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Rosser CJ. Assessing the Causal Relationship between Waterpipe Smoking and Bladder Cancer. Cancer Epidemiol Biomarkers Prev 2024; 33:461-462. [PMID: 38566557 DOI: 10.1158/1055-9965.epi-24-0051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 01/18/2024] [Accepted: 01/19/2024] [Indexed: 04/04/2024] Open
Abstract
Rates of waterpipe use increase with very little data reporting any potential health consequences. The current study, a large case-control study, of 4,194 patients from Iran denotes an elevated risk of bladder cancer in exclusive waterpipe smokers compared with non-users. Additional studies are needed to further understand the risk waterpipe smoking has on bladder cancer. See related article by Hadji et al., p. 509.
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Affiliation(s)
- Charles J Rosser
- Department of Urology, Cedars-Sinai Medical Center, Los Angeles, California
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2
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Mugharbil S, Tleis M, Romani M, Salloum RG, Nakkash R. Understanding Determinants of Electronic Cigarette and Heated Tobacco Product Use among Young Adults in Lebanon: Prevention and Policy Implications. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4273. [PMID: 36901283 PMCID: PMC10001978 DOI: 10.3390/ijerph20054273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/22/2023] [Accepted: 02/24/2023] [Indexed: 06/18/2023]
Abstract
In line with the global trends, electronic cigarettes (e-cigarettes) and heated tobacco products (HTPs) have found their way to the Lebanese market. The present study aims to explore the determinants of e-cigarette and HTP use among young adults in Lebanon. Convenience and snowball sampling were used to recruit participants aged 18-30 residing in Lebanon, who were familiar with e-cigarettes products. Twenty-one consenting participants were interviewed via Zoom and the verbatim transcriptions were analyzed thematically. The outcome expectancy theory was used to categorize the results into determinants and deterrents of use. HTPs were viewed by participants as another mode of smoking. The results showed that most participants perceived e-cigarettes and HTPs to be healthier alternatives to cigarettes/waterpipes and to be used as smoking cessation tools. Both e-cigarettes and HTPs were found to be easily accessible in Lebanon; although, in the recent economic crisis, e-cigarettes have become unaffordable. More research is needed to investigate the motivations and behaviors of e-cigarette and HTP users if effective policies and regulations are to be developed and enforced. Furthermore, greater public health efforts need to be made to increase awareness of the harmful impacts of e-cigarettes and HTPs and to implement evidence-based cessation programs tailored to those modes of smoking.
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Affiliation(s)
- Sanaa Mugharbil
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut 11-0236, Lebanon
| | - Malak Tleis
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut 11-0236, Lebanon
| | - Maya Romani
- Department of Family Medicine, Faculty of Medicine, American University of Beirut Medical Center, Beirut 11-0236, Lebanon
| | - Ramzi G. Salloum
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut 11-0236, Lebanon
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32611, USA
| | - Rima Nakkash
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut 11-0236, Lebanon
- Global and Community Health Department, College of Public Health, George Mason University, Fairfax, VA 22030, USA
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3
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Associations between sense of coherence, psychological distress, escape motivation of internet use, and internet addiction among Chinese college students: A structural equation model. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02257-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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4
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Darawshy F, Abu Rmeileh A, Kuint R, Berkman N. Waterpipe smoking: a review of pulmonary and health effects. Eur Respir Rev 2021; 30:200374. [PMID: 33980668 PMCID: PMC9488736 DOI: 10.1183/16000617.0374-2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 01/27/2021] [Indexed: 01/19/2023] Open
Abstract
Waterpipe smoking is an old form of tobacco smoking, originating in Persia and the Middle East. The popularity of the waterpipe is increasing worldwide, particularly among young adults, and there are widespread misconceptions regarding its negative health effects. The inhaled smoke of the waterpipe contain several toxic and hazardous materials including nicotine, tar, polyaromatic hydrocarbons and heavy metals, all of which are proven to be related to lung diseases and cancer. Regular waterpipe smoking is associated with respiratory symptoms, a decrease in pulmonary function and increased risk for lung disease such as COPD. Additional negative health effects include increased risk for arterial stiffness, ischaemic heart disease and several cancer types including lung cancer. This review summarises the negative health effects of waterpipe smoking, with emphasis on cardiorespiratory complications. Increased awareness and knowledge amongst healthcare professionals will hopefully help identify waterpipe smokers and promote patient education. Applying World Health Organization (WHO) regulations will provide a synergistic effect in reducing waterpipe use and associated disease.
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Affiliation(s)
- Fares Darawshy
- Institute of Pulmonary Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Ayman Abu Rmeileh
- Institute of Pulmonary Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Rottem Kuint
- Institute of Pulmonary Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Neville Berkman
- Institute of Pulmonary Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
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5
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Bashirian S, Barati M, Karami M, Hamzeh B, Afshari M, Ezati E. Determinants of Waterpipe Smoking Among Women: A Systematic Review. Int J Prev Med 2021; 12:25. [PMID: 34249274 PMCID: PMC8218800 DOI: 10.4103/ijpvm.ijpvm_116_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 09/11/2020] [Indexed: 12/30/2022] Open
Abstract
Background The present study aimed to assess the determinants of waterpipe smoking among women based on a systematic review regarding the increasing prevalence of waterpipe smoking in women and the tendency of them to this type of tobacco. Methods The present study was a systematic review. The search strategies were based on using a combination of MeSH and free-text terms. Searches were performed inIranian databasesand PubMed, ScienceDirect, Web of Science, EMBASE, Scopus and Medline. Databases inclusion criteria included articles and gray literature in English or Persian, published between January 2000 and December 2018. The keywords were related to women and waterpipe and related terms. The quality of the articles was assessed using the EPHPP tool. Results In the initial search, out of 1027 articles, 15 articles were studied. Inclusion criteria in this study were the target population of women and girl and descriptive and qualitative studies on waterpipe use among women. The mean prevalence of waterpipe smoking in quantitative studies was 13.980/0. Studies have shown that waterpipe smoking in women is influenced by several individual (awareness, favorable attitudes, and positive prototype), interpersonal (role of family and friends), and socio-political factors. Conclusions Due to the influence of various determinants on women's inclination to waterpipe smoking, there is a necessity to act and impose interventions such as lessening women's favorable attitude toward waterpipe, increasing women's awareness, encouraging negative prototype about waterpipe smoking, and restricting access to tobacco products that can be useful. Interpersonal factors such as the role of family and friends are one of the major determinants in waterpipe smoking. It seems that developing the skill of saying "no" to the pressure of friends can help prevent waterpipe use. Furthermore, educating the family about the risks of waterpipe use is an effective strategy in this respect.
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Affiliation(s)
- Saeed Bashirian
- Social Determinants of Health Research Center, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Majid Barati
- Social Determinants of Health Research Center, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Manoochehr Karami
- Research Center for Health Sciences, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Behrooz Hamzeh
- Research Center for Environmental Determinacies of Health, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Maryam Afshari
- Department of Public Health, School of Health, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Elahe Ezati
- Department of Public Health, School of Health, Hamedan University of Medical Sciences, Hamedan, Iran
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6
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El Shahawy O, Park SH, Rogers ES, Shearston JA, Thompson AB, Cooper SC, Freudenberg N, Ball SA, Abrams D, Shelley D, Sherman SE. Hookah use patterns, social influence and associated other substance use among a sample of New York City public university students. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2020; 15:65. [PMID: 32859230 PMCID: PMC7453717 DOI: 10.1186/s13011-020-00283-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 06/06/2020] [Indexed: 11/26/2022]
Abstract
Background Most hookah use studies have not included racial and ethnic minorities which limits our understanding of its use among these growing populations. This study aimed to investigate the individual characteristics of hookah use patterns and associated risk behaviors among an ethnically diverse sample of college students. Methods A cross-sectional survey of 2460 students (aged 18–25) was conducted in 2015, and data was analyzed in 2017. Descriptive statistics were used to present the sociodemographic characteristics, hookah use-related behavior, and binge drinking and marijuana use according to the current hookah use group, including never, exclusive, dual/poly hookah use. Multivariate logistic regression was conducted to examine how hookah related behavior and other risk behaviors varied by sociodemographics and hookah use patterns. Results Among current hookah users (n = 312), 70% were exclusive hookah users and 30% were dual/poly hookah users. There were no statistically significant differences in sociodemographic characteristics except for race/ethnicity (p < 0.05). Almost half (44%) of the exclusive hookah users reported having at least five friends who also used hookah, compared to 30% in the dual/poly use group. Exclusive users were less likely to report past year binge drinking (17%) and past year marijuana use (25%) compared to those in the dual/poly use group (44 and 48% respectively); p < 0.001. Conclusions The socialization aspects of hookah smoking seem to be associated with its use patterns. Our study calls for multicomponent interventions designed to target poly tobacco use as well as other substance use that appears to be relatively common among hookah users.
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Affiliation(s)
- Omar El Shahawy
- Department of Population Health, New York University School of Medicine, New York, NY, USA. .,NYU/Abu Dhabi Public Health Research Center, Abu Dhabi, United Arab Emirates. .,School of Global Public Health, New York University, New York, USA.
| | - Su Hyun Park
- Department of Population Health, New York University School of Medicine, New York, NY, USA.,Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Erin S Rogers
- Department of Population Health, New York University School of Medicine, New York, NY, USA.,VA New York Harbor Healthcare System, New York, USA
| | - Jenni A Shearston
- Department of Population Health, New York University School of Medicine, New York, NY, USA.,NYU/Abu Dhabi Public Health Research Center, Abu Dhabi, United Arab Emirates.,School of Global Public Health, New York University, New York, USA.,Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, USA
| | - Azure B Thompson
- Department of Community Health Sciences, SUNY Downstate School of Public Health, Brooklyn, NY, USA
| | - Spring C Cooper
- City University of New York Graduate School of Public Health and Health Policy, New York, USA
| | - Nicholas Freudenberg
- City University of New York Graduate School of Public Health and Health Policy, New York, USA
| | - Samuel A Ball
- Yale School of Medicine, Department of Psychiatry, New Haven, CT, USA
| | - David Abrams
- School of Global Public Health, New York University, New York, USA
| | - Donna Shelley
- Department of Population Health, New York University School of Medicine, New York, NY, USA.,School of Global Public Health, New York University, New York, USA
| | - Scott E Sherman
- Department of Population Health, New York University School of Medicine, New York, NY, USA.,NYU/Abu Dhabi Public Health Research Center, Abu Dhabi, United Arab Emirates.,School of Global Public Health, New York University, New York, USA.,VA New York Harbor Healthcare System, New York, USA
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Halas G, Schultz ASH, Rothney J, Wener P, Holmqvist M, Cohen B, Kosowan L, Enns JE, Katz A. A Scoping Review of Foci, Trends, and Gaps in Reviews of Tobacco Control Research. Nicotine Tob Res 2020; 22:599-612. [PMID: 30715468 DOI: 10.1093/ntr/nty269] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 01/17/2019] [Indexed: 12/20/2022]
Abstract
INTRODUCTION The burden of disease associated with tobacco use has prompted a substantial increase in tobacco-related research, but the breadth of this literature has not been comprehensively examined. This review examines the nature of the research addressing the action areas in World Health Organization's Framework Convention on Tobacco Control (FCTC), the populations targeted and how equity-related concepts are integrated. METHOD A scoping review of published reviews addressing tobacco control within the primary prevention domain. We searched PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Educational Resources Information Centre, and PsycInfo from 2004 to 2018. RESULTS The scoping review of reviews offered a "birds-eye-view" of the tobacco control literature. Within the 681 reviews meeting inclusion criteria, there was a strong focus on smoking cessation targeting individuals; less attention has been given to product regulation, packaging, and labeling or sales to minors. Equity-related concepts were addressed in 167/681 (24.5%); few were focused on addressing inequity through structural and systemic root causes. CONCLUSION This analysis of foci, trends, and gaps in the research pursuant to the FCTC illustrated the particular action areas and populations most frequently addressed in tobacco control research. Further research is needed to address: (1) underlying social influences, (2) particular action areas and with specific populations, and (3) sustained tobacco use through the influence of novel marketing and product innovations by tobacco industry. IMPLICATIONS This scoping review of the breadth of tobacco control research reviews enables a better understanding of which action areas and target populations have been addressed in the research. Our findings alongside recommendations from other reviews suggest prioritizing further research to support policymaking and considering the role of the tobacco industry in circumventing tobacco control efforts. The large amount of research targeting individual cessation would suggest there is a need to move beyond a focus on individual choice and decontextualized behaviors. Also, given the majority of reviews that simply recognize or describe disparity, further research that integrates equity and targets various forms of social exclusion and discrimination is needed and may benefit from working in collaboration with communities where programs can be tailored to need and context.
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Affiliation(s)
- Gayle Halas
- Department of Family Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Annette S H Schultz
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Janet Rothney
- Neil John Maclean Health Sciences Library, University of Manitoba, Winnipeg, MB, Canada
| | - Pamela Wener
- Department of Occupational Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Maxine Holmqvist
- Department of Clinical Health Psychology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Benita Cohen
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Leanne Kosowan
- Department of Family Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Jennifer E Enns
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Alan Katz
- Department of Family Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.,Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
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Tanski S, Emond J, Stanton C, Kirchner T, Choi K, Yang L, Ryant C, Robinson J, Hyland A. Youth Access to Tobacco Products in the United States: Findings From Wave 1 (2013-2014) of the Population Assessment of Tobacco and Health Study. Nicotine Tob Res 2020; 21:1695-1699. [PMID: 30407588 DOI: 10.1093/ntr/nty238] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 11/07/2018] [Indexed: 11/12/2022]
Abstract
OBJECTIVES Tobacco products in the US market are growing in diversity. Little is known about how youth access tobacco products given this current landscape. METHODS Data were drawn from 15- to 17-year-olds from the Wave 1 youth sample of the US nationally representative Population Assessment of Tobacco and Health (PATH) Study. Past 30-day tobacco users were asked about usual sources of access to 12 different tobacco products, and if they had been refused sale because of their age. RESULTS Among 15- to 17-year-olds, social sources ("someone offered" or "asked someone") were the predominant usual source of access for each tobacco product. "Bought by self" was the usual source of access for users of smokeless (excluding snus, 23.2%), cigarillos (21.0%), cigarettes (13.8%), hookah (12.0%), and electronic cigarettes (10.5%). Convenience stores and/or gas stations were the most often selected retail source for all products except hookah. Among youth who attempted purchase, 24.3% were refused sale of cigarettes, 23.9% cigarillos, and 13.8% smokeless tobacco. CONCLUSIONS Most 15- to 17-year-old tobacco users obtain tobacco products through social sources; however, among those who purchased tobacco, the majority report not being refused sale because of age. At the time of survey, cigarette and cigar sales to under 18 years were prohibited in all 50 states, and electronic cigarettes sales in 47 states and two territories. 2014 Annual Synar Reports signaled increasing trends in retail violations of state and/or district laws prohibiting tobacco product sales to under 18 years. Monitoring illicit youth sales, conducting compliance check inspections, and penalizing violations remain important to reduce youth tobacco access at retail venues. IMPLICATIONS Access to the spectrum of tobacco products by youth in the United States remains predominantly through social sources. However, of the minority of youth tobacco users in 2014 who purchased tobacco themselves, a few reported being refused sale: Convenience stores and/or gas stations were the most common retail source for tobacco products. The strategies of monitoring illicit youth sales, conducting compliance checks, and penalizing violations remain important to reduce youth tobacco access at retail venues. Limiting sources of youth tobacco access remains an important focus to reduce the burden of tobacco on the public health.
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Affiliation(s)
- Susanne Tanski
- Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, NH
| | - Jennifer Emond
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, NH
| | - Cassandra Stanton
- Westat, Rockville, MD.,Department of Oncology, Georgetown University, Washington, DC
| | - Thomas Kirchner
- New York University, College of Global Public Health, New York, NY
| | - Kelvin Choi
- National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD
| | - Ling Yang
- Food and Drug Administration, Center for Drug Evaluation and Research, Silver Spring, MD
| | - Chase Ryant
- Food and Drug Administration, Center for Tobacco Products, Silver Spring, MD
| | - Joelle Robinson
- Food and Drug Administration, Center for Tobacco Products, Silver Spring, MD
| | - Andrew Hyland
- Department of Health Behavior, Division of Cancer Prevention and Population Sciences, Roswell Park Cancer Center, Buffalo, NY
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El-Shahawy O, Park SH, Duncan DT, Lee L, Tamura K, Shearston JA, Weitzman M, Sherman SE. Evaluating State-Level Differences in E-cigarette and Cigarette Use Among Adults in the United States Between 2012 and 2014: Findings From the National Adult Tobacco Survey. Nicotine Tob Res 2020; 21:71-80. [PMID: 29490078 DOI: 10.1093/ntr/nty013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 02/14/2018] [Indexed: 11/15/2022]
Abstract
Objective To examine the association between state-level tobacco control measures and current use estimates of both e-cigarettes and cigarettes, while accounting for socio-demographic correlates. Methods Using the 2012-2013 and 2013-2014 National Adult Tobacco Survey (NATS), we assessed prevalence estimates of US adults' e-cigarette and cigarette current use. Four state groups were created based on the combined state-specific prevalence of both products: low cigarette/e-cigarette (n = 15), high cigarette/e-cigarette (n = 16), high cigarette/low e-cigarette (n = 11), and low cigarette/high e-cigarette) (n = 9). To evaluate the implementation of state-level tobacco control measures, Tobacco Control Index (TCI) was calculated using the State of Tobacco Control annual reports for 2012 and 2013. Multinomial logistic regression models were used to examine differences among the four groups on socio-demographic factors and TCI. Low cigarette/e-cigarette group was used as the referent group. Results Current use estimates of each product varied substantially by state; current e-cigarette use was highest in Oklahoma (10.3%) and lowest in Delaware (2.7%), and current cigarette use was highest in West Virginia (26.1%), and lowest in Vermont (12.6%). Compared to low cigarette/e-cigarette, all other US-state categories had significantly lower TCI scores (high cigarette/e-cigarette: adjusted Relative Risk Ratio [aRRR] = 0.61; 95% confidence interval [CI]: 0.60-0.61, high cigarette/low e-cigarette: aRRR = 0.74; 95% CI: 0.73-0.74, and low cigarette/high e-cigarette: aRRR = 0.72; 95% CI: 0.71-073). Conclusions Enforcing existing tobacco control measures likely interacts with e-cigarette use despite being cigarette-focused. Continuing to monitor e-cigarette use is critical to establish baseline use and evaluate future e-cigarette specific federal and state-level tobacco regulatory actions while accounting for the existing tobacco control environment. Implications This study investigates state-level current use estimates of e-cigarettes and cigarettes among US adults; and their association with four existing tobacco control measures. The overall score of these measures was negatively associated with state-level current use estimates such that states with low current e-cigarette and cigarette use had the highest mean overall score. This study assesses the potential relationship between existing state-level tobacco control measures and e-cigarette use and calls for improving the enforcement of the known-to-work tobacco control measures across all US states, while developing evidence-based regulations and interventions specific to e-cigarettes within the existing US tobacco use environment.
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Affiliation(s)
- Omar El-Shahawy
- Department of Population Health, New York University School of Medicine, New York, NY.,Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates.,College of Global Public Health, New York University, New York, NY.,AHA Tobacco Regulation and Addiction Center, American Heart Association, Dallas, TX
| | - Su Hyun Park
- Department of Population Health, New York University School of Medicine, New York, NY.,College of Global Public Health, New York University, 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
| | - Lily Lee
- Department of Pediatrics, New York University School of Medicine, New York, NY
| | - Kosuke Tamura
- Cardiovascular and Pulmonary Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Jenni A Shearston
- Department of Population Health, New York University School of Medicine, New York, NY.,Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates.,College of Global Public Health, New York University, New York, NY
| | - Michael Weitzman
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates.,College of Global Public Health, New York University, New York, NY.,Department of Pediatrics, 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.,Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates.,College of Global Public Health, New York University, New York, NY
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10
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El Shahawy O, Sherman SE, Palamar JJ. High Prevalence of Tobacco Product and E-Cigarette Use among Electronic Dance Music Party Attendees. Subst Use Misuse 2020; 55:1561-1566. [PMID: 32412343 PMCID: PMC7337989 DOI: 10.1080/10826084.2020.1717536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Electronic dance music (EDM) party attendees are at high risk for use of various illegal drugs; however, little is known about their tobacco use. Understanding tobacco use patterns in this population at high risk for illegal drug use can inform multi-product interventions. Objectives: 954 EDM party attendees (ages 18-40) were surveyed in New York City in 2017. We estimated prevalence of use of cigarettes, hookah, cigars, other tobacco, and e-cigarettes and delineated correlates of current (past-month) use using bivariable and multivariable models. Results: Past-month use of cigarettes (36.2%), e-cigarettes (15.6%), cigars (12.5%), and hookah (11.7%) in particular was prevalent. In multivariable models, females were less likely to use e-cigarettes than males (adjusted prevalence ratio [aPR] = 0.63, p = .030), and those who attended graduate school were less likely to use cigarettes (aPR = 0.55, p = .003) and/or e-cigarettes (aPR = 0.33, p = .026). Past-year ecstasy/MDMA/Molly use was a risk factor for past-month use of cigarettes (aPR = 1.38, p = .013) and/or cigars (aPR = 1.61, p = .032), and past-year cocaine use was a risk factor for past-month use of cigarettes (aPR = 1.80, p < .001), cigars (aPR = 1.80, p = .013), other tobacco products (aPR = 3.05, p = .003), and/or e-cigarettes (aPR = 2.39, p = .003). 55.4% of ecstasy users and 60.3% of cocaine users were current cigarette smokers, but use of other products among users of these drugs was less prevalent (9.8-27.9%). Conclusions: Results suggest that current tobacco use is prevalent in this population who is also at high risk for use of drugs such as ecstasy and cocaine. Prevention and cessation efforts need to target tobacco users in this scene while incorporating components addressing illegal drug use.
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Affiliation(s)
- Omar El Shahawy
- Department of Population Health, New York University Langone Medical Center, New York City, New York, USA.,Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates.,College of Global Public Health, New York University, New York City, New York, USA.,The American Heart Association Tobacco Center for Regulatory Science (A-TRAC), Dallas, Texas, USA
| | - Scott E Sherman
- Department of Population Health, New York University Langone Medical Center, New York City, New York, USA.,Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates.,College of Global Public Health, New York University, New York City, New York, USA
| | - Joseph J Palamar
- Department of Population Health, New York University Langone Medical Center, New York City, New York, USA
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11
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Al-Sowygh ZH, Al-Kheraif AA, Akram Z, Vohra F, Javed F. Peri-implant soft tissue inflammatory parameters and crestal bone loss among waterpipe (narghile) smokers and never-smokers with and without type 2 diabetes mellitus. J Periodontol 2019. [PMID: 29520801 DOI: 10.1002/jper.17-0554] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Peri-implant soft tissue inflammatory parameters and crestal bone loss (CBL) among waterpipe smokers (WS) with and without type 2 diabetes mellitus (T2DM) remains uninvestigated. The aim of the present study was to assess peri-implant soft tissue inflammatory parameters and CBL among WS and never smokers (NS) with and without T2DM. METHODS Demographic data and information regarding duration of implants in function, daily frequency of smoking, duration and treatment of T2DM, and daily toothbrushing was collected using a questionnaire. Peri-implant plaque index (PI), bleeding on probing (BOP), probing depth (PD) ≥4 mm, CBL, and hemoglobin A1c (HbA1c) levels were assessed in all individuals. Level of significance was set at 5%. RESULTS Seventy-nine male individuals (39 patients with T2DM [20 WS and 19 NS] and 40 systemically healthy individuals [21 WS smokers and 19 NS]) were included. The mean age was comparable among individuals in all groups. The mean HbA1c levels were significantly higher among patients with T2DM compared to controls (P < 0.01). Peri-implant PI, BOP, PD, and CBL were comparable among WS and NS with T2DM. Among patients without T2DM, PI (P < 0.05), PD ≥4 mm (P < 0.05) and mesial and distal CBL (P < 0.05) were significantly higher in WS than NS. Among individuals without T2DM, BOP was significantly higher among NS (P < 0.05) than WS. In patients with T2DM, BOP was comparable among WS and NS. CONCLUSIONS Peri-implant soft tissue inflammatory parameters and CBL were comparable among WS and NS with T2DM. Among individuals without T2DM, these parameters were worse among WS than NS.
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Affiliation(s)
- Zeyad H Al-Sowygh
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Abdulaziz A Al-Kheraif
- Dental Biomaterials Research Chair, Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Zohaib Akram
- Department of Periodontology, Ziauddin University, Karachi, Pakistan
| | - Fahim Vohra
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Fawad Javed
- Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY
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12
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Abstract
Waterpipe (hookah, shisha, narghileh) smoking is emerging as an epidemic, particularly among young people in the USA and globally. Unlike cigarettes, waterpipe smoking involves several components (eg, tobacco, charcoal, device and venues) and is characterised by unique smoking patterns that expose smokers to significant amounts of nicotine and other toxic substances. With the rising prevalence of use among young people and continuing misperceptions about waterpipe's harmful nature, a better understanding of health risks associated with waterpipe smoking is warranted. In response to waterpipe's rising trends, a Deeming Rule that extended the US Food and Drug Administration's (FDA) regulatory authority to all tobacco products was issued in 2016. This rule includes waterpipe tobacco, components and parts. This development created the need for evidence to guide the FDA into best evidence-based strategies to limit waterpipe's spread among young people and harm to public health. This special issue presents some of the studies that were funded under the 'Chemistry, Toxicology, and Addiction Research on Waterpipe Tobacco' programme to inform promising regulatory action on waterpipe products. In this preamble, we briefly summarise findings from these studies and discusses their policy and regulatory implications for different waterpipe products and components.
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Affiliation(s)
- Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
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13
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Cooper M, Pacek LR, Guy MC, Barrington-Trimis JL, Simon P, Stanton C, Kong G. Hookah Use Among US Youth: A Systematic Review of the Literature From 2009 to 2017. Nicotine Tob Res 2019; 21:1590-1599. [PMID: 29961895 PMCID: PMC6861827 DOI: 10.1093/ntr/nty135] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 06/25/2018] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Given the US Food and Drug Administration (FDA)'s authority to regulate hookah, more research is needed to inform regulations intended to prevent youth from using hookah. This systematic review summarizes and assesses the literature related to hookah use among adolescents (11 to ≤18 years of age) in the United States from 2009 to 2017. METHODS Database searches yielded 867 peer-reviewed articles. After duplicates were removed, authors reviewed 461 articles for inclusion. Included articles (n = 55) were coded for study themes, study quality, and their relevance to FDA's research priorities. A qualitative synthesis is presented. RESULTS The following themes were identified: (1) prevalence of hookah use (n = 42), (2) tobacco use transitions (n = 7), (3) sociodemographic correlates (n = 35), (4) psychosocial risk factors (n = 21), (5) concurrent use of other tobacco products (n = 31), (6) concurrent use of other substances (n = 9), and (7) other (n = 15)-which includes low prevalence themes. The qualitative synthesis showed increasing rates of hookah use. Older age, male gender, positive social normative beliefs, higher peer use, as well as lower perceived risk were associated with hookah use. Longitudinal studies of youth hookah use showed bidirectional relationships between use of hookah and other tobacco products. All articles fell within FDA's research priority related to "behavior," and three priorities ("impact analysis," "health effects," and "toxicity") have not been explored for hookah use among US youth since 2009. CONCLUSIONS The prevalence of hookah use among youth in the United States is increasing, thus more research is needed to inform policies targeted to protect this vulnerable population. IMPLICATIONS This study represents a novel contribution to our understanding of hookah use among youth in the United States from 2009-the year that the Family Smoking Prevention and Tobacco Control Act was passed-to 2017. In recent years, hookah has become a more popular tobacco product among US youth; however, to date, no systematic reviews of hookah use among this population exist. Results highlight implications for future US FDA regulatory policy and identify gaps in research to be addressed in future studies.
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Affiliation(s)
- Maria Cooper
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health in Austin, Austin, TX
| | - Lauren R Pacek
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC
| | - Mignonne C Guy
- Department of African American Studies, Virginia Commonwealth University, Richmond, VA
| | | | - Patricia Simon
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Cassandra Stanton
- Westat, Center for Evaluation and Coordination of Training and Research (CECTR) in Tobacco Regulatory Science, Rockville, MD
- The Department of Oncology, Georgetown University Medical Center/Lombardi Comprehensive Cancer Center, Washington, DC
| | - Grace Kong
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
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14
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Azagba S, Latham K, Shan L. Waterpipe tobacco smoking trends among middle and high school students in the United States from 2011 to 2017. Drug Alcohol Depend 2019; 200:19-25. [PMID: 31071495 DOI: 10.1016/j.drugalcdep.2019.04.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 03/30/2019] [Accepted: 04/02/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Waterpipe smoking has increased in popularity globally. Despite evidence regarding the harmful effects of waterpipe smoking, there is a common belief that it is less harmful than traditional cigarettes. Little is known about trends in waterpipe use in the U.S. This study examined national trends in waterpipe smoking among middle and high school students. METHODS We used the 2011-2017 National Youth Tobacco Survey data (n = 140195). For trend analyses, logistic regression was used for the prevalence of waterpipe ever use and current use. Joinpoint regression analysis was performed to identify where significant changes in trend occurred. Additionally, we examined the correlates of waterpipe smoking. RESULTS Overall prevalence of adolescent waterpipe ever and current use increased significantly from 7.6% and 2.8% in 2011 to 14.6% and 6.4% in 2014, then decreased significantly to 7.7% and 2.5% in 2017. This trend was consistent in most subgroups including male, female, Hispanic, White, middle school, and high school students. Joinpoint occurred in 2015 for Black adolescents. For example, current waterpipe use increased significantly from 1.4% in 2011 to 4.1% in 2015, declining to 2.5% in 2017. Multivariable analysis showed that cigarette smoking, e-cigarette use, curiosity about waterpipes, and tobacco smoke exposure at home were associated with ever and current waterpipe tobacco use among all participants as well as male and female subgroups. CONCLUSIONS Findings indicate a decreasing trend of ever and current waterpipe tobacco use, which began in 2014 or 2015 for all groups included in the analyses.
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Affiliation(s)
- Sunday Azagba
- Department of Family and Preventive Medicine, University of Utah School of Medicine, 375 Chipeta Way, Suite A, Salt Lake City, UT, United States.
| | - Keely Latham
- Department of Family and Preventive Medicine, University of Utah School of Medicine, 375 Chipeta Way, Suite A, Salt Lake City, UT, United States
| | - Lingpeng Shan
- Department of Family and Preventive Medicine, University of Utah School of Medicine, 375 Chipeta Way, Suite A, Salt Lake City, UT, United States
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15
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Asfar T, Schmidt M, Ebrahimi Kalan M, Wu W, Ward KD, Nakkash RT, Thrasher J, Eissenberg T, Ben Romdhane H, Maziak W. Delphi study among international expert panel to develop waterpipe-specific health warning labels. Tob Control 2019; 29:159-167. [PMID: 30696784 DOI: 10.1136/tobaccocontrol-2018-054718] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 11/20/2018] [Accepted: 12/20/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND Waterpipe (WP) smoking is increasing globally. The rise of WP has been fuelled by widespread misperception of reduced-harm compared to cigarettes. Health warning labels (HWLs) are one strategy to communicate smoking-related risks and address reduced-harm misperceptions. Therefore, the development of WP-specific HWLs represents a priority for WP control. METHODS A panel of experts in WP science developed 28 WP-specific HWLs corresponding to five themes (health risks, addiction, harm to others, WP-specific harm, WP harm compared to cigarettes). Subsequently, a three-round Delphi study was conducted among international expert panel to reach consensus on a set of the most effective HWLs for each theme. Levels of agreement between participants were assessed using interquartile deviations, and the rank between the tied HWLs was based on the median. RESULTS Starting with 28 candidate HWLs stratified according to five WP-related themes, our international expert panel reached consensus on the 13 most important WP-specific HWLs. Labels with the highest agreement were related to oral and heart disease, WP's harmful effects on newborn children and the amount of smoke inhaled from WP compared to cigarettes. CONCLUSION This study is the first to systematically develop and evaluate potential WP-specific HWLs based on the scientific evidence about WP's harmful effects, scientific understanding of HWL for cigarettes and the opinions of experts in WP science, tobacco control and health communication. The final selected HWLs can be adapted based on the context and policy landscape of the target country and can be further fine-tuned based on feedback from WP smokers and non-smokers.
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Affiliation(s)
- Taghrid Asfar
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA.,Syrian Center for Tobacco Studies, Aleppo, Syria.,Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, Florida, US
| | - Michael Schmidt
- Department of Art, The University of Memphis, Memphis, Tennessee, USA
| | - Mohammad Ebrahimi Kalan
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, Florida, USA
| | - Wensong Wu
- Department of Mathematics and Statistics, Florida International University, Miami, Florida, USA
| | - Kenneth D Ward
- Syrian Center for Tobacco Studies, Aleppo, Syria.,School of Public Health, The University of Memphis, Miami, Florida, USA
| | - Rima T Nakkash
- Health Behaviour and Education Department, American University of Beirut, Beirut, Lebanon
| | - James Thrasher
- Health Promotion, Education, and Behavior, School of Public Health, University of South Carolina, Columbia, South Carolina, USA.,Department of Tobacco Research, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Thomas Eissenberg
- Syrian Center for Tobacco Studies, Aleppo, Syria.,USA Center for the Study of Tobacco Products, Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Habiba Ben Romdhane
- Cardiovascular Epidemiology and Prevention Research Laboratory, Faculty of Medicine of Tunis-Tunisia, Tunis, Tunisia
| | - Wasim Maziak
- Syrian Center for Tobacco Studies, Aleppo, Syria.,Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, Florida, USA
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16
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Pratiti R, Mukherjee D. Epidemiology and Adverse Consequences of Hookah/Waterpipe Use: A Systematic Review. Cardiovasc Hematol Agents Med Chem 2019; 17:82-93. [PMID: 31483237 DOI: 10.2174/1871525717666190904151856] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 08/15/2019] [Accepted: 08/15/2019] [Indexed: 06/10/2023]
Abstract
Hookah smoking is becoming a popular trend globally. Waterpipe smoking is the second most prevalent form of alternate tobacco products. The rapid increase in hookah use is because of the misconception prevalent in society that hookah smoking is less harmful than cigarette smoking. Smoking ban policies had given impetus of switching from cigarette smoking to alternate tobacco products like waterpipe. Hookah users regard hookah to be more socially acceptable, less stigmatizing with flavors and to alleviate cigarette craving symptoms. Newer basic science research on animal models and human cells has shown consistently mutagenic, oxidative, and inflammatory changes that could cause possible health effects of premalignant oral lesion and chronic diseases like atherosclerosis and chronic obstructive pulmonary disease. Studies on the chemistry of waterpipe smoke had shown alarming results with the smoke containing seven carcinogens, 39 central nervous system depressants, and 31 respiratory irritants. Enormous data exist showing waterpipe smoking causing various health effects. Hookah smoking effects on cardiovascular disease is additive with hookah containing a significant amount of nicotine, tar, and heavy metals causing both acute and chronic effects on the cardiovascular system. These effects include increased heart rate, blood pressure, prevalence of coronary heart disease, heart failure, ST-segment elevation myocardial ischemia, recurrent ischemia, and worse outcomes including mortality related to these diseases. The objectives of the review are to assess the factor associated with the increasing use of hookah, its health effects, options for hookah smoking cessation, and public health policy initiatives to mitigate waterpipe use.
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Affiliation(s)
- Rebecca Pratiti
- McLaren HealthCare, G-3245 Beecher Rd, Flint, MA 48532, United States
| | - Debabrata Mukherjee
- Texas Tech University Health Science Center, Department of Internal Medicine, El Paso, TX 79905, United States
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17
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King JL, Reboussin D, Cornacchione Ross J, Wiseman KD, Wagoner KG, Sutfin EL. Polytobacco Use Among a Nationally Representative Sample of Adolescent and Young Adult E-Cigarette Users. J Adolesc Health 2018; 63:407-412. [PMID: 30115508 PMCID: PMC6388402 DOI: 10.1016/j.jadohealth.2018.04.010] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 03/02/2018] [Accepted: 04/18/2018] [Indexed: 01/11/2023]
Abstract
PURPOSE Electronic nicotine delivery systems (ENDS) are adolescents' most commonly used tobacco product and young adults' second most used. Little is known about ENDS use alongside other tobacco products (polytobacco use) and whether exclusive ENDS users differ from polytobacco ENDS users. METHODS In spring 2016, we surveyed a nationally representative sample of 3,517 13-25-year olds (36.9% 13-17-year olds), and examined sociodemographic and relative risk perceptions between two groups of past 30-day ENDS users: exclusive (only ENDS) and polytobacco (ENDS and at least one other tobacco product). RESULTS 4.5% of adolescents and 10% of young adults reported past 30-day ENDS use (n = 281; analytic sample). ENDS users were 38.8% female and 70.6% white. Over half (55.9%) were polytobacco ENDS users. The most common patterns of polytobacco ENDS use were ENDS and cigarettes (11.5%), ENDS and cigars (7.7%), and ENDS, cigars, and waterpipe (5.2%). Those who perceived ENDS to be less harmful than cigarettes were more likely to be exclusive ENDS users than those who perceived ENDS to be as or more harmful than cigarettes (adjusted odds ratio = 2.6, confidence interval = 1.2, 5.7). There were no differences between ENDS groups on age, race, sex, parental education, sexual orientation, or ENDS use frequency. CONCLUSIONS Just over half of ENDS users also used other tobacco products, increasing their risk for nicotine addiction and other health harms. The Food and Drug Administration is responsible for communicating product risk to consumers and should consider common patterns of use and relative risk perceptions in its ENDS public education efforts.
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Affiliation(s)
- Jessica L King
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina.
| | - David Reboussin
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina.
| | - Jennifer Cornacchione Ross
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina.
| | - Kimberly D Wiseman
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina.
| | - Kimberly G Wagoner
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina.
| | - Erin L Sutfin
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina.
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18
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Agaku I, Odani S, Armour B, Glover-Kudon R. Social Aspects of Hookah Smoking Among US Youth. Pediatrics 2018; 142:peds.2018-0341. [PMID: 29967055 DOI: 10.1542/peds.2018-0341] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/18/2018] [Indexed: 11/24/2022] Open
Abstract
UNLABELLED : media-1vid110.1542/5789657771001PEDS-VA_2018-0341Video Abstract BACKGROUND: We investigated 3 social dimensions of youth hookah smoking: frequency, places smoked, and descriptive social norms. METHODS Data were from the 2016 National Youth Tobacco Survey of US sixth- to 12th-graders (n = 20 675). Hookah smoking frequency was classified as never, former, current occasional, and current frequent. Places where past 30-day hookah smoking occurred and students' perceptions of their classmates' hookah smoking prevalence were assessed. Descriptive and multivariable analyses were performed (P < .05). RESULTS Overall, 10.5% reported smoking hookah ≥1 time in their lifetime. Of these, 65.8% were former, 26.3% were current occasional, and 7.9% were current frequent smokers. Overall, 59.3% of students overestimated hookah smoking prevalence in their grade. Current occasional smoking was predicted by female sex (adjusted odds ratio [aOR] = 1.54) and peer hookah-smoking overestimation (aOR = 9.30). Current frequent smoking was most strongly predicted by living with a hookah smoker (aOR = 20.56), speaking a second language other than English (aOR = 2.17), and co-use of mentholated cigarettes (aOR = 19.94) or other flavored noncigarette tobacco products (aOR = 17.59). The top 3 places hookah was smoked were a friend's house (47.7%), the respondent's own house (31.8%), and another family member's house (20.8%). CONCLUSIONS The home environment was the most common place for youth hookah smoking. Home-tailored interventions that encourage voluntary smoke-free rules and warn about the dangers of social smoking could help denormalize hookah smoking.
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Affiliation(s)
- Israel Agaku
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Satomi Odani
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Brian Armour
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Rebecca Glover-Kudon
- 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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Abudayyeh HS, Glasser AM, Johnson AL, Cohn AM, Wagener TL, Mays D, Villanti AC. Social and substance use correlates of adult hookah use, 2016. Addict Behav 2018; 79:39-44. [PMID: 29245025 PMCID: PMC5807119 DOI: 10.1016/j.addbeh.2017.12.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 12/07/2017] [Accepted: 12/08/2017] [Indexed: 12/24/2022]
Abstract
Introduction Hookah prevalence has been increasing in U.S. adults. This study examines correlates and frequency of hookah use in a national sample of U.S. adults (18–44 years). Methods Data were drawn from Wave 10 (October 2016) respondents aged 18–44 years from the Truth Initiative Young Adult Cohort Study (n=4,085). Weighted bivariate analyses were used to estimate correlates and frequency of hookah use, and differences between past 30-day and noncurrent hookah users on social and substance use (alcohol, marijuana, and other drugs) correlates. Results Twenty percent of the sample ever used hookah, and 2% used hookah in the past 30 days. Compared to never users and non-current users, a significantly greater proportion of ever and past 30-day hookah users reported past 30-day e-cigarette, tobacco, and substance use (p’s<0.01). Eighty-one percent of past 30-day hookah users had at least one close friend who also used hookah, and 35% self-identified as social/occasional smokers. The majority (68%) of past 30-day users reported hookah use on fewer than five of the past 30 days, and 58% engaged in two or more hookah sessions on those days. Conclusions Ever and past 30-day hookah use are associated with concurrent tobacco, e-cigarette, and substance use. They are also correlated with peer hookah use and self-identification as a social/occasional smoker. Even infrequent hookah sessions can expose users to health risks. Research identifying contexts in which hookah is used and how it is used with other substances is needed to inform interventions to reduce hookah use.
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Affiliation(s)
- Haneen S Abudayyeh
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, 900 G St NW, Fourth Floor, Washington, DC 20001, USA; Battelle Memorial Institute, 2111 Wilson Blvd, #1000, Arlington, VA 22201, USA.
| | - Allison M Glasser
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, 900 G St NW, Fourth Floor, Washington, DC 20001, USA
| | - Amanda L Johnson
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, 900 G St NW, Fourth Floor, Washington, DC 20001, USA
| | - Amy M Cohn
- Battelle Memorial Institute, 2111 Wilson Blvd, #1000, Arlington, VA 22201, USA; Department of Oncology, Georgetown University Medical Center, Cancer Prevention and Control Program, Georgetown Lombardi Comprehensive Cancer Center, 3800 Reservoir Road NW, Washington, DC 20057, USA
| | - Theodore L Wagener
- Department of Pediatrics, University of Oklahoma Health Sciences Center, 1200 Children's Ave, Suite 14000, Oklahoma city, OK 73104, USA; Oklahoma Tobacco Research Center, University of Oklahoma Health Sciences Center, 655 Research Pkwy #400, Oklahoma City, OK 73104, USA
| | - Darren Mays
- Department of Oncology, Georgetown University Medical Center, Cancer Prevention and Control Program, Georgetown Lombardi Comprehensive Cancer Center, 3800 Reservoir Road NW, Washington, DC 20057, USA
| | - Andrea C Villanti
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, 900 G St NW, Fourth Floor, Washington, DC 20001, USA; Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont College of Medicine, 1 South Prospect Street, MS 482, Burlington, VT 05401, USA
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20
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Primack BA, Shensa A, Sidani JE, Hoffman BL, Soneji S, Sargent JD, Hoffman RM, Fine MJ. Initiation of Traditional Cigarette Smoking after Electronic Cigarette Use Among Tobacco-Naïve US Young Adults. Am J Med 2018; 131:443.e1-443.e9. [PMID: 29242110 PMCID: PMC7054856 DOI: 10.1016/j.amjmed.2017.11.005] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 04/25/2017] [Accepted: 11/03/2017] [Indexed: 12/24/2022]
Abstract
BACKGROUND Although electronic cigarettes (e-cigarettes) may help some smokers quit, some young adult never-smokers are now using e-cigarettes recreationally, potentially increasing their risk for initiation of smoking. We aimed to determine the association between baseline e-cigarette use and subsequent initiation of cigarette smoking among initially never-smoking young adults. METHODS We conducted a prospective cohort study with assessments at baseline (March 2013) and follow-up (October 2014). We used sampling frames representing 97% of the US population to recruit a nationally representative sample of never-smoking young adults aged 18 to 30 years. The independent variable was baseline ever use of e-cigarettes. The main outcome measure was initiation of traditional cigarette smoking between baseline and 18-month follow-up. RESULTS Baseline surveys were completed by 1506 never-smoking young adults, of whom 915 (60.8%) completed follow-up. There were no demographic differences between responders and nonresponders. After applying survey weights-which accounted for both nonresponse and overcoverage or undercoverage-2.5% of the represented population of never-smokers (801,010 of 32,040,393) used e-cigarettes at baseline. Cigarette smoking was initiated by 47.7% of e-cigarette users and 10.2% of nonusers (P = .001). In fully adjusted multivariable models, e-cigarette use at baseline was independently associated with initiation of smoking at 18 months (adjusted odds ratio, 6.8; 95% confidence interval, 1.7-28.3). Results remained similar in magnitude and statistically significant in all sensitivity analyses. CONCLUSIONS Baseline e-cigarette use was independently associated with initiation of traditional cigarette smoking at 18 months. This finding supports policy and educational interventions designed to decrease use of e-cigarettes among nonsmokers.
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Affiliation(s)
- Brian A Primack
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pa; Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, Pittsburgh, Pa; Division of Adolescent Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pa; University of Pittsburgh Honors College, University of Pittsburgh, Pittsburgh, Pa.
| | - Ariel Shensa
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pa; Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, Pittsburgh, Pa
| | - Jaime E Sidani
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pa; Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, Pittsburgh, Pa
| | - Beth L Hoffman
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pa; Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, Pittsburgh, Pa
| | - Samir Soneji
- C. Everett Koop Institute at Dartmouth, Geisel School of Medicine, Hanover, NH; Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, NH
| | - James D Sargent
- C. Everett Koop Institute at Dartmouth, Geisel School of Medicine, Hanover, NH; Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, NH; Department of Pediatrics, Geisel School of Medicine, Dartmouth College, Hanover, NH
| | | | - Michael J Fine
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pa; Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, Pittsburgh, Pa; VA Pittsburgh Healthcare System, Pittsburgh, Pa
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Scherr A, Schmidlin J, Albisser S, Tamm M, Stolz D. Airway reactivity to mannitol is similarly increased in chronic cigarette and water pipe smokers. Int J Chron Obstruct Pulmon Dis 2018; 13:157-163. [PMID: 29379280 PMCID: PMC5757204 DOI: 10.2147/copd.s152085] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background In contrast to cigarette smoking, the association between water pipe smoking and airway hyperresponsiveness remains widely unexplored. Methods A bronchoprovocation challenge with mannitol was performed in young adults recruited at the University of Basel, Switzerland. Subjects were categorized as acute water pipe smokers (single episode of water pipe smoking, no or <0.5 pack-years cigarette smoking); chronic water pipe smokers (weekly for ≥4 weeks, no or <0.5 pack-years cigarette smoking); cigarette smokers (no water pipe smokers); and never-smokers (no cigarette or water pipe smokers). Primary outcomes were airway reactivity as measured by the response-to-dose ratio (RDR) and airway responsiveness measured by the provocation dose to cause a 15% fall in forced expiratory volume in 1s (FEV1; PD15). Results Seventy-four subjects with a mean age of 22.5±2.5 years and FEV1 % predicted 90.1%±8.6% were included. Subgroups were matched in terms of age, gender, and spirometry results. RDR in chronic water pipe smokers and cigarette smokers was similar (0.013%/mg [0.010–0.015] vs 0.023%/mg [0.011–0.051], respectively; p=0.12) but significantly higher than in never-smokers (0.007%/mg [0.005–0.010], p<0.01). Neither a history of asthma (p=0.88) nor a positive skin prick test (p=0.69) was associated with increased airway reactivity to the mannitol challenge test. PD15 differed significantly between cigarette smokers and never-smokers (155 mg [115–395] vs 315 mg [155–475], respectively; p=0.04). Conclusion Weekly water pipe smoking may increase airway reactivity to a similar extent as cigarette smoking.
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Affiliation(s)
- Andreas Scherr
- Clinic for Pneumology and Respiratory Cell Research, University Hospital of Basel, Basel, Switzerland
| | - Jerome Schmidlin
- Clinic for Pneumology and Respiratory Cell Research, University Hospital of Basel, Basel, Switzerland
| | - Silvio Albisser
- Clinic for Pneumology and Respiratory Cell Research, University Hospital of Basel, Basel, Switzerland
| | - Michael Tamm
- Clinic for Pneumology and Respiratory Cell Research, University Hospital of Basel, Basel, Switzerland
| | - Daiana Stolz
- Clinic for Pneumology and Respiratory Cell Research, University Hospital of Basel, Basel, Switzerland
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22
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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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23
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Majeed BA, Sterling KL, Weaver SR, Pechacek TF, Eriksen MP. Prevalence and harm perceptions of hookah smoking among U.S. adults, 2014-2015. Addict Behav 2017; 69:78-86. [PMID: 28161620 DOI: 10.1016/j.addbeh.2017.01.032] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 01/18/2017] [Accepted: 01/24/2017] [Indexed: 10/20/2022]
Abstract
This study aimed to determine the prevalence and factors associated with hookah smoking and perceptions of harm among U.S. adults. Data were pooled from the Tobacco Products and Risk Perceptions Surveys conducted separately in the summers of 2014 and 2015, among a probability sample selected from an online research panel. Descriptive, logistic regression, and multinomial logistic regression analyses were conducted. In 2014/2015, prevalence of ever and past 30-day hookah smoking among U.S. adults were 15.8% (95% C.I.: 15.0%, 16.7%) and 1.5% (95% C.I.: 1.2%, 1.8%), respectively. Adults who used other alternative tobacco products had a higher odds of hookah smoking than those who did not. Adults with some college education (AOR, 1.53) and with a college degree or more (AOR, 2.21), those identified as non-Hispanic other (AOR, 1.38) were more likely to be ever hookah smokers. Being a young adult (AOR, 2.7), college-educated (AOR, 2.3), never smoker (AOR, 2.1), and an ever hookah smoker (AOR, 2.8) were associated with lower perceptions of harm. Findings suggest that young college students are at higher risk of smoking hookah and that hookah smoking is more prevalent among individuals who use other tobacco products, such as little cigars and cigarillos, traditional cigars, and e-cigarettes, indicating a distinct group of users of alternative tobacco products. Regarding potential harm of hookah, the study highlights a knowledge gap and misperception especially among young, college-educated, and never smokers. Public health interventions should target these subpopulations to provide them with accurate information on hookah smoking.
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24
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Ramôa CP, Eissenberg T, Sahingur SE. Increasing popularity of waterpipe tobacco smoking and electronic cigarette use: Implications for oral healthcare. J Periodontal Res 2017; 52:813-823. [PMID: 28393367 DOI: 10.1111/jre.12458] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2017] [Indexed: 01/02/2023]
Abstract
Cigarette smoking increases the risk of developing several systemic conditions including cancer, cardiovascular and pulmonary diseases. Cigarette smoking is also detrimental to oral health as it increases the incidence and severity of oral cancer, periodontal diseases and peri-implantitis, as well as impacting negatively on the dental patients' response to therapy. Therefore, consideration of smoking behavior and recommendation of smoking cessation are important parts of dental treatment planning. However, cigarettes are no longer the most popular form of tobacco use among adolescents in the United States and globally. In recent years, tobacco smoking using a waterpipe ("hookah," "shisha") and use of electronic cigarettes (ECIGs) has increased significantly. Thus, dental clinicians likely will treat more patients who are waterpipe and/or ECIG users. Yet, the literature on the health effects of waterpipe and ECIGs use is sparse. Both waterpipe and ECIGs deliver the dependence-producing drug nicotine. Waterpipe tobacco smoking has been associated with periodontitis, dry socket, premalignant lesions, and oral and esophageal cancer. The health effects of long-term ECIG use are unknown. The purpose of this review is to inform healthcare professionals about waterpipes and ECIGs, highlight emerging evidence on the biological effects of these increasingly popular tobacco products, and introduce perspectives for dental patient management and future research.
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Affiliation(s)
- C P Ramôa
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - T Eissenberg
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - S E Sahingur
- Department of Periodontics, Virginia Commonwealth University, Richmond, VA, USA.,Philips Institute for Oral Health Research, Virginia Commonwealth University, Richmond, VA, USA
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25
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Allem JP, Unger JB. Emerging adulthood themes and hookah use among college students in Southern California. Addict Behav 2016; 61:16-9. [PMID: 27208879 DOI: 10.1016/j.addbeh.2016.05.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 03/22/2016] [Accepted: 05/01/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Hookah (or waterpipe) use is increasing worldwide with implications for public health. Emerging adults (ages 18 to 25) have a higher risk for hookah use relative to younger and older groups. While research on the correlates of hookah use among emerging adults begins to accumulate, it may be useful to examine how transition-to-adulthood themes, or specific thoughts and feelings regarding emerging adulthood, are associated with hookah use. This study determined which transition-to-adulthood themes were associated with hookah use to understand the risk and protective factors for this tobacco-related behavior. METHODS Participants (n=555; 79% female; mean age 22) completed surveys on demographic characteristics, transition-to-adulthood themes, hookah, and cigarette use. RESULTS Past-month hookah use was more common than past-month cigarette use (16% versus 12%). In logistic regression analyses, participants who felt emerging adulthood was a time of experimentation/possibility were more likely to report hookah use. However, transition-to-adulthood themes were not statistically significantly related to cigarette use. CONCLUSIONS The profile for hookah use may differ from that of cigarettes among emerging adults. Themes of experimentation/possibility should be addressed in prevention programs on college campuses and popular recreational spots where emerging adults congregate. These findings can inform future studies of risk and protective factors for hookah use among emerging adults.
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26
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Maziak W, Ben Taleb Z, Jawad M, Afifi R, Nakkash R, Akl EA, Ward KD, Salloum RG, Barnett TE, Primack BA, Sherman S, Cobb CO, Sutfin EL, Eissenberg T. Consensus statement on assessment of waterpipe smoking in epidemiological studies. Tob Control 2016; 26:338-343. [PMID: 27165995 DOI: 10.1136/tobaccocontrol-2016-052958] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Accepted: 04/20/2016] [Indexed: 01/03/2023]
Abstract
Numerous epidemiological accounts suggest that waterpipe smoking (aka hookah, shisha, narghile) has become a global phenomenon, especially among youth. The alarming spread of waterpipe and accumulating evidence of its addictive and harmful effects represent a new threat in the global fight to limit tobacco-related morbidity and mortality. In response to waterpipe's alarming trends, major public health and tobacco control organisations have started or are considering systematic collection of data about waterpipe smoking to monitor its trends and assess its harmful effects in different societies. Such plans require coordination and agreement on epidemiological measurement tools that reflect the uniqueness of this tobacco use method, and at the same time allow comparison of waterpipe trends across time and place, and with other tobacco use methods. We started a decade ago our work to develop standardised measures and definitions for the assessment of waterpipe smoking in epidemiological studies. In this communication, we try to expand and update these assessment tools in light of our increased knowledge and understanding of waterpipe use patterns, its context and marketing, as well as the need for evidence-guided policies and regulations to curb its spread. We have assembled for this purpose a group of leading waterpipe researchers worldwide, and worked through an iterative process to develop the suggested instruments and definitions based on what we know currently about the waterpipe epidemic. While the suggested measures are by no means comprehensive, we hope that they can provide the building blocks for standard and comparable surveillance of waterpipe smoking globally.
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Affiliation(s)
- Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA.,Syrian Center for Tobacco Studies, Aleppo, Syria
| | - Ziyad Ben Taleb
- Department of Epidemiology, Florida International University, Miami, Florida, USA
| | - Mohammed Jawad
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
| | - Rima Afifi
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Rima Nakkash
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Elie A Akl
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon.,Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Kenneth D Ward
- Syrian Center for Tobacco Studies, Aleppo, Syria.,Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, Tennessee, USA
| | - Ramzi G Salloum
- Department of Health Outcomes and Policy, and Institute for Child Health Policy, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Tracey E Barnett
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Brian A Primack
- Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Scott Sherman
- Departments of Population Health, Medicine and Psychiatry, New York University School of Medicine, New York University, New York, New York, USA
| | - Caroline O Cobb
- Department of Psychology and Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Erin L Sutfin
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Thomas Eissenberg
- Syrian Center for Tobacco Studies, Aleppo, Syria.,Department of Psychology and Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
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27
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Sidani JE, Shensa A, Shiffman S, Switzer GE, Primack BA. Behavioral associations with waterpipe tobacco smoking dependence among US young adults. Addiction 2016; 111:351-9. [PMID: 26417942 PMCID: PMC4715762 DOI: 10.1111/add.13163] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 06/11/2015] [Accepted: 09/04/2015] [Indexed: 01/19/2023]
Abstract
BACKGROUND AND AIMS Waterpipe tobacco smoking (WTS) is increasingly prevalent in the United States, especially among young adults. We aimed to (1) adapt items from established dependence measures into a WTS dependence scale for US young adults (the US Waterpipe Dependence Scale), (2) determine the factor structure of the items and (3) assess associations between scale values and behavioral use characteristics known to be linked to dependence. DESIGN Cross-sectional survey. SETTING United States. PARTICIPANTS A total of 436 past-year waterpipe tobacco users ages 18-30 years selected at random from a national probability-based panel. MEASUREMENTS Participants responded to six tobacco dependence items adapted for WTS in US populations. Behavioral use characteristics included factors such as frequency of use and age of initiation. FINDINGS Principal components analysis yielded an unambiguous one-factor solution. Approximately half (52.9%) of past-year waterpipe tobacco users received a score of 0, indicating that none of the six WTS dependence items were endorsed. Approximately one-quarter (25.4%) endorsed one dependence item and 22.7% endorsed two or more items. Higher WTS dependence scores were associated significantly with all five behavioral use characteristics. For example, compared with those who endorsed no dependence items, those who endorsed two or more had an adjusted odds ratio (AOR) of 3.90 [95% confidence interval (CI) = 1.56-9.78] for having had earlier age of initiation and an AOR of 32.75 (95% CI = 9.76-109.86) for more frequent WTS sessions. CONCLUSIONS Scores on a six-item waterpipe tobacco smoking dependence scale (the US Waterpipe Dependence Scale) correlate with measures that would be expected to be related to dependence, such as amount used and age of initiation.
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Affiliation(s)
- Jaime E Sidani
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, UPMC Montefiore Hospital, Pittsburgh, PA, USA.,Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ariel Shensa
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, UPMC Montefiore Hospital, Pittsburgh, PA, USA.,Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Galen E Switzer
- Center for Health Equity Research and Promotion, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA.,Departments of Medicine, Psychiatry, Clinical and Translational Science, University of Pittsburgh, Pittsburgh, PA, USA
| | - Brian A Primack
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, UPMC Montefiore Hospital, Pittsburgh, PA, USA.,Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA, USA.,Division of Adolescent Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, 3420 Fifth Avenue, Pittsburgh, PA, USA
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28
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Kahr MK, Padgett S, Shope CD, Griffin EN, Xie SS, Gonzalez PJ, Levison J, Mastrobattista J, Abramovici AR, Northrup TF, Stotts AL, Aagaard KM, Suter MA. A qualitative assessment of the perceived risks of electronic cigarette and hookah use in pregnancy. BMC Public Health 2015; 15:1273. [PMID: 26692352 PMCID: PMC4687310 DOI: 10.1186/s12889-015-2586-4] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 12/08/2015] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Studies reveal that electronic cigarette (e-cigarette) and hookah use are increasing among adolescents and young adults. However, the long-term health effects are unknown, especially with regards to pregnancy. Because of the increased use in women of reproductive age, and the unknown long-term health risks, our primary objectives were to determine the perceived risks of e-cigarette and hookah use in pregnancy, and learn common colloquial terms associated with e-cigarettes. Furthermore, we sought to determine if there is a stigma associated with e-cigarette use in pregnancy. METHODS Eleven focus groups including 87 participants were conducted immediately following regularly scheduled CenteringPregnancy® prenatal care with women at three different clinics in the greater Houston area. A minimum of two facilitators led the groups, using ten lead-in prompts, with Spanish translation as necessary. Facilitators took notes which were compared immediately following each group discussion and each group was audio recorded and transcribed. Three facilitators utilized NVivo 9.0 software to organize the transcribed data into nodes to identify major themes. To increase rigor, transcripts were further analyzed by two obstetricians who were instructed to find the major themes. RESULTS Analyses revealed contradicting themes concerning e-cigarette use. In general, e-cigarettes were perceived as safer alternatives to regular tobacco cigarettes, especially if used as smoking cessation devices. A major theme is that use in pregnancy is harmful to the fetus. However, it was perceived that use for smoking cessation in pregnancy may have fewer side effects. We found that a common term for e-cigarettes is "Blu." In our discussion of hookah use, participants perceived use as popular among teenagers and that use in pregnancy is dangerous for the fetus. CONCLUSIONS Although a strong theme emerged against hookah use, we found contradicting themes in our discussions on e-cigarette use in pregnancy. It is possible that e-cigarette use will not carry the same stigma as regular cigarette smoking in pregnancy. In addition, the impression of e-cigarettes as a healthier alternative to smoking may influence use in pregnancy. Clinicians need to be prepared for questions of e-cigarette safety and efficacy as smoking cessation devices from their pregnant patients who smoke, and women who smoke and are planning to become pregnant.
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Affiliation(s)
- Maike K Kahr
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA.
| | - Shannon Padgett
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA.
| | - Cindy D Shope
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA.
| | - Emily N Griffin
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA.
| | - Susan S Xie
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA.
| | - Pablo J Gonzalez
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA.
| | - Judy Levison
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA.
| | - Joan Mastrobattista
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA.
| | - Adi R Abramovici
- Department of Obstetrics and Gynecology, University of Texas Medical School at Houston, 6431 Fannin Street, Houston, TX, 77030, USA.
| | - Thomas F Northrup
- Department of Family and Community Medicine, University of Texas Health Science Center at Houston, 6431 Fannin Street, JJL 324, Houston, TX, 77030, USA.
| | - Angela L Stotts
- Department of Family and Community Medicine, University of Texas Health Science Center at Houston, 6431 Fannin Street, JJL 324, Houston, TX, 77030, USA.
| | - Kjersti M Aagaard
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA.
| | - Melissa A Suter
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA.
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29
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Kassem NOF, Jackson SR, Boman-Davis M, Kassem NO, Liles S, Daffa RM, Yasmin R, Madanat H, Hovell MF. Hookah Smoking and Facilitators/Barriers to Lounge Use among Students at a US University. Am J Health Behav 2015; 39:832-48. [PMID: 26450551 DOI: 10.5993/ajhb.39.6.11] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To examine hookah tobacco use, hookah lounge attendance, and facilitators and barriers to hookah lounge attendance. METHODS A cross-sectional Web-based survey of a random sample of 1332 undergraduate students (Mean Age = 21.2 years) attending a United States university. RESULTS The majority of respondents (72.8%) had ever smoked hookah tobacco, and 28% of those had ever smoked during adolescence. The majority of ever hookah smokers (81.5%) and a portion of never hookah smokers (20%) had ever been to a hookah lounge. The adjusted odds of ever visiting a hookah lounge were 2.1 times higher among participants who reported that the closest hookah lounge to the university was < 5 miles away than those who reported that the closest hookah lounge was ≥ 5 miles away. Facilitators of visiting hookah lounges included friends and close proximity of hookah lounges to campus; barriers included cost of smoking hookah, crowded lounges, and having to be 18 years old. CONCLUSION Youth are vulnerable to experimenting with hookah tobacco smoking. Hookah lounges provide patrons the opportunity to smoke hookah tobacco with smoker and non-smoker friends in entertaining settings. Our findings suggest that zoning laws and anti-hookah smoking legislation may help curb hookah uptake by prohibiting hookah lounges from opening in close proximity to universities, reducing the density of hookah lounges in cities, and raising the admission age for hookah lounges to 21 years.
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Affiliation(s)
- Nada O F Kassem
- Center for Behavioral Epidemiology and Community Health (CBEACH), San Diego State University Research Foundation, San Diego, CA, USA.
| | - Sheila R Jackson
- Center for Behavioral Epidemiology and Community Health (CBEACH), San Diego State University Research Foundation, San Diego, CA, USA
| | | | - Noura O Kassem
- Center for Behavioral Epidemiology and Community Health (CBEACH), San Diego State University Research Foundation, San Diego, CA, USA
| | - Sandy Liles
- Center for Behavioral Epidemiology and Community Health (CBEACH), San Diego State University Research Foundation, San Diego, CA, USA
| | - Reem M Daffa
- Center for Behavioral Epidemiology and Community Health (CBEACH), San Diego State University Research Foundation, San Diego, CA, USA
| | - Roxana Yasmin
- Center for Behavioral Epidemiology and Community Health (CBEACH), San Diego State University Research Foundation, San Diego, CA, USA
| | - Hala Madanat
- Graduate School of Public Health, San Diego State University, San Diego, CA, USA
| | - Melbourne F Hovell
- Center for Behavioral Epidemiology and Community Health (CBEACH), San Diego State University Research Foundation, San Diego, CA, USA
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