- Sherry Zhou
- New York University School of Medicine, New York, NY
| | - Michael Weitzman
- Department of Environmental Medicine, New York University School of Medicine, New York, NY
- Department of Pediatrics, New York University School of Medicine, New York, NY
| | - Ruzmyn Vilcassim
- Department of Environmental Medicine, New York University School of Medicine, New York, NY
| | | | | | - Eric Saunders
- Department of Environmental Medicine, New York University School of Medicine, New York, NY
| | | | - Lung-Chi Chen
- Department of Environmental Medicine, New York University School of Medicine, New York, NY
| | - Richard Peltier
- Division of Environmental Health Science, University of Massachusetts, Amherst, MA
| | - Terry Gordon
- Department of Environmental Medicine, New York University School of Medicine, New York, NY
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Brinkman MC, Kim H, Gordon SM, Kroeger RR, Reyes IL, Deojay DM, Chitwood C, Lane TE, Clark PI. Design and Validation of a Research-Grade Waterpipe Equipped With Puff Topography Analyzer. Nicotine Tob Res 2015; 18:785-93. [PMID: 26377514 DOI: 10.1093/ntr/ntv180] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 08/07/2015] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Worldwide, commercially available waterpipes vary widely in design and durability, including differences in fabrication materials, degree of leak-tight fit, and flow path diameter. Little is known about how the components of the waterpipe may influence puffing behavior and user's exposure to toxins. To systematically evaluate exposure, it is necessary to use a standardized research-grade waterpipe (RWP) when conducting clinical and laboratory-based trials. METHODS We developed a RWP that is configured with an in-line topography system which allows real-time measurement and recording of the smoke volume drawn through the RWP. The RWP was calibrated across the flow rate range expected for waterpipe tobacco smoking and the calibration was verified for known puff volumes using a smoking machine. Operation of the RWP was qualified in a cohort of experienced waterpipe smokers, each smoker using the RWP ad libitum in a laboratory setting while smoker topography and subjective effects data were collected. RESULTS RWP machine smoking was highly reproducible and yielded puff volumes that agreed well with true values. User acceptance was comparable, and puffing behavior was similar in pattern, with more frequent puffing in the beginning of the session, but significantly different in intensity from that used to estimate the majority of toxicant exposure reported in the literature. CONCLUSIONS The RWP operates with known precision and accuracy and is well accepted by experienced smokers. This tool can be used to determine the extent to which puffing behaviors are affected by the waterpipe design, components, and/or accessories, tobacco nicotine content, sweet flavorings and/or additives known to increase addictiveness. IMPLICATIONS This study describes a standardized RWP, equipped with a puffing topography analyzer, which can operate with known precision and accuracy, and is well-accepted by experienced smokers in terms of satisfaction and reward. The RWP is an important tool for determining if puffing behaviors, and thus estimated toxin exposures, are affected by the waterpipe design, components, and/or accessories, tobacco nicotine content, sweet flavorings, and/or additives that are known to increase addictiveness.
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Affiliation(s)
- Marielle C Brinkman
- Public Health Center for Tobacco Research, Battelle, Columbus, OH; Health and Analytics, Battelle, Columbus, OH;
| | - Hyoshin Kim
- Public Health Center for Tobacco Research, Battelle, Columbus, OH; Health and Analytics, Battelle, Seattle, WA
| | - Sydney M Gordon
- Public Health Center for Tobacco Research, Battelle, Columbus, OH; Health and Analytics, Battelle, Columbus, OH
| | - Robyn R Kroeger
- Public Health Center for Tobacco Research, Battelle, Columbus, OH; Health and Analytics, Battelle, Columbus, OH
| | - Iza L Reyes
- Public Health Center for Tobacco Research, Battelle, Columbus, OH
| | | | - Caleb Chitwood
- Public Health Center for Tobacco Research, Battelle, Columbus, OH
| | - Timothy E Lane
- Applied Biology and Aerosol Technology, Battelle, Columbus, OH
| | - Pamela I Clark
- School of Public Health, University of Maryland, College Park, MD
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Kassem NOF, Kassem NO, Jackson SR, Liles S, Daffa RM, Zarth AT, Younis MA, Carmella SG, Hofstetter CR, Chatfield DA, Matt GE, Hecht SS, Hovell MF. Benzene uptake in Hookah smokers and non-smokers attending Hookah social events: regulatory implications. Cancer Epidemiol Biomarkers Prev 2015; 23:2793-809. [PMID: 25416714 DOI: 10.1158/1055-9965.epi-14-0576] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Benzene is a human hematotoxicant and a leukemogen that causes lymphohematopoietic cancers, especially acute myelogenous leukemia. We investigated uptake of benzene in hookah smokers and non-smokers attending hookah social events in naturalistic settings where hookah tobacco was smoked exclusively. METHODS We quantified S-phenylmercapturic acid (SPMA), a metabolite of benzene, in the urine of 105 hookah smokers and 103 non-smokers. Participants provided spot urine samples the morning of and the morning after attending an indoor hookah-only smoking social event at a hookah lounge or in a private home. RESULTS Urinary SPMA levels in hookah smokers increased significantly following a hookah social event (P < 0.001). This increase was 4.2 times higher after hookah lounge events (P < 0.001) and 1.9 times higher after home events (P = 0.003). In non-smokers, urinary SPMA levels increased 2.6 times after hookah lounge events (P = 0.055); however, similar urinary SPMA levels were detected before and after home events, possibly indicating chronic exposure to benzene (P = 0.933). CONCLUSIONS Our data provide the first evidence for uptake of benzene in hookah smokers and non-smokers exposed to hookah tobacco secondhand smoke at social events in private homes compared with their counterparts in hookah lounges. Hookah tobacco smoke is a source of benzene exposure, a risk factor for leukemia. IMPACT Because there is no safe level of exposure to benzene, our results call for interventions to reduce or prevent hookah tobacco use, regulatory actions to limit hookah-related exposure to toxicants including benzene, initiate labeling of hookah-related products, and include hookah smoking in clean indoor air legislation.
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Prevalence and predictors of hookah use in US Air Force military recruits. Addict Behav 2015; 47:5-10. [PMID: 25841088 DOI: 10.1016/j.addbeh.2015.03.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 03/10/2015] [Accepted: 03/12/2015] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Hookah use has gained recent popularity among U.S. youth. The current study describes the characteristics and correlates associated with hookah use in late adolescent and young adult US Air Force (USAF) recruits. METHODS Data were obtained from a cross-sectional questionnaire of USAF personnel in Technical Training School at Joint Base San Antonio (N=10,997). Response rate was 78%. Logistic regression was used to analyze the associations between hookah use, demographic variables, other tobacco and nicotine containing product (TNCP) use, and the social environment. RESULTS The prevalence of ever hookah use was 28%; at least monthly hookah use was 10%. Increased hookah use was positively associated with Hispanic ethnicity (OR [odds ratio] 1.52; 95% CI: 1.25, 1.85), cigarette smoking (OR 4.05; CI: 3.41, 4.82) and smokeless tobacco use (OR 1.35; 95% CI: 1.07, 1.71). Hookah use was negatively associated with age (OR 0.84; 95% 0.71 to 1.00), living as married (OR 0.54; 95% CI: 0.40-0.72), African American (OR 0.53; 95% CI: 0.40, 0.69) and ≥4-year degree (OR 0.54; 95% CI: 0.35, 0.82). Hookah use was highest among recruits who "many or almost all" of their friends smoked cigarettes (OR 2.43; 95% CI: 1.80, 3.30) and for those who reported willingness to try a tobacco product that claims to be safer than cigarettes (OR 3.16; 95% CI: 2.64, 3.77). CONCLUSIONS Hookah use among military recruits is similar to the civilian population. A willingness to try TNCPs claiming to be safer than cigarettes may influence hookah use. Public health campaigns disseminating accurate information about hookah health risks may be needed to reduce hookah use among youth.
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The Effect of Waterpipe Tobacco Smoke Exposure on Learning and Memory Functions in the Rat Model. J Mol Neurosci 2015; 57:249-56. [PMID: 26160697 DOI: 10.1007/s12031-015-0613-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 06/29/2015] [Indexed: 01/06/2023]
Abstract
Tobacco smoking is a global health hazard that kills about 5 million people annually. Waterpipe smoking is among the most popular methods of tobacco consumption worldwide. In this study, we investigated whether waterpipe smoking impairs learning and memory in the hippocampus, a question of special concern due to the particular popularity of waterpipe use among youth. Additionally, possible molecular targets for expected learning and memory impairment were determined. In this study, rats were exposed to waterpipe smoke (WTS) by whole body exposure 1 h × 5 days/week, for 1 month, and outcomes were compared to a control group exposed only to fresh air. Outcomes included spatial learning and memory using the radial arm water maze (RAWM) and oxidative stress biomarkers (catalase, glutathione peroxidase (GPx), superoxide dismutase (SOD), glutathione (GSH), oxidized glutathione (GSSG), GSH/GSSG ratio). We found that WTS exposure led to impaired short- and long-term memory. This impairment was accompanied by reduced hippocampal activity of catalase, SOD, GPx, GSH, and GSH/GSSG, elevated GSSG, thus marked changes in oxidative stress biomarkers. In conclusion, there is reason for concern that WTS exposure may impair cognitive ability.
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Shihadeh A, Schubert J, Klaiany J, El Sabban M, Luch A, Saliba NA. Toxicant content, physical properties and biological activity of waterpipe tobacco smoke and its tobacco-free alternatives. Tob Control 2015; 24 Suppl 1:i22-i30. [PMID: 25666550 PMCID: PMC4345918 DOI: 10.1136/tobaccocontrol-2014-051907] [Citation(s) in RCA: 140] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 01/14/2015] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Waterpipe smoking using sweetened, flavoured tobacco products has become a widespread global phenomenon. In this paper, we review chemical, physical and biological properties of waterpipe smoke. DATA SOURCES Peer-reviewed publications indexed in major databases between 1991 and 2014. Search keywords included a combination of: waterpipe, narghile, hookah, shisha along with names of chemical compounds and classes of compounds, in addition to terms commonly used in cellular biology and aerosol sizing. STUDY SELECTION The search was limited to articles published in English which reported novel data on waterpipe tobacco smoke (WTS) toxicant content, biological activity or particle size and which met various criteria for analytical rigour including: method specificity and selectivity, precision, accuracy and recovery, linearity, range, and stability. DATA EXTRACTION Multiple researchers reviewed the reports and collectively agreed on which data were pertinent for inclusion. DATA SYNTHESIS Waterpipe smoke contains significant concentrations of toxicants thought to cause dependence, heart disease, lung disease and cancer in cigarette smokers, and includes 27 known or suspected carcinogens. Waterpipe smoke is a respirable aerosol that induces cellular responses associated with pulmonary and arterial diseases. Except nicotine, smoke generated using tobacco-free preparations marketed for 'health conscious' users contains the same or greater doses of toxicants, with the same cellular effects as conventional products. Toxicant yield data from the analytical laboratory are consistent with studies of exposure biomarkers in waterpipe users. CONCLUSIONS A sufficient evidence base exists to support public health interventions that highlight the fact that WTS presents a serious inhalation hazard.
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Affiliation(s)
- Alan Shihadeh
- Department of Mechanical Engineering, American University of Beirut, Beirut, Lebanon
- Department of Psychology, Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Jens Schubert
- Department of Safety of Pesticides, German Federal Institute for Risk Assessment, Berlin, Germany
| | - Joanne Klaiany
- Department of Chemistry, American University of Beirut, Beirut, Lebanon
| | - Marwan El Sabban
- Department of Human Morphology, American University of Beirut, Beirut, Lebanon
| | - Andreas Luch
- Department of Chemicals and Product Safety, German Federal Institute for Risk Assessment, Berlin, Germany
| | - Najat A Saliba
- Department of Psychology, Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Chemistry, American University of Beirut, Beirut, Lebanon
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Jawad M, Bakir AM, Ali M, Jawad S, Akl EA. Key health themes and reporting of numerical cigarette-waterpipe equivalence in online news articles reporting on waterpipe tobacco smoking: a content analysis. Tob Control 2015; 24:43-7. [PMID: 23868396 DOI: 10.1136/tobaccocontrol-2013-050981] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
INTRODUCTION There is anecdotal evidence that health messages interpreted from waterpipe tobacco smoking (WTS) research are inconsistent, such as comparing the health effects of one WTS session with that of 100 cigarettes. This study aimed to identify key health themes about WTS discussed by online news media, and how numerical cigarette-waterpipe equivalence (CWE) was being interpreted. METHODS We identified 1065 online news articles published between March 2011 and September 2012 using the 'Google Alerts' service. We screened for health themes, assessed statements mentioning CWE and reported differences between countries. We used logistic regression to identify factors associated with articles incorrectly reporting a CWE equal to or greater than 100 cigarettes, in the absence of any comparative parameter ('CWE ≥100 cigarettes'). RESULTS Commonly mentioned health themes were the presence of tobacco (67%) and being as bad as cigarettes (49%), and we report on differences between countries. While 10.8% of all news articles contained at least one positive health theme, 22.9% contained a statement about a CWE. Most of these (18.6% total) were incorrectly a CWE ≥100 cigarettes, a quarter of which were made by healthcare professionals/organisations. Compared with the Middle East, articles from the USA and the UK were the most significant predictors to contain a CWE ≥100 cigarettes statement. CONCLUSIONS Those wishing to write or publish information related to WTS may wish to avoid comparing WTS to cigarettes using numerical values as this is a major source of confusion. Future research is needed to address the impact of the media on the attitudes, initiation and cessation rates of waterpipe smokers.
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Affiliation(s)
- Mohammed Jawad
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Ali M Bakir
- Faculty of Medicine, Imperial College London, London, UK
| | - Mohammed Ali
- Faculty of Medicine, Imperial College London, London, UK
| | - Sena Jawad
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Elie A Akl
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada Department of Medicine, State University of New York at Buffalo, Buffalo, New York, USA
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Markowicz P, Löndahl J, Wierzbicka A, Suleiman R, Shihadeh A, Larsson L. A study on particles and some microbial markers in waterpipe tobacco smoke. THE SCIENCE OF THE TOTAL ENVIRONMENT 2014; 499:107-13. [PMID: 25181042 PMCID: PMC4297659 DOI: 10.1016/j.scitotenv.2014.08.055] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 07/29/2014] [Accepted: 08/19/2014] [Indexed: 05/21/2023]
Abstract
Waterpipe smoking is becoming increasingly popular worldwide. Research has shown that cigarette smoke, in addition to hundreds of carcinogenic and otherwise toxic compounds, may also contain compounds of microbiological origin. In the present study we analyzed waterpipe smoke for some microbial compounds. Both of the two markers studied, viz 3-hydroxy fatty acids of bacterial lipopolysaccharide (LPS) and ergosterol of fungal biomass, were found in waterpipe tobacco, in amounts similar as previously found in cigarette tobacco, and in smoke. Waterpipe mainstream smoke contained on average 1800 pmol LPS and 84.4 ng ergosterol produced per session. An average concentration of 2.8 pmol/m(3) of LPS was found in second hand smoke during a 1-2-h waterpipe smoking session while ergosterol was not detected; corresponding concentrations from smoking five cigarettes were 22.2 pmol/m(3) of LPS and 87.5 ng/m(3) of ergosterol. This is the first time that waterpipe smoking has been shown to create a bioaerosol. In the present study we also found that waterpipe smoking generated several polycyclic aromatic hydrocarbons, carbon monoxide, and high fraction of small (<200 nm) particles that may have adverse effects on human health upon inhalation.
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Affiliation(s)
- P Markowicz
- Lund University, Department of Laboratory Medicine, Division of Medical Microbiology, Sölvegatan 23, SE-22362 Lund, Sweden
| | - J Löndahl
- Division of Ergonomics and Aerosol Technology, Lund University, P.O. Box 118, SE-221 00, Lund, Sweden
| | - A Wierzbicka
- Division of Ergonomics and Aerosol Technology, Lund University, P.O. Box 118, SE-221 00, Lund, Sweden
| | - R Suleiman
- Mechanical Engineering Department, American University of Beirut, Beirut, Lebanon
| | - A Shihadeh
- Mechanical Engineering Department, American University of Beirut, Beirut, Lebanon
| | - L Larsson
- Lund University, Department of Laboratory Medicine, Division of Medical Microbiology, Sölvegatan 23, SE-22362 Lund, Sweden.
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Al-Amad SH, Awad MA, Nimri O. Oral cancer in young Jordanians: potential association with frequency of narghile smoking. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 118:560-5. [DOI: 10.1016/j.oooo.2014.08.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Revised: 07/14/2014] [Accepted: 08/03/2014] [Indexed: 12/15/2022]
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Cobb CO, Blank MD, Morlett A, Shihadeh A, Jaroudi E, Karaoghlanian N, Kilgalen B, Austin J, Weaver MF, Eissenberg T. Comparison of puff topography, toxicant exposure, and subjective effects in low- and high-frequency waterpipe users: a double-blind, placebo-control study. Nicotine Tob Res 2014; 17:667-74. [PMID: 25257982 DOI: 10.1093/ntr/ntu196] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 09/13/2014] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Clinical laboratory work among intermittent and daily waterpipe tobacco smokers has revealed significant risks for tobacco dependence and disease associated with waterpipe tobacco smoking (WTS). No studies have compared these groups directly. This study examined whether WTS frequency was associated with differential puff topography, toxicant exposure, and subjective response using a placebo-control design. METHODS Eighty participants reporting WTS of 2-5 episodes (LOW; n = 63) or ≥20 episodes (HIGH; n = 17) per month for ≥6 months completed 2 double-blind, counterbalanced 2-hr sessions that were preceded by ≥12hr of tobacco abstinence. Sessions differed by product smoked ad libitum for 45+ min: preferred brand/flavor of waterpipe tobacco (active) or a flavor-matched tobacco-free waterpipe product (placebo). Outcomes included puff topography, plasma nicotine, carboxyhemoglobin (COHb), and subjective response. RESULTS HIGH users had more puffs, shorter inter-puff-intervals, and a higher total puff volume for placebo relative to active, as well as relative to LOW users during placebo. Plasma nicotine concentrations increased when smoking active (but not placebo) with no significant differences between groups at 25min post-product administration. COHb increased significantly during all conditions; the largest increase was for HIGH users when smoking placebo. There was some evidence of higher baseline scores for nicotine/tobacco nicotine abstinence symptomology. CONCLUSIONS Higher frequency waterpipe users may be more sensitive to the effects of waterpipe smoke nicotine content. Among HIGH users, higher baseline nicotine/tobacco abstinence symptoms may indicate greater nicotine dependence. These data support continued surveillance of WTS and development of dependence measures specific to this product.
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Affiliation(s)
- Caroline O Cobb
- Schroeder Institute for Tobacco Research and Policy Studies, Legacy, Washington, DC
| | - Melissa D Blank
- Department of Psychology, West Virginia University, Morgantown, WV
| | - Alejandra Morlett
- Department of Psychology, Virginia Commonwealth University, Richmond, VA
| | - Alan Shihadeh
- Department of Mechanical Engineering, American University of Beirut, Beirut, Lebanon
| | - Ezzat Jaroudi
- Department of Mechanical Engineering, American University of Beirut, Beirut, Lebanon; Currently at the Department of Chemical Engineering and Applied Chemistry, University of Toronto, Toronto, Canada
| | - Nareg Karaoghlanian
- Department of Mechanical Engineering, American University of Beirut, Beirut, Lebanon
| | - Barbara Kilgalen
- Department of Psychology, Virginia Commonwealth University, Richmond, VA
| | - Janet Austin
- Department of Psychology, Virginia Commonwealth University, Richmond, VA
| | - Michael F Weaver
- Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA; Currently at the Center for Neurobehavioral Research on Addiction, University of Texas Medical School, Houston, TX
| | - Thomas Eissenberg
- Department of Psychology, Virginia Commonwealth University, Richmond, VA;
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Talih S, Balhas Z, Eissenberg T, Salman R, Karaoghlanian N, El Hellani A, Baalbaki R, Saliba N, Shihadeh A. Effects of user puff topography, device voltage, and liquid nicotine concentration on electronic cigarette nicotine yield: measurements and model predictions. Nicotine Tob Res 2014; 17:150-7. [PMID: 25187061 DOI: 10.1093/ntr/ntu174] [Citation(s) in RCA: 265] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Some electronic cigarette (ECIG) users attain tobacco cigarette-like plasma nicotine concentrations while others do not. Understanding the factors that influence ECIG aerosol nicotine delivery is relevant to regulation, including product labeling and abuse liability. These factors may include user puff topography, ECIG liquid composition, and ECIG design features. This study addresses how these factors can influence ECIG nicotine yield. METHODS Aerosols were machine generated with 1 type of ECIG cartridge (V4L CoolCart) using 5 distinct puff profiles representing a tobacco cigarette smoker (2-s puff duration, 33-ml/s puff velocity), a slow average ECIG user (4 s, 17 ml/s), a fast average user (4 s, 33 ml/s), a slow extreme user (8 s, 17 ml/s), and a fast extreme user (8 s, 33 ml/s). Output voltage (3.3-5.2 V or 3.0-7.5 W) and e-liquid nicotine concentration (18-36 mg/ml labeled concentration) were varied. A theoretical model was also developed to simulate the ECIG aerosol production process and to provide insight into the empirical observations. RESULTS Nicotine yields from 15 puffs varied by more than 50-fold across conditions. Experienced ECIG user profiles (longer puffs) resulted in higher nicotine yields relative to the tobacco smoker (shorter puffs). Puff velocity had no effect on nicotine yield. Higher nicotine concentration and higher voltages resulted in higher nicotine yields. These results were predicted well by the theoretical model (R (2) = 0.99). CONCLUSIONS Depending on puff conditions and product features, 15 puffs from an ECIG can provide far less or far more nicotine than a single tobacco cigarette. ECIG emissions can be predicted using physical principles, with knowledge of puff topography and a few ECIG device design parameters.
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Affiliation(s)
- Soha Talih
- Department of Mechanical Engineering, American University of Beirut, Beirut, Lebanon; Department of Psychology, Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA
| | - Zainab Balhas
- Department of Mechanical Engineering, American University of Beirut, Beirut, Lebanon; Department of Psychology, Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA
| | - Thomas Eissenberg
- Department of Psychology, Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA
| | - Rola Salman
- Department of Mechanical Engineering, American University of Beirut, Beirut, Lebanon
| | - Nareg Karaoghlanian
- Department of Mechanical Engineering, American University of Beirut, Beirut, Lebanon
| | - Ahmad El Hellani
- Department of Mechanical Engineering, American University of Beirut, Beirut, Lebanon; Department of Psychology, Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA
| | - Rima Baalbaki
- Department of Mechanical Engineering, American University of Beirut, Beirut, Lebanon; Department of Psychology, Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA
| | - Najat Saliba
- Department of Mechanical Engineering, American University of Beirut, Beirut, Lebanon; Department of Psychology, Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA
| | - Alan Shihadeh
- Department of Mechanical Engineering, American University of Beirut, Beirut, Lebanon; Department of Psychology, Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA
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The growing epidemic of water pipe smoking: health effects and future needs. Respir Med 2014; 108:1241-53. [PMID: 25130679 DOI: 10.1016/j.rmed.2014.07.014] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 07/01/2014] [Accepted: 07/29/2014] [Indexed: 11/22/2022]
Abstract
Water pipe smoking (WPS), an old method of tobacco smoking, is re-gaining widespread popularity all over the world and among various populations. Smoking machine studies have shown that the water pipe (WP) mainstream smoke (MSS) contains a wide array of chemical substances, many of which are highly toxic and carcinogenic for humans. The concentrations of some substances exceed those present in MSS of cigarettes. Despite being of low grade, current evidence indicates that WPS is associated with different adverse health effects, not only on the respiratory system but also on the cardiovascular, hematological, and reproductive systems, including pregnancy outcomes. In addition, association between WPS and malignancies, such as lung, oral and nasopharyngeal cancer, has been suggested in different studies and systematic reviews. Despite its long standing history, WPS research still harbors a lot of deficiencies. The magnitude of toxicants and carcinogen exposures, effects on human health, as well as the addiction and dependence potentials associated with WPS need to be studied in well-designed prospective trials. Unfortunately, many of the tobacco control and clean indoor policies have exempted water pipes. World wide awareness among the public, smokers, and policymakers about the potential health effects of WPS is urgently required. Furthermore, stringent policies and laws that control and ban WPS in public places, similar to those applied on cigarettes smoking need to be implemented.
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Carroll MV, Chang J, Sidani JE, Barnett TE, Soule E, Balbach E, Primack BA. Reigniting tobacco ritual: waterpipe tobacco smoking establishment culture in the United States. Nicotine Tob Res 2014; 16:1549-58. [PMID: 24972889 DOI: 10.1093/ntr/ntu101] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Waterpipe tobacco smoking (WTS) is an increasingly prevalent form of tobacco use in the United States. Its appeal may stem from its social, ritualistic, and aesthetic nature. Our aim in this study was to understand WTS as a social ritual with the goal of informing prevention efforts. METHODS We conducted a covert observational study consisting of 38 observation sessions in 11 WTS establishments in 3 U.S. cities. Data collection was based on an established conceptual framework describing ritualistic elements of tobacco use. Iterative codebook development and qualitative thematic synthesis were used to analyze data. RESULTS Atmospheres ranged from quiet coffee shop to boisterous bar party environments. While some children and older adults were present, the majority of clientele were young adults. Men and women were evenly represented. However, there were 19 occurrences of a male smoking by himself, but no women smoked alone. The vast majority (94%) of the clientele were actively smoking waterpipes. All 83 observed groups manifested at least 1 of the ritual elements of our conceptual framework, while 41 of the 83 observed groups (49%) demonstrated all 4 ritual elements. CONCLUSIONS Despite its heterogeneity, WTS is often characterized by 1 or more established elements of a tobacco-related social ritual. It may be valuable for clinical and public health interventions to acknowledge and address the ritualistic elements and social function of WTS.
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Affiliation(s)
- Mary V Carroll
- Program for Research on Media and Health, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA; Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Judy Chang
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA; Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Jaime E Sidani
- Program for Research on Media and Health, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA; Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Tracey E Barnett
- Department of Behavioral Science and Community Health, University of Florida College of Public Health and Health Professions, Gainesville, FL
| | - Eric Soule
- Department of Behavioral Science and Community Health, University of Florida College of Public Health and Health Professions, Gainesville, FL
| | - Edith Balbach
- Community Health Program, School of Arts and Sciences, Tufts University, Medford, MA
| | - Brian A Primack
- Program for Research on Media and Health, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA; Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA; Division of Adolescent Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA
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50
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Martinasek MP, Gibson-Young L, Forrest J. Hookah smoking and harm perception among asthmatic adolescents: findings from the Florida youth tobacco survey. THE JOURNAL OF SCHOOL HEALTH 2014; 84:334-341. [PMID: 24707928 DOI: 10.1111/josh.12153] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 08/07/2013] [Accepted: 11/09/2013] [Indexed: 06/03/2023]
Abstract
BACKGROUND Hookah tobacco smoking has increased in prevalence among Florida adolescents and is often viewed as a safer alternative to cigarette smoking by young adults. Asthmatic adolescents are at increased risk of the negative health effects of hookah smoking. The purpose of this study is to examine if hookah use and harm perception vary by asthma status. METHODS The Florida Youth Tobacco Survey was conducted in 2012 among 36,578 high school students. Secondary data analysis was conducted to compare the rates of hookah use among asthmatic youth to their nonasthmatic counterparts. Risk perception of hookah use compared to cigarette smoking was also assessed among asthmatic and nonasthmatic adolescents. RESULTS One in 5 high school students reported lifetime asthma. These asthmatic students have a significantly higher prevalence of hookah smoking and greater perception of hookah use as being less harmful than cigarette smoking, than their nonasthmatic counterparts. Among asthmatics, 12th graders and Hispanic students had the highest prevalence of hookah smoking. CONCLUSION Common misperceptions of hookah smoking as being less harmful than cigarette smoking are prominent among high school students in Florida and are greater among students with asthma than those students who do not have asthma. Efforts to increase education to dispel the myths surrounding hookah smoking as a safer alternative to cigarette smoking needs to exist at the high school level for both students with and without asthma.
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Affiliation(s)
- Mary P Martinasek
- Public Health, Department of Health Sciences and Human Performance, The University of Tampa, 401 W. Kennedy Boulevard, Box 30F, Tampa, FL 33606
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