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Rashidian H, Hadji M, Ansari-Moghaddam A, Bakhshi M, Nejatizadeh A, Marzban M, Rezaianzadeh A, Seyyedsalehi MS, Moradi A, Gholipour M, Alizadeh-Navaei R, Freedman ND, Malekzadeh R, Etemadi A, Kamangar F, Weiderpass E, Pukkala E, Boffetta P, Zendehdel K. Association between waterpipe smoking and lung cancer: a multicentre case-control study in Iran. Public Health 2024; 231:166-172. [PMID: 38701659 DOI: 10.1016/j.puhe.2024.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 02/06/2024] [Accepted: 03/05/2024] [Indexed: 05/05/2024]
Abstract
OBJECTIVES This study investigated the association between lung cancer and waterpipe smoking, which is an emerging global public health concern. STUDY DESIGN Multicentre case-control study. METHODS This study included 627 cases and 3477 controls from the Iranian Study of Opium and Cancer (IROPICAN) study, which was conducted between 2017 and 2020. One frequency-matched control for each lung cancer patient was selected by age, gender and residential place; however, this study used controls of four cancer types in the analyses. The multivariable logistic regression model estimated the odds ratio (OR) and 95% confidence intervals (CIs). Additional analyses were performed among 181 lung cancer cases and 2141 controls who were not cigarette smokers or opium or nass/pipe users. RESULTS The odds of lung cancer were higher among waterpipe smokers than never-smokers (OR = 1.3, 95% CI: 1.0-1.7). Results showed a higher OR of lung cancer for those who smoked the waterpipe daily (OR = 2.1, 95% CI: 1.4-3.0), smoked more than two heads per day (OR = 2.7, 95% CI: 1.8-4.0), had smoked for >20 years (OR = 1.9, 95% CI: 1.3-2.7), smoked more than 20 head-years (OR = 2.8, 95% CI: 1.9-4.1) and initiated smoking before the age of 30 years (OR = 1.7, 95% CI: 1.1-2.5). The association was only statistically significant for squamous cell carcinomas (OR = 1.8, 95% CI 1.2-2.7). Furthermore, this study observed a higher OR of lung cancer among exclusive waterpipe smokers (OR = 2.3, 95% CI: 1.6, 3.5). CONCLUSIONS Waterpipe smoking was associated with an increased risk of lung cancer. The association was stronger with higher frequency, duration and intensity of exposure to waterpipe smoking. The association increases in exclusive waterpipe smokers, which is likely due to controlling for residual confounding by cigarette smoking and opium consumption, and higher exposure levels in this subpopulation.
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Affiliation(s)
- H Rashidian
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - M Hadji
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland; Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - A Ansari-Moghaddam
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - M Bakhshi
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - A Nejatizadeh
- Tobacco and Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - M Marzban
- Statistical Genetics Lab, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia; Department of Public Health, School of Public Health, Bushehr University of Medical Science, Bushehr, Iran
| | - A Rezaianzadeh
- Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - M S Seyyedsalehi
- Department of Medical and Surgical Sciences, University of Bologna, Italy; Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - A Moradi
- Golestan University of Medical Sciences, Gorgan, Iran
| | - M Gholipour
- Metabolic Disorders Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - R Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - N D Freedman
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - R Malekzadeh
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - A Etemadi
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA; Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - F Kamangar
- Department of Biology, School of Computer, Mathematical, and Natural Sciences, Morgan State University, Baltimore, MD, USA
| | - E Weiderpass
- International Agency for Research on Cancer, Lyon, France
| | - E Pukkala
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland; Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
| | - P Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, Italy; Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY, USA.
| | - K Zendehdel
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Medical and Surgical Sciences, University of Bologna, Italy.
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Alrashdan MS, Al-Shorman H, Bouzid A, Al-Dwairi A, Alazzam M, Alqudah M. The expression of salivary EGF, VEGF, endothelin, and transferrin in waterpipe and cigarette smokers. Odontology 2024:10.1007/s10266-024-00947-9. [PMID: 38710904 DOI: 10.1007/s10266-024-00947-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 04/24/2024] [Indexed: 05/08/2024]
Abstract
The aim of this study was to evaluate the effects of two forms of tobacco smoking, cigarettes and water pipe smoking (WPS), on the expression of a panel of salivary proteins in healthy adults. Three groups of age and gender-matched participants were enrolled in the study: never-smokers, cigarette smokers and WPS (N = 55 per group). Expression of epidermal growth factor (EGF), vascular endothelial growth factor (VEGF), endothelin and transferrin in unstimulated whole saliva was estimated using enzyme-linked immunosorbent assays. Statistical analysis consisted of one-way ANOVA and Tukey's post hoc tests, in addition to bioinformatics analysis. VEGF expression was the least in WPS (51.1 ± 14.5 pg/ml) compared to both controls (150.1 ± 13.8 pg/ml) and cigarette smokers (93 ± 9.9 pg/ml), with a significant difference in WPS (p < 0.001) and cigarette smokers (p < 0.01) compared to controls. Furthermore, transferrin showed the weakest expression in the WPS group (1238 ± 261.4 pg/ml) compared to controls (2205.6 ± 298.6 pg/ml) (p = 0.05) and cigarette smokers (1805.4 ± 244 pg/ml). Neither EGF nor endothelin expression showed any statistical difference between the groups (p > 0.05). Gene-gene interaction network demonstrated that FLT1, TFRC, KDR, VEGFB and PGF genes had the highest potential for interaction with the studied proteins. Further functional annotations on the identified markers in the interaction network were performed to identify HIF-1 pathways among the most relevant pathways. In conclusion, smoking habits alter the expression of salivary VEGF and transferrin, which may correspond to early sub-clinical changes in the oral mucosa. The clinical relevance of these salivary changes requires further research.
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Affiliation(s)
- Mohammad S Alrashdan
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, P.O.Box: 27272, Sharjah, UAE.
- Department of Oral Medicine and Oral Surgery, Faculty of Dentistry, Jorda University of Science and Technology, Irbid, Jordan.
| | - Hisham Al-Shorman
- Department of Oral and Maxillofacial Surgery and Periodontics, Faculty of Dentistry, Zarqa University, Zarqa, Jordan
- Department of Preventive Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Amal Bouzid
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, UAE
| | - Ahmed Al-Dwairi
- Department of Physiology and Biochemistry, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Melanie Alazzam
- Department of Oral Medicine and Oral Surgery, Faculty of Dentistry, Jorda University of Science and Technology, Irbid, Jordan
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Abdul-Nabi SS, Tamim H, Hitti E. Waterpipe vs non-Waterpipe carbon monoxide poisoning: Comparison of patient characteristics, clinical presentation and outcomes. Am J Emerg Med 2024; 79:70-74. [PMID: 38382236 DOI: 10.1016/j.ajem.2024.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 02/08/2024] [Indexed: 02/23/2024] Open
Abstract
OBJECTIVE The aim of this study is to describe the difference between carboxyhemoglobin (CO-Hb) acute poisoning caused by waterpipe vs non-waterpipe exposures as they relate to demographics, clinical presentations and outcome of patients. DESIGN Retrospective cohort study conducted in the Emergency Department (ED) at the Lebanon. PATIENTS All adult patients presenting with a CO-Hb level ≥ 10 between January 2019 and August 2023 with exposure types stratified as waterpipe or non-waterpipe. MEASUREMENTS AND MAIN RESULTS 111 ED visits were identified. Among these, 73.9% were attributed to waterpipe exposure, while 26.1% were non-waterpipe sources. These included cigarette smoking (17.2%), burning coal (24.1%), fire incidents (3.6%), gas leaks (6.9%), heating device use (10.3%), and undocumented sources (37.9%). Patients with waterpipe-related carbon monoxide exposure were younger (41 vs 50 years, p = 0.015) women (63.4 vs 41.4%, p = 0.039) with less comorbidities compared to non-waterpipe exposures (22.2 vs 41.4%, p = 0.047). Waterpipe smokers were more likely to present during the summer (42.7 vs 13.8%, p = 0.002) and have shorter ED length of stays (3.9 vs 4.5 h, p = 0.03). A higher percentage of waterpipe smokers presented with syncope (52.4 vs 17.2%, p = 0.001) whereas cough/dyspnea were more common in non-waterpipe exposures (31 vs 9.8%, p = 0.006). The initial CO-Hb level was found to be significantly higher in waterpipe exposure as compared to non-waterpipe (19.7 vs 13.7, p = 0.004). Non-waterpipe exposures were more likely to be admitted to the hospital (24.1 vs 4.9%, p = 0.015). Waterpipe smokers had significantly higher odds of experiencing syncope, with a 5.74-fold increase in risk compared to those exposed to non-waterpipe sources (p = 0.004) irrespective of their CO-Hb level. Furthermore, males had significantly lower odds of syncope as compared to females, following carbon monoxide exposure (aOR 0.31, 95% CI 0.13-0.74). CONCLUSION CO-Hb poisoning related to waterpipe smoking has distinctive features. Syncope is a commonly associated presentation that should solicit a focused social history in communities where waterpipe smoking is common. Furthermore, CO-Hb poisoning should remain on the differential in patients presenting with headache, syncope, dizziness, vomiting or shortness of breath, even outside of the non-waterpipe exposure peaks of winter season.
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Affiliation(s)
- Sarah S Abdul-Nabi
- Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hani Tamim
- Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Eveline Hitti
- Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
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Malaeb D, Hassan BAR, Mohammed AH, Farhan SS, Al-Ani OA, Sarray El Dine A, Fekih-Romdhane F, Obeid S, Hallit S. Association between textual and pictorial warnings on tumbac ( waterpipe tobacco) boxes and motivation to quit waterpipe smoking among Lebanese and Iraqi adolescents. BMC Pediatr 2024; 24:169. [PMID: 38459469 PMCID: PMC10921803 DOI: 10.1186/s12887-024-04649-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 02/15/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Waterpipe tobacco smoking has increased tremendously at a global level among all age groups, particularly young people. Previous studies have examined the impact of waterpipe tobacco pictorial health warnings on adults but scarce studies were done on adolescents. The aim of this study was to assess the association of textual versus pictorial warnings on tumbac boxes and the motivation to quit waterpipe smoking among adolescents located in two Eastern Mediterranean countries Lebanon and Iraq. METHODS A cross-sectional study was conducted between May and November 2022, involving 294 adolescents waterpipe smokers from Lebanon and Iraq. The questionnaire included the Lebanese Waterpipe Dependence Smoking-11, the Depression, Anxiety and Stress Scale, the Waterpipe Harm Perception Scale, Waterpipe Knowledge Scale, Waterpipe Attitude Scale, the Fagerstrom Test for Nicotine Dependence, and the Motivation to Stop Scale. RESULTS When adjusting the results over confounding variables, the results showed that compared to finding the warnings to stop smoking not efficacious at all, adolescents who find the warnings moderately (aOR = 2.83) and very (aOR = 6.64) efficacious had higher motivation to quit. Compared to finding the warnings not increasing their curiosity for information about how to stop waterpipe smoking at all, participants who confessed that warnings increased their curiosity a little (aOR = 2.59), moderately (aOR = 3.34) and very (aOR = 3.58) had higher motivation to quit. Compared to not considering changing the tumbac brand if the company uses pictorial warnings, adolescents who would consider changing the tumbac brand (aOR = 2.15) had higher motivation to quit. CONCLUSION Pictorial and textual warnings on waterpipe packs were associated with higher motivation to stop waterpipe smoking. Public health education programs for this purpose seem warranted.
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Affiliation(s)
- Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | | | - Ali Haider Mohammed
- Department of Pharmacy, Al Rafidain University College, Baghdad, Iraq
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia, Selangor, 47500, Malaysia
| | - Sinan Subhi Farhan
- Department of Anesthesia, College of Medical Science Technology, University of Mashreq, Baghdad, Iraq
| | | | | | - Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of psychiatry "Ibn Omrane", Razi hospital, Manouba, 2010, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
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Shahabi N, Shahbazi Sighaldeh S, Eshaghi Sani Kakhaki H, Mohseni S, Dadipoor S, El-Shahawy O. The effectiveness of a theory -based health education program on waterpipe smoking cessation in Iran: one year follow-up of a quasi-experimental research. BMC Public Health 2024; 24:664. [PMID: 38429705 PMCID: PMC10908080 DOI: 10.1186/s12889-024-18169-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 02/21/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND The present research aimed to determine the effect of an educational intervention based on the extended theory of planned behavior (ETPB) on waterpipe (WT) smoking cessation in women. METHODS The present quasi-experimental had a pre-test, post-test design with 3, 6 and 12 months follow-ups was conducted in Bandar Abbas city, south of Iran in December 2021-March 2023. A total of 448 women over the age of 15 (224 in the intervention group (IG), 224 in the control group (CG)), using a two-stage cluster sampling method participated. The educational intervention focused on WT smoking cessation implemented in 14 sessions. The educational methods in the training sessions were lectures, collaborative discussions, Q&As, brainstorming, role plays, and peer education. The main outcome was WT cessation behavior. Repeated measures ANOVA tests and post hoc were run to compare the IG and CG at baseline in terms of demographic variables, t-test and chi square test, and in the four points of time of data collection. The data were analyzed in Stata14. A p-value < 0.05 was considered as statistically significant. RESULTS The mean and standard deviation of WT cessation behavior and all ETPB constructs in the IG was significantly higher than the CG. After the educational intervention, in the IG, the perceived behavioral control, attitude, subjective norm, intention and knowledge increased, and the weekly smoking and WT smoking habit decreased (P < 0.001). The CG did not have any significant change in other variables except for the increased knowledge score. During the 12-month follow-up, the cessation rate was 43.81% (P = 0.645) in the IG and 7.45% in the CG (P = 0.081). CONCLUSIONS The educational intervention positively affected WT smoking reduction and cessation in women through influencing the ETPB constructs. It is strongly recommended to design theory-based interventions beyond the individual level with an emphasis on interpersonal relationships to facilitate WT cessation as far as possible.
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Affiliation(s)
- Nahid Shahabi
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Shirin Shahbazi Sighaldeh
- Midwifery and Reproductive Health Department, School of Nursing and Midwifery, Tehran Universities of Medical Sciences, Tehran, Iran
- Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Shokrollah Mohseni
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Sara Dadipoor
- Tobacco and Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
| | - Omar El-Shahawy
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
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Awada Z, Cahais V, Cuenin C, Akika R, Silva Almeida Vicente AL, Makki M, Tamim H, Herceg Z, Khoueiry Zgheib N, Ghantous A. Waterpipe and cigarette epigenome analysis reveals markers implicated in addiction and smoking type inference. Environ Int 2023; 182:108260. [PMID: 38006773 PMCID: PMC10716859 DOI: 10.1016/j.envint.2023.108260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/02/2023] [Accepted: 10/09/2023] [Indexed: 11/27/2023]
Abstract
Waterpipe smoking is frequent in the Middle East and Africa with emerging prevalence worldwide. The epigenome acts as a molecular sensor to exposures and a crucial driver in several diseases. With the widespread use of waterpipe smoking, it is timely to investigate its epigenomic markers and their role in addiction, as a central player in disease prevention and therapeutic strategies. DNA methylome-wide profiling was performed on an exposure-rich population from the Middle East, constituting of 216 blood samples split equally between never, cigarette-only and waterpipe-only smokers. Waterpipe smokers showed predominantly distinct epigenetic markers from cigarette smokers, even though both smoking forms are tobacco-based. Moreover, each smoking form could be accurately (∼90 %) inferred from the DNA methylome using machine learning. Top markers showed dose-response relationship with extent of smoking and were validated using independent technologies and additional samples (total N = 284). Smoking markers were enriched in regulatory regions and several biological pathways, primarily addiction. The epigenetically altered genes were not associated with genetic etiology of tobacco use, and the methylation levels of addiction genes, in particular, were more likely to reverse after smoking cessation. In contrast, other epigenetic markers continued to feature smoking exposure after cessation, which may explain long-term health effects observed in former smokers. This study reports, for the first time, blood epigenome-wide markers of waterpipe smokers and reveals new markers of cigarette smoking, with implications in mechanisms of addiction and the capacity to discriminate between different smoking types. These markers may offer actionable targets to reverse the epigenetic memory of addiction and can guide future prevention strategies for tobacco smoking as the most preventable cause of illnesses worldwide.
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Affiliation(s)
- Zainab Awada
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer, Lyon, France
| | - Vincent Cahais
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer, Lyon, France
| | - Cyrille Cuenin
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer, Lyon, France
| | - Reem Akika
- Department of Pharmacology and Toxicology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Anna Luiza Silva Almeida Vicente
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer, Lyon, France; Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Maha Makki
- Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hani Tamim
- Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Zdenko Herceg
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer, Lyon, France
| | - Nathalie Khoueiry Zgheib
- Department of Pharmacology and Toxicology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
| | - Akram Ghantous
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer, Lyon, France.
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Rezk-Hanna M, Adolfo A, Warda US, Brecht ML, Benowitz NL. Association of non-daily hookah tobacco smoking and cardiovascular disease-related exposure biomarkers among U.S. users: The Population Assessment of Tobacco and Health Study. Prev Med Rep 2023; 36:102417. [PMID: 37753385 PMCID: PMC10518337 DOI: 10.1016/j.pmedr.2023.102417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/28/2023] Open
Abstract
Hookah smoking has grown to become a global tobacco epidemic. While cigarette smoking is a well-established cardiovascular disease (CVD) risk factor, the CVD risks of hookah smoking are unknown, particularly among regular U.S. adult hookah users who are predominantly non-daily users. Herein, we examined the association between hookah smoking and biomarkers of CVD risk among regular exclusive hookah smokers (n = 75), compared to regular exclusive cigarette smokers (n = 1773), dual hookah and cigarette smokers (n = 43) and never tobacco users (n = 757), using data from a nationally representative sample of adults from the Population Assessment of Tobacco and Health Study (2013-2014). Whereas 84% of cigarette smokers reported daily use, only 8% of hookah smokers reported daily use, with more than a third reporting monthly use. Adjusting for age and sex and as compared to exclusive cigarette smokers, exclusive hookah smokers had significantly lower geometric mean concentrations in serum sICAM-1 and urinary F2-isoprostane (p < 0.05). Although not statistically significant, a signal of increased oxidative stress was observed among hookah smokers as compared to never tobacco users (urinary F2-isoprostane). CVD-related harm biomarkers appear to be lower among hookah smokers than cigarette smokers. These findings represent patterns of hookah smoking predominantly shared among adult U.S. users who report non-daily occasional use and do not reflect solitary, daily use as is common in the Middle East. Future studies with longer exposure and longitudinal hookah use are warranted to explore the association between hookah smoking and CVD risk.
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Affiliation(s)
- Mary Rezk-Hanna
- School of Nursing, University of California, Los Angeles, Los Angeles, CA, United States
| | - Amanda Adolfo
- School of Nursing, University of California, Los Angeles, Los Angeles, CA, United States
| | - Umme Shefa Warda
- School of Nursing, University of California, Los Angeles, Los Angeles, CA, United States
| | - Mary-Lynn Brecht
- School of Nursing, University of California, Los Angeles, Los Angeles, CA, United States
| | - Neal L. Benowitz
- Divsion of Cardiology, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
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Mohsen G, Kemmerer M, Eichhorn L. Carbon monoxide intoxication with a CO-Hb of 30% while smoking waterpipe: a case report. Int J Emerg Med 2023; 16:83. [PMID: 37936075 PMCID: PMC10630999 DOI: 10.1186/s12245-023-00560-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/26/2023] [Indexed: 11/09/2023] Open
Abstract
Carbon monoxide (CO) poisoning is a significant public health issue and a considerable economic burden in developed countries. While the majority of non-fire-related CO poisonings are attributed to gas heating, there are several other less recognized sources that should be considered in the initial differential diagnosis.The patient in this case was a 21-year-old who experienced a brief episode of loss of consciousness and was subsequently admitted to the Emergency department. Upon evaluation, the patient was diagnosed with CO poisoning, which necessitated hyperbaric oxygen therapy to mitigate the effects of this toxic exposure.Despite exhibiting harmful symptoms initially, the patient stated in a phone interview two and a half years post-incident that they have not experienced any enduring effects such as cardiac arrhythmia or concentration deficits. While their understanding of the risks associated with waterpipe smoking has increased, it has not influenced any major changes in their waterpipe smoking habits.
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Affiliation(s)
- Ghaith Mohsen
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany.
| | | | - Lars Eichhorn
- Department of Anaesthesiology and Intensive Care Medicine, Helios Hospital Bonn/Rhein-Sieg, Bonn, Germany
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Masjedi MR, Torkshavand Z, Arfaeinia H, Dobaradaran S, Soleimani F, Farhadi A, Rashidi R, Novotny TE, Dadipoor S, Schmidt TC. First report on BTEX leaching from waterpipe tobacco wastes (WTWs) into aquatic environment. Heliyon 2023; 9:e21946. [PMID: 38034754 PMCID: PMC10682136 DOI: 10.1016/j.heliyon.2023.e21946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/20/2023] [Accepted: 11/01/2023] [Indexed: 12/02/2023] Open
Abstract
Waterpipe tobacco wastes (WTWs) may contain considerable levels of hazardous contaminants such as BTEX (benzene, toluene, ethylbenzene, o-xylene, and m/p-xylene). However, no research has been carried out on BTEX levels in WTWs and the release of these pollutants into the water environment. This research examined the levels of BTEX in WTWs of flavored/local tobacco and also the release rate of these toxins into three kinds of water, including seawater (SW), tap water (TW), and distilled water (DW) with different leaching times (15, 30 min, 1.2, 4, 8 h, and 1, 2, and 4 days). The mean contents of BTEX in WTW samples of Al-Mahmoud, Al-Fakher, Mazaya, Al-Ayan brands, and local tobacco samples were 17.0 ± 4.14, 19.1 ± 4.65, 19.6 ± 4.19, 18.8 ± 4.14, and 3.16 ± 0.63 μg/kg, respectively. The mean BTEX levels in flavored tobacco samples were considerably greater than that of local tobacco (p < 0.05). The WTWs leaching experiments showed that the levels of BTEX ranged from 5.26 to 6.12, 5.02-5.60, and 3.83-5.46 μg/L in DW, TW, and SW, respectively. All target compounds were found for all exposure times in DW, TW, and SW samples. After adding sodium azide as an antibacterial agent to water samples (simulating biodegradation processes), higher levels of BTEX compounds were detected in SW. Further research is needed to address the potential environmental hazards due to WTWs leaching into aquatic environments.
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Affiliation(s)
- Mohammad Reza Masjedi
- Tobacco Control Research Center (TCRC), Iranian Anti-Tobacco Association, Tehran, Iran
| | - Zahra Torkshavand
- Environmental and Occupational Health Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Hossein Arfaeinia
- Systems Environmental Health and Energy Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
- Department of Environmental Health Engineering, Faculty of Health, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Sina Dobaradaran
- Systems Environmental Health and Energy Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
- Department of Environmental Health Engineering, Faculty of Health, Bushehr University of Medical Sciences, Bushehr, Iran
- Instrumental Analytical Chemistry and Centre for Water and Environmental Research (ZWU), Faculty of Chemistry, University of Duisburg-Essen, Universitätsstr. 5, Essen, Germany
- Centre for Water and Environmental Research, University of Duisburg-Essen, Universitätsstr. 5, Essen, 45141, Germany
| | - Farshid Soleimani
- Tobacco and Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Akram Farhadi
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Roshana Rashidi
- Department of Civil Engineering, School of Engineering, Persian Gulf University, Bushehr, Iran
| | - Thomas E. Novotny
- School of Public Health, San Diego State University, San Diego, CA 92182, United States
- San Diego State University Research Foundation, San Diego, CA 92182, United States
| | - Sara Dadipoor
- Tobacco and Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Torsten C. Schmidt
- Instrumental Analytical Chemistry and Centre for Water and Environmental Research (ZWU), Faculty of Chemistry, University of Duisburg-Essen, Universitätsstr. 5, Essen, Germany
- Centre for Water and Environmental Research, University of Duisburg-Essen, Universitätsstr. 5, Essen, 45141, Germany
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Karimi Jaberi M, Shahabi N, Mohseni S, Karimi Jaberi Z, Abbaszadeh S, Zarei F, Dadipoor S. Smoking waterpipe, cigarette, and heart disease: a cross-sectional analysis of baseline data from the Kong Cohort Study in the South of Iran. J Ethn Subst Abuse 2023:1-14. [PMID: 37682695 DOI: 10.1080/15332640.2023.2253185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2023]
Abstract
Previous studies have shown the association between smoking and increased risk of cardiovascular diseases, but long-term effects of waterpipe use are unknown and more research is needed. The present study explored the relationship between cigarette and waterpipe smoking and heart disease in southern Iran. This cross-sectional study used the basic data of Bandar Kong Cohort Study (KCS) to test the relationship between waterpipe and cigarette smoking and heart disease in 4009 participants. A multivariate binary logistic regression was run to estimate adjusted odds ratios (ORs) in SPSS 16. The prevalence of tobacco use was 27.7%. The frequency of heart disease was 7.8% percent (n = 314). There was a statistically significant relationship between cigarette smoking and heart disease (OR = 2.11; 95% CI:1.41-3.16). In individuals who only smoked waterpipes, the odds of heart disease were higher than non-smokers. This relationship was not statistically significant (OR = 1.25, 95% CI:0.88-1.78). In those who smoked cigarettes and waterpipe at the same time, the odds of heart disease were higher than non-smokers (OR = 1.42; 95% C.I: 0.83-2.59). In general, cigarette smoking increases the risk of heart disease. As well as waterpipe smoking was associated with heart disease. However, this association was not statistically significant. More studies are required to validate the association between waterpipe smoking and heart disease. Also, waterpipe use was more common at younger ages, and on the other hand, heart diseases have a long latent period, so in this age group, high incidence of heart disease is likely in the future.
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Affiliation(s)
- Maryam Karimi Jaberi
- Social Determinants in Health Promotion Research Centre, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Nahid Shahabi
- Tobacco and Health Research Centre, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Shokrollah Mohseni
- Social Determinants in Health Promotion Research Centre, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Zahra Karimi Jaberi
- Social Determinants in Health Promotion Research Centre, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Shahin Abbaszadeh
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Faeghe Zarei
- Social Determinants in Health Promotion Research Centre, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Sara Dadipoor
- Tobacco and Health Research Centre, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Ogunkoya JO, Sodeinde KJ, Bamidele FE, Ladele AE, Abiodun O, Imishue OT, Ehioghae O, Ogunkoya OA. Knowledge, Attitude and Practice of Shisha Smoking among Undergraduates in a Private Tertiary Institution in Nigeria: A Cross-Sectional Study. West Afr J Med 2023; 40:814-819. [PMID: 37639340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
BACKGROUND Shisha smoking is a growing health concern in most countries and this habit of smoking tobacco is on the increase in Nigeria. It is on the rise among youths along with proliferation of clubs, bars and hotels all over the country. The increased use in Nigeria can be attributed to easy access to tobacco products. OBJECTIVE To determine the prevalence of Shisha smoking and evaluate the knowledge, attitude and practice of Shisha smoking among university undergraduates at a private university in Nigeria. METHODS In 2021, a cross-sectional online study was carried out among university students at Babcock University, Ilishan-Remo, Ogun State, Nigeria, using a self-administered questionnaire. RESULTS Overall, a total of 446 students took part in the study (115 males, 321 females) with mean age of 19.7 ± 2.9. The prevalence of Shisha smoking amongst the study respondents was 4.6%. About 25.0% of those that smoked shisha stated that they have been trying to quit with none of them seeking professional help. The mean knowledge score was 6.1 ± 2.6. The knowledge of shisha was highest among females and year 6 students. A little over half of the study respondents did not know that Shisha smoking was associated with cancers (52.8%) or that Shisha contained tobacco (58.3%). On the average, the study participants had very good attitude towards Shisha smoking with an average attitude score of 3.4 ± 0.4. The best attitude score was seen in females and year 6 students. The difference was not statistically significant. (p>0.05). CONCLUSION The habit of shisha smoking occurs among youths who may be unaware of the tobacco content and increasing evidences of possible health risks. The findings in this study may help in formulating policies which are geared towards combating this growing menace in our schools and the society at large.
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Affiliation(s)
- J O Ogunkoya
- Benjamin Carson Senior, College of Health and Medical Sciences, Babcock University, Ilishan Remo, Ogun State, Nigeria
- Division of Respiratory Medicine and Allergy, Department of Medicine, Babcock University Teaching Hospital, Ilishan Remo, Ogun State, Nigeria
| | - K J Sodeinde
- Benjamin Carson Senior, College of Health and Medical Sciences, Babcock University, Ilishan Remo, Ogun State, Nigeria
- Department of Community Medicine, Babcock University Teaching Hospital, Ilishan Remo, Ogun State, Nigeria
| | - F E Bamidele
- Benjamin Carson Senior, College of Health and Medical Sciences, Babcock University, Ilishan Remo, Ogun State, Nigeria
- Department of Community Medicine, Babcock University Teaching Hospital, Ilishan Remo, Ogun State, Nigeria
| | - A E Ladele
- Benjamin Carson Senior, College of Health and Medical Sciences, Babcock University, Ilishan Remo, Ogun State, Nigeria
| | - O Abiodun
- Benjamin Carson Senior, College of Health and Medical Sciences, Babcock University, Ilishan Remo, Ogun State, Nigeria
- Department of Community Medicine, Babcock University Teaching Hospital, Ilishan Remo, Ogun State, Nigeria
| | - O T Imishue
- Benjamin Carson Senior, College of Health and Medical Sciences, Babcock University, Ilishan Remo, Ogun State, Nigeria
| | - O Ehioghae
- Benjamin Carson Senior, College of Health and Medical Sciences, Babcock University, Ilishan Remo, Ogun State, Nigeria
| | - O A Ogunkoya
- Ogun State, Local Government Service Commission, Oke Mosan, Abeokuta, Ogun State, Nigeria
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Moghadam TZ, Zandian H, Fazlzadeh M, Kalan ME, Pourfarzi F. Socioeconomic and environmental factors associated with waterpipe tobacco smoking among Iranian adults: a PERSIAN cohort-based cross-sectional study. BMC Public Health 2023; 23:1295. [PMID: 37407959 DOI: 10.1186/s12889-023-16176-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 06/22/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Waterpipe tobacco smoking (WTS) is associated with several deleterious health outcomes. We sought to estimate the prevalence of WTS and explore socioeconomic inequalities associated with this culturally-rooted tobacco smoking practice among Iranian adults. METHODS A cross-sectional analysis was conducted among 20,460 adults (ages 18 and older) enrolled in the PERSIAN cohort study during 2020. Data were collected on socioeconomic status (SES), lifestyle, alcohol consumption, cigarette smoking, and several risk factors related to non-communicable diseases. The concentration curve and relative concentration index (RCI) were administered to assess and quantify the SES-based inequality in WTS. RESULTS Overall age-adjusted prevalence of past-month WTS was 5.1% (95%CI:4.6-5.8), with about 1% for women and 10.6 for men. Age-adjusted prevalence of WTS was higher among younger adults, men, cigarette smokers, obese adults, and those with higher SES. The RCI estimation showed that WTS is more popular among adults with high income and education. WTS was higher among younger adults, cigarette smokers, obese adults, and those with higher SES. CONCLUSION There is a clear socioeconomic inequality in WTS, with a higher prevalence among adults with higher income and education. The findings suggest the need for targeted interventions to address this inequality and reduce the prevalence of WTS among high-income communities.
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Affiliation(s)
- Telma Zahirian Moghadam
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Hamed Zandian
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran.
- Centre for Public Health and Wellbeing, School of Health and Social Wellbeing, College of Health, Science and Society, University of the West of England, Bristol, UK.
| | - Mehdi Fazlzadeh
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
- Lung Diseases Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | | | - Farhad Pourfarzi
- Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran.
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Bertani AL, Tanni SE, Godoy I. Dual and Poly Use of Tobacco Products in a Sample of Pregnant Smokers: A Cross-sectional Study. Matern Child Health J 2023:10.1007/s10995-023-03698-1. [PMID: 37395976 PMCID: PMC10359197 DOI: 10.1007/s10995-023-03698-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2023] [Indexed: 07/04/2023]
Abstract
OBJECTIVES Our aim was to assess the use of dual/poly tobacco in a sample of pregnant women. DESIGN cross-sectional survey. METHODS Twenty prenatal care units in Botucatu, Sao Paulo, Brazil. We evaluated 127 high-risk pregnant smokers during prenatal care. Those who were 12-38 weeks pregnant and were currently smoking conventional cigarettes. The study enrollment took place between January 2015 and December 2015. The dual/poly prevalence of tobacco products during pregnancy and the characteristics related to smoking in pregnant smokers through a specific questionnaire containing questions related to sociodemographic characteristics, comorbidities, gestational history, smoking history, secondhand smoke exposure, nicotine dependence, motivation stage and use of alternative forms of tobacco. RESULTS Mean age was 26.9 ± 6.6 years, most had only elementary education and belonged to lower income economic groups. Twenty-five (19.7%) smoked conventional cigarettes only while 102 used conventional and alternative forms of tobacco products. Smoking pack-years was significantly lower in those only smoking conventional cigarettes than in dual/poly users. Proportion of patients with elevated degree of nicotine dependence was higher in conventional cigarettes users. On the other side, alcohol intake was higher in dual/poly smokers when compared to conventional cigarettes group. The alternative forms of smoking were associated with significantly higher occurrences of comorbidities as pulmonary, cardiovascular and cancer. CONCLUSIONS FOR PRACTICE The prevalence of alternative forms users of smoking products is high during pregnancy. These data reinforce the importance of a family approach towards smoking in pregnant women and education about the risks of alternative forms of tobacco.
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Affiliation(s)
- André Luís Bertani
- Department of Internal Medicine, Botucatu Medical School, UNESP - Univ Estadual Paulista, Botucatu Campus, Pneumology Area - UNESP, Distrito de Rubião Junior S/N, Botucatu, São Paulo, 18618-970, Brazil.
| | - Suzana Erico Tanni
- Department of Internal Medicine, Botucatu Medical School, UNESP - Univ Estadual Paulista, Botucatu Campus, Pneumology Area - UNESP, Distrito de Rubião Junior S/N, Botucatu, São Paulo, 18618-970, Brazil
| | - Irma Godoy
- Department of Internal Medicine, Botucatu Medical School, UNESP - Univ Estadual Paulista, Botucatu Campus, Pneumology Area - UNESP, Distrito de Rubião Junior S/N, Botucatu, São Paulo, 18618-970, Brazil
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Masjedi MR, Arfaeinia H, Dobaradaran S, Keshtkar M, Soleimani F, Novotny TE, Torkshavand Z. Post-consumption waterpipe tobacco waste as an unrecognized source of toxic metal(loid)s leachates into aquatic environments. Sci Total Environ 2023; 879:163207. [PMID: 37011674 DOI: 10.1016/j.scitotenv.2023.163207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/25/2023] [Accepted: 03/28/2023] [Indexed: 05/17/2023]
Abstract
Waterpipe is a common form of tobacco smoking, and recently, its use has been increasing globally. Therefore, concern arises regarding the large quantity of post-consumption waterpipe tobacco waste produced and released into the environment and which can contain high levels of dangerous pollutants such as toxic meta(loid)s. This study reports the concentrations of meta(loid)s in waste from fruit-flavoured and traditional tobacco smoking as well as the release rate of these pollutants from waterpipe tobacco waste into three types of water. These include distilled water, tap water, and seawater and contact times ranging from 15 min to 70 days. The mean concentration levels of Ʃmetal(loid)s in waste samples of Al-mahmoud, Al-Fakher, Mazaya, Al-Ayan brands and traditional tobacco brands were 212 ± 92.8, 198 ± 94.4, 197 ± 75.7, 214 ± 85.8 and 40.6 ± 16.1 μg/g, respectively. The concentration levels of Ʃmetal(loid)s in fruit-flavoured tobacco samples were significantly higher than for traditional tobacco samples (p < 0.05). It was found that waterpipe tobacco wastes leached toxic metal(loid)s into different water samples with similar trends. In addition distribution coefficients showed that most metal(loid)s are highly likely to enter the liquid phase. The concentration levels of these pollutants (except Ni and As) in deionized water and tap water exceeded the surface fresh water standards for sustaining aquatic life during long contact time (up to 70 days). In seawater, concentration levels of Cu and Zn exceeded the recommended standards for maintaining aquatic life in the sea. Therefore, due to the possibility of contamination by soluble metal(loid)s through disposal of waterpipe tobacco waste in wastewater, there is concern that these toxic chemicals might enter the human food chain. Appropriate regulatory measures for disposal of waterpipe tobacco waste are necessary to prevent environmental pollution due to discarded wastes into aquatic ecosystems.
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Affiliation(s)
- Mohammad Reza Masjedi
- Tobacco Control Research Center (TCRC), Iranian Anti-Tobacco Association, Tehran, Iran
| | - Hossein Arfaeinia
- Systems Environmental Health and Energy Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran; Department of Environmental Health Engineering, Faculty of Health and Nutrition, Bushehr University of Medical Sciences, Bushehr, Iran.
| | - Sina Dobaradaran
- Systems Environmental Health and Energy Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran; Department of Environmental Health Engineering, Faculty of Health and Nutrition, Bushehr University of Medical Sciences, Bushehr, Iran; Instrumental Analytical Chemistry and Centre for Water and Environmental Research (ZWU), Faculty of Chemistry, University of Duisburg-Essen, Universit¨atsstr. 5, Essen, Germany; Centre for Water and Environmental Research, University of Duisburg-Essen, Universitätsstr. 5, Essen 45141, Germany.
| | - Mozhgan Keshtkar
- Systems Environmental Health and Energy Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Farshid Soleimani
- Department of Environmental Health Engineering, Faculty of Health and Nutrition, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Thomas E Novotny
- School of Public Health, San Diego State University, San Diego, CA 92182, United States
| | - Zahra Torkshavand
- Department of Environmental Health Engineering, School of Public Health and Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
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Al Ali NM, Khazaaleh FK. Assessment of food consumption, smoking, alcohol use, and physical activity by sex and major of study among a sample of college students in Jordan. Heliyon 2023; 9:e16405. [PMID: 37274724 PMCID: PMC10238686 DOI: 10.1016/j.heliyon.2023.e16405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 05/13/2023] [Accepted: 05/15/2023] [Indexed: 06/06/2023] Open
Abstract
This study aimed to assess the food frequency and health-related risk behaviors based on gender and major of study (health and non-health majors) in a sample of undergraduate university students. A cross-sectional study was conducted among 708 undergraduate university students (37.4% males; 62.6% females) with a mean age of 20.88(SD = 2.20), ranging from 18 to 37 years from five universities. A self-reported questionnaire was administered in the university classrooms to collect data. Results showed that 47.3% of students reported consuming fruits and vegetables (38.1%), and 54% reported consuming unhealthy foods at least once in the preceding 24 h. About 16% of the students were cigarette smokers, 17% were waterpipe smokers, and slightly more than 4% were alcohol consumers. Significant associations were found between the participants based on their sexes, and study majors (P < 0.001). Male students smoked and consumed alcohol at significantly higher rates than female students. As with regards to the physical activity in the preceding week, students had not carried out any stretching activities (52.8%), strengthening activities (62.4%), cycling (35%), or taken part in any physical activity classes (68.4%). The rates of physical activity were significantly higher among male students than female students (p < 0.001). The results showed that non-health major students differ from those in health majors in the consumption of cigarettes (p < 0.001) and waterpipe smoking (p = 0.027). Students in non-health majors were more likely than students in health majors to have carried out stretching activities (p = 0.021) and participated in physical activity classes (p = 0.02). Our findings highlighted the importance of identifying health-related risk behaviors among university students to develop a health-promoting intervention tailored to a specific group of students considering their sex and study majors.
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Affiliation(s)
- Nahla Mansour Al Ali
- Associate Professor Community and Mental Health Department/Faculty of Nursing Jordan University of Science & Technology P.O.Box:3030 Irbid 22110 Jordan
| | - Fatima Khazaal Khazaaleh
- Community and Mental Health Department/Faculty of Nursing, Jordan University of Science & Technology, P.O.Box:3030 Irbid 22110 Jordan
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Laqqan MM, Al-Ghora SS, Yassin MM. Impact of waterpipe and tobacco cigarette smoking on global DNA methylation and nuclear proteins genes transcription in spermatozoa: a comparative investigation. Inhal Toxicol 2023:1-10. [PMID: 37145555 DOI: 10.1080/08958378.2023.2208608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
BACKGROUND Waterpipe smoking is harmful and dangerous, and it is a growing threat to public health. OBJECTIVES This study was performed to evaluate the influence of waterpipe smoking on global DNA methylation, DNA fragmentation, and protamine deficiency in spermatozoa compared to cigarette heavy smokers and nonsmokers, and to determine whether the transcription levels of spermatozoa nuclear proteins genes 'PRM1, PRM2, and H2BFWT' in waterpipe smokers are different compared to cigarette heavy smokers and nonsmokers. METHODS A total of 900 semen samples were collected from males with a mean age of 32.5 ± 6.3 years (300 waterpipe smokers, 300 cigarette heavy smokers, and 300 nonsmokers). The nucleic acids were isolated from purified spermatozoa, and then the global DNA methylation and transcription levels of the PRM1, PRM2, and H2BFWT genes were assessed using ELISA and qPCR, respectively. RESULTS A significant increase was found in the level of global DNA methylation (8.6 ± 0.6 ng/μl vs. 7.1 ± 0.6 ng/μl and 4.7 ± 0.6 ng/μl, p < 0.001), protamine deficiency (72.8 ± 15.3 vs. 51.7 ± 19.2 and 15.3 ± 5.9%, p < 0.001), and DNA fragmentation (73.4 ± 13.4 vs. 50.5 ± 18.9 and 9.3 ± 4.3%, p < 0.001) in waterpipe smokers compared to cigarette heavy smokers and nonsmokers. A significant increase was shown in the transcription levels of PRM1, PRM2, and H2BFWT genes in waterpipe smokers compared to cigarette heavy smokers and nonsmokers (p < 0.001). A down-regulation was found in the transcription level of these genes in different smoker groups compared to nonsmokers (<0.001). CONCLUSION This study suggests that waterpipe smoking is more harmful than cigarette smoking on semen parameters, global DNA methylation, and transcription of nuclear protein genes.
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Affiliation(s)
- Mohammed M Laqqan
- Faculty of Health Sciences, Department of Medical Laboratory Sciences, Islamic University of Gaza, Gaza, Palestine
| | - Said S Al-Ghora
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Maged M Yassin
- Faculty of Medicine, Department of Human Physiology, Islamic University of Gaza, Gaza, Palestine
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Shafiee A, Oraii A, Jalali A, Alaeddini F, Saadat S, Masoudkabir F, Tajdini M, Ashraf H, Omidi N, Heidari A, Shamloo AS, Sadeghian S, Boroumand M, Vasheghani-Farahani A, Karimi A, Franco OH. Epidemiology and prevalence of tobacco use in Tehran; a report from the recruitment phase of Tehran cohort study. BMC Public Health 2023; 23:740. [PMID: 37085856 PMCID: PMC10122292 DOI: 10.1186/s12889-023-15629-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 04/07/2023] [Indexed: 04/23/2023] Open
Abstract
INTRODUCTION Tobacco use is a major health concern worldwide, especially in low/middle-income countries. We aimed to assess the prevalence of cigarette smoking, waterpipe, and pipe use in Tehran, Iran. METHODS We used data from 8272 participants of the Tehran Cohort Study recruitment phase. Tobacco use was defined as a positive answer to using cigarettes, waterpipes, or pipes. Participants who did not report tobacco use during the interview but had a previous smoking history were categorized as former users. Age- and sex-weighted prevalence rates were calculated based on the national census data, and characteristics of current and former tobacco users were analyzed. RESULTS Age- and sex-weighted prevalence of current tobacco users, cigarette smokers, waterpipe, and pipe users in Tehran was 19.8%, 14.9%, 6.1%, and 0.5%, respectively. Current tobacco use was higher in younger individuals (35-45 years: 23.4% vs. ≥ 75 years: 10.4%, P < 0.001) and men compared to women (32.9% vs. 7.7% P < 0.001). The prevalence of tobacco use increased with more years of education (> 12 years: 19.3% vs. illiterate: 9.7%, P < 0.001), lower body mass index (< 20 kg/m2: 31.3% vs. ≥ 35 kg/m2: 13.8%, P < 0.001), higher physical activity (high: 23.0% vs. low: 16.4%, P < 0.001), opium (user: 66.6% vs. non-user: 16.5%, P < 0.001), and alcohol use (drinker: 57.5% vs. non-drinker: 15.4%, P < 0.001). Waterpipe users were younger (46.1 vs. 53.2 years) and had a narrower gender gap in prevalence than cigarette smokers (male/female ratio in waterpipe users: 2.39 vs. cigarette smokers: 5.47). Opium (OR = 5.557, P < 0.001) and alcohol consumption (OR = 4.737, P < 0.001) were strongly associated with tobacco use. Hypertension was negatively associated with tobacco use (OR = 0.774, P = 0.005). CONCLUSION The concerning prevalence of tobacco use in Tehran and its large gender gap for cigarette and waterpipe use warrant tailored preventive policies.
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Affiliation(s)
- Akbar Shafiee
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Oraii
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Jalali
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Farshid Alaeddini
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheil Saadat
- Department of Emergency Medicine, University of California, Irvine, CA, USA
| | - Farzad Masoudkabir
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Masih Tajdini
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Haleh Ashraf
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Omidi
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirhossein Heidari
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Alireza Sepehri Shamloo
- Department of Electrophysiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany
| | - Saeed Sadeghian
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohamamdali Boroumand
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Vasheghani-Farahani
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbasali Karimi
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Oscar H Franco
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
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Mortazavi SH, Moghadasi AN, Almasi-Hashiani A, Sahraian MA, Goudarzi H, Eskandarieh S. Waterpipe and cigarette smoking and drug and alcohol consumption, and the risk of primary progressive multiple sclerosis: A population-based case-control study. Curr J Neurol 2023; 22:72-81. [PMID: 38011368 PMCID: PMC10460924 DOI: 10.18502/cjn.v22i2.13331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 02/06/2023] [Indexed: 11/29/2023]
Abstract
Background: Multiple sclerosis (MS) is a chronic central nervous system disease, and primary progressive multiple sclerosis (PPMS) is one the main types of MS, which has unknown environmental risk factors. The present study was conducted with the aim to identify the association of waterpipe and cigarette smoking, substance abuse, and alcohol consumption with the risk of PPMS development. Methods: A population-based, case-control study was conducted in Tehran, Iran, on 146 PPMS cases and 294 controls. PPMS cases were diagnosed and confirmed by neurologists. Standard random digit dialing was used to select sex-matched healthy control participants from the same source population as the cases. Logistic regression analysis was used to estimate unadjusted and adjusted odds ratios (OR). Results: In total, 440 subjects participated in the study. PPMS was associated with ever smoking cigarettes [OR = 2.48; confidence interval (CI) = 1.44-4.27], and passive smoking (OR = 2.20; CI = 1.34-3.62). However, having ever smoked waterpipe was not significantly associated with PPMS risk (OR = 1.19; CI = 0.62-2.26). Those who had all 3 types of smoking had an accumulative OR that was 10.45 times higher than that in individuals without any type of smoking (OR: 10.45; 95% CI = 3.5-31.2). We did not find any significant association between PPMS risk and substance abuse and alcohol consumption. Conclusion: Cigarette smoking and being exposed to passive smoking are important risk factors for developing PPMS; in addition, the use of 3 types of smoking, showed an OR higher than that in those without any smoking. Considering the global increase in tobacco smoking, this finding emphasizes the importance of interventional programs for the prevention of tobacco smoking.
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Affiliation(s)
- Seyyed Hosein Mortazavi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdorreza Naser Moghadasi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Almasi-Hashiani
- Department of Epidemiology, School of Health, Arak University of Medical Sciences, Arak, Iran
- Traditional and Complementary Medicine Research Center, Arak University of Medical Sciences, Arak, Iran
| | - Mohammad Ali Sahraian
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hooman Goudarzi
- Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan
- Center for Medical Education and International Relations, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Sharareh Eskandarieh
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
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Zare S, Kazemnejad A, Hamta A, Raeesi Dehkordi F. The Intention of Waterpipe Tobacco Smoking by Women in the COVID-19 Pandemic and its Contributing Factors: a Nonparametric Path Analysis. Med J Islam Repub Iran 2023; 37:30. [PMID: 37180856 PMCID: PMC10167644 DOI: 10.47176/mjiri.37.30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Indexed: 05/16/2023] Open
Abstract
Background People with waterpipe tobacco smoking (WTS) seem to be more at risk for the serious complications of coronavirus disease 2019 (COVID-19). This study aimed at assessing the behavioral intention (BI) of WTS by women in the COVID-19 pandemic and its contributing factors. Methods This cross-sectional descriptive-correlational study was conducted in 2020 (ie, during the COVID-19 pandemic). Participants were 300 women randomly selected through multistage sampling from comprehensive healthcare centers in Khorramabad, Iran. Data collection instrument was a 42-item questionnaire with 4 main subscales, namely knowledge, attitude, differential association, and BI. Data were collected through both online and phone-based methods and were analyzed using non-parametirc path analysis. Results The prevalence of WTS among women was 13% (95% CI, 11.06-14.94) and the mean scores of attitude, differential association, and behavioral intention among participants with WTS were significantly higher than participants without WTS (P < 0.001). Moreover, 46.12% (95% CI, 38.12-54.08) of participants with WTS reported intention to quit WTS due to the COVID-19 pandemic and 43.6% (95% CI, 35.66-51.54) of women with WTS and 16.5% (95% CI, 14.20-18.80) of women without WTS believed in the protective effects of WTS against COVID-19. The path analysis model showed that the BI of WTS had a significant inverse relationship with knowledge and a significant direct relationship with attitude and differential association. Conclusion This study suggests the need for quality educational and counseling interventions for the general public to correct popular misconceptions about the protective effects of WTS against COVID-19.
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Affiliation(s)
- Soodabeh Zare
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Anoshirvan Kazemnejad
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Amir Hamta
- Department of Biostatistics, Faculty of Medical Sciences, Arak University of Medical Sciences, Arak, Iran
| | - Fatemeh Raeesi Dehkordi
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
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Gautam P, Kalan ME, Li W, Taleb ZB, Vargas-Rivera M, Jebai R, Osibogun O, Maziak W. The Effects of Pictorial Health Warning Label on Waterpipe (Low- and High-Frequency) Smokers' Experiences, Toxicant Exposures, and Puffing Behavior. Int J Behav Med 2023; 30:146-153. [PMID: 35260948 PMCID: PMC10127153 DOI: 10.1007/s12529-022-10074-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Pictorial health warning label (PHWL) is an effective risk communication measure among cigarette smokers. However, there is a lack of knowledge regarding the effect of PHWL on low- and high-frequency waterpipe (WP) smokers. This study examined the effects of PHWL on puffing behavior, subjective experiences, and toxicant exposures among low- and high-frequency WP smokers in the United States (US). METHODS Sixty current (past-month) WP smokers (low-frequency; n = 30 and high-frequency; n = 30) completed two 45-min ad libitum WP smoking sessions in a cross-over design study (WP with no-PHWL vs. WP with PHWL). We compared the mean differences of puff topography, expired carbon monoxide (eCO), plasma nicotine concentration, and subjective experiences between the two smoking groups. RESULTS Mean age of low-frequency smokers was 21.5 years and high-frequency smokers was 21.3 years. Compared to high-frequency, low-frequency smokers had significant reduction in average total smoking time [mean difference (SD) = -7.6 (10.2) min vs. -2.6 (6.7) min, p = 0.03] and number of puffs [mean difference (SD) = -33.37 (70.7) vs. -0.70 (29.2), p = 0.02] following exposure to PHWL compared to no-PHWL condition. Post-session subjective experiences were lower among high-frequency smokers compared to low-frequency smokers following smoking WP with PHWL compared to the no-PHWL session (puff liking -1.2 vs. -0.5; puff satisfaction -1.0 vs. -0.3; craving reduction -0.5 vs. 1.2) (p < 0.05 for all). CONCLUSION Our findings indicate that placing PHWL on the WP device may be a promising strategy with differential effectiveness among WP smokers: low-frequency (reduce puffing behaviors) and high-frequency (reduce smoking experience).
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Affiliation(s)
- Prem Gautam
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, 1240 S.W. 108 AVE, Path, University Park, Miami, FL, 33174, USA
| | - Mohammad Ebrahimi Kalan
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Wei Li
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, 1240 S.W. 108 AVE, Path, University Park, Miami, FL, 33174, USA
| | - Ziyad Ben Taleb
- Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, USA
| | - Mayra Vargas-Rivera
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, 1240 S.W. 108 AVE, Path, University Park, Miami, FL, 33174, USA
| | - Rime Jebai
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, 1240 S.W. 108 AVE, Path, University Park, Miami, FL, 33174, USA
| | - Olatokunbo Osibogun
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, 1240 S.W. 108 AVE, Path, University Park, Miami, FL, 33174, USA
| | - Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, 1240 S.W. 108 AVE, Path, University Park, Miami, FL, 33174, USA. .,Syrian Center for Tobacco Studies, Tishreen Street, P.O.Box: 16542, Sheehan, Aleppo, Syria.
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21
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Alzoubi KH, Halboup AM, Khabour OF, Alomari MA. The Protective Effects of the Combination of Vitamin E and Swimming Exercise on Memory Impairment Induced by Exposure to Waterpipe Smoke. CNS Neurol Disord Drug Targets 2023; 22:304-312. [PMID: 35306997 DOI: 10.2174/1871527321666220318113635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/12/2021] [Accepted: 12/29/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Waterpipe smoking (WP) exposure involves a negative health impact, including memory deficit, which is attributed to the elevation of oxidative stress. Vitamin E (VitE) in combination with swimming exercise exerts protective effects that prevent memory impairment. In the current study, the modulation of WP-induced memory impairment by the combined effect of VitE and swimming exercise (SE) was investigated. METHODS Animals were exposed to WP one hour/day, five days per week for four weeks. Simultaneously, VitE (100 mg/kg, six days/week for four weeks) was administered via oral gavage, and the rats were made to swim one hour/day, five days/week for four weeks. Changes in memory were evaluated using radial arm water maze (RAWM), and oxidative stress biomarkers were examined in the hippocampus. RESULTS WP exposure induced short-term/long-term memory impairment (p<0.05). This impairment was prevented by a combination of VitE with SE (p<0.05). Additionally, this combination normalized the hippocampal catalase, GPx, and GSH/GSSG ratios that were modulated by WP (p<0.05). The combination further reduced TBARs levels below those of the control group (p<0.05). CONCLUSION WP-induced memory impairments were prevented by the combination of VitE with SE. This could be attributed to preserving the hippocampal oxidative mechanism by combining VitE and SE during WP exposure.
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Affiliation(s)
- Karem H Alzoubi
- Department of Pharmacy Practice and Pharmacotherapeutics, University of Sharjah, Sharjah, UAE
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Abdulsalam M Halboup
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, University of Science and Technology, Sana\'a, Yemen
| | - Omar F Khabour
- Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Jordan
| | - Mahmoud A Alomari
- Department of Rehabilitation Sciences, Division of Physical Therapy, Jordan University of Science and Technology, Irbid, Jordan
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22
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Sabet S, Mirmohammadi SJ, Zare Sakhvidi MJ, Vakili M, Mehrparvar AH, Mirzaei M. Spirometric Parameters in Waterpipe Smokers, Cigarette Smokers, and Non-smokers of Shahedieh Cohort Study. Addict Health 2023; 15:17-22. [PMID: 37560079 PMCID: PMC10408739 DOI: 10.34172/ahj.2023.1350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 05/30/2022] [Indexed: 08/11/2023]
Abstract
BACKGROUND Different kinds of smoking tobacco may affect pulmonary function and reduce some spirometric parameters. This study aimed to assess the relationship between smoking cigarettes and waterpipe and spirometric parameters. METHODS This was a cross-sectional study on 1543 middle-aged individuals, as a sub-study of the Shahedieh cohort study in Yazd. The participants were randomly selected from the Shahedieh cohort population and were divided into 6 groups according to their smoking habits: non-smokers (n=455), cigarette smokers (n=139), waterpipe smokers (n=287), ex-cigarette smokers (n=131), concurrent waterpipe and cigarette smokers (n=121), and cigarette or waterpipe passive smokers (n=410). Spirometry was performed on all participants and spirometric parameters were compared between different groups. The data were analyzed by SPSS (version 20) using Kolmogorov-Smirnov, Kruskal-Wallis, and Mann-Whitney U tests. FINDINGS FEV1 %, FEV1/FVC, and PEF25-75% were significantly lower in cigarette smokers, compared to waterpipe smokers and non-smokers. The measures were not significantly lower in waterpipe smokers in comparison to non-smokers. The frequency of obstructive pattern and small airway diseases was significantly higher in cigarette smokers compared to waterpipe smokers and non-smokers. CONCLUSION The results of this study showed that in the middle-aged population, spirometric parameters related to airway obstruction (FEV1, FEV1/FVC, and FEF25-75%) were significantly lower in cigarette smokers than in non-smokers and waterpipe smokers, but these parameters were not significantly different between waterpipe smokers and non-smokers.
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Affiliation(s)
- Sobhan Sabet
- Occupational Medicine Resident, Industrial Diseases Research Center, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Seyyed Jalil Mirmohammadi
- Department of Occupational Medicine, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Javad Zare Sakhvidi
- Department of Occupational Health, Faculty of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mahmood Vakili
- Department of Social Medicine, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Amir Houshang Mehrparvar
- Industrial Diseases Research Center, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Masoud Mirzaei
- Yazd Cardiovascular Research Center, Faculty of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Ghobadi H, Rostami R, Saranjam B, Aslani MR, Fazlzadeh M, Ghaffari HR. Urinary concentrations of BTEX in waterpipe smokers and nonsmokers: Investigating the influence of conventional activities and multiple factors. Ecotoxicol Environ Saf 2022; 241:113717. [PMID: 35679732 DOI: 10.1016/j.ecoenv.2022.113717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 05/16/2022] [Accepted: 05/26/2022] [Indexed: 06/15/2023]
Abstract
The aim of this study was to compare the concentrations of the benzene, toluene, ethylbenzene, and xylene (BTEX) compounds in the urine of smokers and the control group considering the role of age, weight, job, history of waterpipe and cigarette smoking, and driving time. The chemicals in the urine of 99 smokers and 31 nonsmokers were extracted by liquid-liquid extraction method and their concentrations were measured by liquid injection GC/MS. The mean concentration of benzene, toluene, ethylbenzene, m-xylene, o-xylene, p-xylene, and total BTEX in waterpipe smokers were found to be 471.40, 670.90, 127.91, 167.64, 90.62, 46.04, and 1574.50 ng/g. creatinine, respectively. For the waterpipe&cigarette smokers, the concentration of the compounds were 708.00, 959.00, 146.40, 192.50, 93.30, 53.07, and 2152.00 ng/g.creatinine, respectively. For nonsmokers the concentrations of these compounds were 88.12, 140.40, 36.68, 57.29, 31.53, 26.21, and 380.30 ng/g.creatinine, respectively. Driving time, waterpipe smoking and cigarette smoking were positively associated with BTEX concentration (p < 0.05). Fruity tobacco showed higher concentrations of BTEX compared to the regular tobacco, and athlete persons had les urinary BTEX than the non-athletes. There was not significant correlation between the BTEX and age, height, weight, and BMI. High concentrations of BTEX compounds in the urine of waterpipe and cigarette smokers compared to nonsmokers indicate that waterpipe and cigarette can be an important source of exposure to these compounds and the known adverse effects of these compounds, especially carcinogenicity, threaten the health of smokers.
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Affiliation(s)
- Hassan Ghobadi
- Department of Internal Medicine, Pulmonary Division, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran; Lung Diseases Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Roohollah Rostami
- Research Center for Health Sciences and Technologies, Semnan University of Medical Sciences, Semnan, Iran
| | - Behzad Saranjam
- Department of Occupational Health Engineering, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mohammad Reza Aslani
- Lung Diseases Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mehdi Fazlzadeh
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Tehran, Iran.
| | - Hamid Reza Ghaffari
- Tobacco and Health research center, Hormozgan university of medical sciences, Bandar abbas, Iran.
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de Carvalho Guimarães GL, Belo IS, Siqueira LFR, Ribeiro MTL, de Castro LL, de Oliveira GJPL, de Castro LA. Hookah Smoking among Brazilian University Students: An Exploratory Survey on the Prevalence and Perceptions of Addiction and its Harmfulness. Addict Health 2022; 14:166-174. [PMID: 36544976 PMCID: PMC9743827 DOI: 10.34172/ahj.2022.1354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 03/12/2022] [Indexed: 11/29/2022]
Abstract
Background This study aimed to determine the prevalence, beliefs, attitudes, and perceptions of hookah use in a population of undergraduate students at a large public university in Brazil. Methods The sample consisted of 1348 undergraduate students aged over 18-year-old. They completed structured questionnaires on demographic information and close-ended questions on the past and current experiences of smoking hookah. The data underwent descriptive analysis and binary logistic regression. Findings Finally, 1298 valid survey forms were obtained from printed and digital questionnaires. More than half (53.9%) of participants reported having tried hookah at least once, however, only 10.8% reported they had experienced it within the last 30 days. The majority of the studied population presented acceptable beliefs about the harmfulness and addictive capacity of hookah smoking. However, when comparing the perceptions of those who had smoked and those who had never smoked hookah, and also, the perceptions of users and non-users, significant differences were observed. Students who were users or had already tried hookah showed a tendency to underestimate the deleterious effects of this type of smoking. Conclusion It could be concluded that hookah smoking was common among Brazilian university students. In addition, preoccupying misperceptions of hookah's harmfulness and addictive capacity were found. The results showed that the epidemic of hookah smoking, especially among young people, has spread far beyond the Arab world and the Persians. Accordingly, preventive measures must be taken if this population is to be protected from addiction and other serious health problems.
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Affiliation(s)
| | - Iara Silva Belo
- School of Dentistry, Federal University of Goiás, Goiânia, Brazil
| | | | | | | | | | - Luciano Alberto de Castro
- Department of Stomatological Sciences, School of Dentistry, Federal University of Goiás, Goiânia, Brazil,Corresponding Author: Luciano Alberto de Castro, DDS, MSc, PhD; Assistant Professor at the Department of Stomatological Sciences, Faculty of Dentistry, Federal University of Goiás, Campus 1, Sem número, Praça Universitária, Goiânia, Brazil. Postal code: 74605-020, Tel/Fax: 55 62-3209- 6230,
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Chan L, El-Haddad N, Freeman B, MacKenzie R, Woodland L, O'Hara BJ, Harris-Roxas BF. Evaluation of 'Shisha No Thanks' - a co-design social marketing campaign on the harms of waterpipe smoking. BMC Public Health 2022; 22:386. [PMID: 35197044 PMCID: PMC8866041 DOI: 10.1186/s12889-022-12792-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 02/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Waterpipe (shisha) is becoming increasingly popular worldwide, particularly among young people; and in some countries, it is one of the few forms of tobacco use that is increasing. While there is a growing body of evidence of the harms of waterpipe smoke, there is a scarcity of research of interventions to address this form of tobacco consumption. METHODS The Shisha No Thanks project was a co-design social marketing campaign that aimed to raise awareness of the harms of waterpipe smoking among young people from an Arabic speaking background in Sydney, Australia. The campaign distributed material through social media and community events. We evaluated the project through an SMS community panel using a longitudinal study design. The cohort were sent questions before and after the project asking about their awareness of messages of harms, attitudes, intention to reduce waterpipe smoking, and awareness of support services. Data was analysed as matched pre- post- data. RESULTS The evaluation recruited 133 people to the panel. There was a significantly greater proportion of people who reported seeing, hearing or reading something about the harms of waterpipe smoking after the campaign (67.5%) compared with before (45.0%) (p=0.003). Post-campaign, there were higher proportions of people who strongly agreed that waterpipe smoking causes damage, and that it contains cancer-causing substances, but these increases were not statistically significant. There was low awareness of waterpipe cessation services at baseline and post campaign (22.5%). CONCLUSIONS The Shisha No Thanks project increased awareness of messages about the harms of waterpipe smoking. Although this is a small study, the longitudinal evaluation findings have international relevance and make a useful contribution to the understanding of the impact such interventions can have in addressing one of the few forms of tobacco use that is growing in both developed and developing countries.
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Affiliation(s)
- Lilian Chan
- Prevention Research Collaboration, Sydney School of Public Health and Charles Perkins Centre, The University of Sydney, 2006, Camperdown, NSW, Australia.
| | - Nouhad El-Haddad
- Centre for Primary Health Care and Equity, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Becky Freeman
- Prevention Research Collaboration, Sydney School of Public Health and Charles Perkins Centre, The University of Sydney, 2006, Camperdown, NSW, Australia
| | - Ross MacKenzie
- Centre for Primary Health Care and Equity, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Lisa Woodland
- Population and Community Health, South Eastern Sydney Local Health District, Darlinghurst, Australia
| | - Blythe J O'Hara
- Prevention Research Collaboration, Sydney School of Public Health and Charles Perkins Centre, The University of Sydney, 2006, Camperdown, NSW, Australia
| | - Ben F Harris-Roxas
- School of Population Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
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Obeid S, Hallit S, Sacre H, Salameh P. Factors associated with the onset of smoking and alcohol consumption: A cross-sectional study among Lebanese adolescents in schools. Arch Pediatr 2022; 29:194-199. [PMID: 35094905 DOI: 10.1016/j.arcped.2022.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 11/06/2021] [Accepted: 01/13/2022] [Indexed: 12/11/2022]
Abstract
OBJECTIVES This study aimed to evaluate factors and profiles associated with the earlier onset of cigarette/waterpipe smoking and alcohol consumption among Lebanese adolescents in schools. METHODS A total of 4000 adolescents (mean age = 15.31 ± 2.01 years) participated in this cross-sectional study. The standardized questionnaire was taken from the Health Behavior in School Children (HBSC) study in different countries (France, Belgium, and the USA) and adjusted to the Lebanese population. K-means clustering analysis was conducted to classify participants into three clusters according to their patterns (surrounded by smokers, surrounded by drinkers, and ease of talking to family members and friends) and Cox regression analyzes were conducted. RESULTS Participants were divided into three clusters. Cluster 1 (16.75% of participants) included adolescents with the lowest ease of talking to a family member or friend, with the latter smoking and drinking a lot (worst cluster). Cluster 2 (54.95%) included adolescents with moderate ease of talking to a family member and more to friends, surrounded by low-to-moderate smoking and alcohol consumption, particularly for a best friend (positive influence cluster). Finally, cluster 3 (28.30%) included adolescents with low ease of talking to friends, moderate ease of talking to a family member, and low-to-moderate smoking and alcohol consumption (low influence cluster). The results of the Cox regressions (taking the age at onset of smoking cigarettes and waterpipes as the dependent variables) showed that older age at onset of cigarette and waterpipe smoking was significantly associated with female participants and those belonging to clusters 2 and 3 compared to cluster 1. Moreover, a younger age at first alcohol use and getting drunk was significantly associated with living outside Beirut, whereas female gender and belonging to clusters 2 or 3 compared to cluster 1 were significantly associated with older age at first alcohol use and getting drunk. CONCLUSION This study identified risk factors (ease of talking as well as smoking and alcohol-drinking status of parents, siblings, and friends) and profiles related to early alcohol and cigarette/waterpipe use. These risk factors and profiles could help implement prevention campaigns to reduce substance use and improve adolescent health.
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Affiliation(s)
- Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
| | - Souheil Hallit
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon; Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
| | - Hala Sacre
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
| | - Pascale Salameh
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon; Faculty of Pharmacy, Lebanese University, Beirut, Lebanon; University of Nicosia Medical School, Nicosia, Cyprus
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27
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Al-Jayyousi GF, Kurdi R, Islam N, Alhussaini NWZ, Awada S, Abdul Rahim H. Factors Affecting Waterpipe Tobacco Smoking among University Students in Qatar. Subst Use Misuse 2022; 57:392-401. [PMID: 34913828 DOI: 10.1080/10826084.2021.2012695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Background: Recent data show an increase in the prevalence of waterpipe tobacco smoking (WTS) among university students in the Arab Gulf region alongside an attitude of social acceptability and a perception that WTS is less harmful than traditional cigarette smoking. Objective: This study measures the prevalence of WTS among university students and examines the individual, sociocultural, and environmental factors influencing this practice. Methods: Participants were selected through stratified random sampling of students in the largest national university in Qatar. Data were collected anonymously using an online questionnaire. Descriptive univariate and bivariate analyses were conducted to examine the association of WTS with participants' sociodemographic characteristics, knowledge, and attitudes. Results: 199 students completed the questionnaire. Among students who reported using tobacco products, waterpipe (shisha) was the most common product (70.6%). WTS was significantly associated with having a mother (p = 0.015) or a close friend (p < 0.001) who smoked. Compared to non-users, waterpipe tobacco users were significantly more likely to believe that waterpipe tobacco is less addictive than cigarettes (p = 0.009) and significantly less likely to believe that waterpipe tobacco can lead to cardiovascular diseases (p = 0.003) or dental problems (p = 0.02). More waterpipe tobacco users than non-users disagreed that parents (p = 0.005) or advertisements (p = 0.002) could influence use. More waterpipe tobacco users (70%) than non-users (37%) believed that females were more comfortable using waterpipes than cigarettes. Conclusions and implications: The findings shed light on factors shaping WTS and provide evidence for designing multilevel behavioral interventions to decrease the prevalence of WTS among youth.
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Affiliation(s)
| | - Rana Kurdi
- College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Nazmul Islam
- College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | | | - Sawsan Awada
- College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Hanan Abdul Rahim
- College of Health Sciences, QU Health, Qatar University, Doha, Qatar
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Abstract
This work provides insights on waterpipe tobacco and waterpipe charcoal as potential sources of environmental toxicants. Selected harmful and potentially harmful constituents (HPHCs) from ten U.S. commercial waterpipe tobacco filler products (before and after electric heating) and five waterpipe charcoal products (before and after burning) were investigated. The differences in quantities of HPHCs between the evaluated products appear to be affected by raw material properties and/or the manufacturing processes involved in product production. Trace metal quantities in waterpipe tobacco and charcoal products were observed after heating or burning conditions compared to unheated or unburned conditions, which could impact the environment through the generation of toxic tobacco product waste. This study demonstrates that waterpipe tobacco and waterpipe charcoal contain substantial quantities of benzo[a]pyrene (B[a]P) and trace metals (i.e., selenium, arsenic, cadmium, chromium, cobalt, lead, nickel) before use and that extensive and varied changes in trace metal quantities take place as a result of heating, and more studies are needed to estimate the magnitude of the environmental impact of waterpipe tobacco use.
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Affiliation(s)
- Jason R. Hsieh
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Calverton, MD, USA
| | - Megan L. Mekoli
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Calverton, MD, USA
| | - Ronald L. Edwards
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Calverton, MD, USA
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Al-Shatnawi SF, Alzoubi KH, Khabour OF. Withdrawal Symptoms among Cigarette and Waterpipe Smokers: A Study in Natural Setting. Clin Pract Epidemiol Ment Health 2021; 17:114-120. [PMID: 34733350 PMCID: PMC8493827 DOI: 10.2174/1745017902117010114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 05/05/2021] [Accepted: 06/27/2021] [Indexed: 11/22/2022]
Abstract
Background: The rates of tobacco use, including cigarette and waterpipe smoking, are surging in the Eastern Mediterranean region. The use of these products causes nicotine dependence that makes even short-term tobacco abstinence difficult due to aversive symptoms. During the daytime fasting of the month of “Ramadan”, people accept significant disruption in regular activities, including tobacco smoking. Thus, daytime during Ramadan (before sunset) is likely associated with abstinence symptoms emerging among tobacco smokers. We assessed this hypothesis by measuring tobacco/nicotine abstinence symptoms and craving among smokers of cigarettes or waterpipes during Ramadan. Methods: A cross-sectional survey-based study was conducted on a convenience sample of adults. Participants were assessed for general information about tobacco smoking, dependence, and nicotine desire or craving, and withdrawal symptoms using the Minnesota Nicotine Withdrawal Scale (MNWS) and the Tiffany-Drobes Questionnaire on Smoking Urges. Results: The study sample included 632 exclusive cigarette smokers and 161 exclusive waterpipe tobacco smokers. After fasting and abstaining from tobacco during the day, approximately 75% of cigarette smokers and 20% of waterpipe smokers reported smoking within the first 30 minutes. In addition, 10% of cigarette smokers and 30% of waterpipe smokers reported smoking within the first 60 minutes. Regarding smoking urge, no significant difference was found between cigarette and waterpipe smokers. For nicotine craving and withdrawal, significant differences between cigarette and waterpipe smokers were found when comparing mean scores for each of the following items: (i) urge to smoke, (ii) craving nicotine, (iii) hunger, (iv) desire for sweets, and (v) depression/feeling blue (P-values < 0.05). Conclusion: This study provided evidence from the month of Ramadan that waterpipe smoking is associated with abstinence-induced smoking urge and withdrawal symptoms that are comparable to cigarette smoking. More interdisciplinary research must be focused on developing interventions to reduce tobacco smoking, including waterpipe.
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Affiliation(s)
- Samah F Al-Shatnawi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Karem H Alzoubi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan.,Department of Pharmacy Practice and Pharmacotherapeutics, University of Sharjah, Sharjah, UAE
| | - Omar F Khabour
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
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Ebrahimi Kalan M, Abazari M, Ben Taleb Z, Adham D, Abbasi A, Bursac Z, Ward KD, Cobb CO, Behaleh R, Wipfli HL, Fazlzadeh M. Characteristics of flavored and non-flavored waterpipe tobacco users: a real-world setting study. Environ Sci Pollut Res Int 2021; 28:57629-57639. [PMID: 34089452 PMCID: PMC8179087 DOI: 10.1007/s11356-021-14706-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 05/31/2021] [Indexed: 05/05/2023]
Abstract
We aimed to compare sociodemographic characteristics, smoking patterns, beliefs and perceptions, nicotine dependence, and psychological indicators between flavored waterpipe (WP) tobacco (FWT) and non-flavored WP tobacco (non-FWT) smokers in Iran. A cross-sectional study was conducted in 94 WP-serving venues surrounding Tehran and Ardabil metropolitans in Iran. Convenience sampling was applied to select 900 current WP smokers [508 (56%) FWT-only and 392 (44%) non-FWT-only smokers] aged 18 years and older. Multivariable logistic regression was used to examine the independent characteristics of FWT and non-FWT smokers. Compared to non-FWT smokers, FWT smokers were younger (adjusted odds ratio [AOR]=0.88, 95% confidence interval [CI]: 0.87-0.90) and more likely to have ≥ 1 sibling who smoked WP (AOR=1.54, 95% CI: 1.06-2.24), share WP with others (AOR=2.52, 95% CI: 1.68-3.77), report current cigarette smoking (AOR=2.05, 95% CI: 1.23-3.42), and report confidence in quitting at any time (AOR=3.64, 95% CI: 2.45-5.39). FWT smokers were less likely to have seen (AOR=0.40, 95% CI: 0.27-0.60) or read (AOR=0.44, 95% CI: 0.24-0.80) warning messages on WP tobacco packages relative to non-FTW smokers. The most common self-reported reason for smoking WP was entertainment for both groups, followed by stress relief for non-FWT smokers and the escape from loneliness for FWT smokers. FWT-only smokers differ from non-FWT-only smokers in several aspects including being younger, having more positive beliefs and perceptions regarding WP use, and having higher cigarette smoking prevalence. These findings will help in developing more effective and targeted policies and cessation interventions for WP smokers according to flavor type they use, especially in the Middle East.
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Affiliation(s)
- Mohammad Ebrahimi Kalan
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | - Malek Abazari
- Department of Public Health, School of Health, Ardabil University of Medical Sciences, Daneshgah St, Ardabil, 5615731567, Iran
| | - Ziyad Ben Taleb
- Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, USA
| | - Davoud Adham
- Department of Public Health, School of Health, Ardabil University of Medical Sciences, Daneshgah St, Ardabil, 5615731567, Iran.
| | - Abbas Abbasi
- Department of Public Health, School of Health, Ardabil University of Medical Sciences, Daneshgah St, Ardabil, 5615731567, Iran
| | - Zoran Bursac
- Department of Biostatistics, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | - Kenneth D Ward
- School of Public Health, University of Memphis, Memphis, TN, USA
| | - Caroline O Cobb
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Raed Behaleh
- School of Health Sciences, Baldwin Wallace University, Berea, OH, USA
| | - Heather Lynn Wipfli
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Mehdi Fazlzadeh
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran.
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Hallit S, Obeid S, Sacre H, Salameh P. Lebanese Waterpipe Dependence Scale (LWDS-11) validation in a sample of Lebanese adolescents. BMC Public Health 2021; 21:1627. [PMID: 34488694 PMCID: PMC8422680 DOI: 10.1186/s12889-021-11662-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 08/25/2021] [Indexed: 12/15/2022] Open
Abstract
Background Salameh et al. developed the Lebanese Waterpipe Dependence Scale (LWDS-11) that assesses nicotine dependence among adult waterpipe smokers. In view of the high waterpipe use among Lebanese youth and other neighboring countries, it was deemed necessary to check the psychometric properties of the LWDS-11, originally adapted to the Lebanese population, to measure nicotine dependence among adolescents. Methods Two cross-sectional investigations were conducted; Study 1 (January and May 2019) enrolled a total of 449 students who were exclusive waterpipe smokers; this sample was used to conduct the exploratory factor analysis. Study 2 enrolled another sample composed of 243 waterpipe smoking adolescents. This sample was independent from the first one and was used to conduct the confirmatory analysis. Results The results also showed that 312 (69.5%) [95% CI 0.652–0.738] had high waterpipe dependence (scores of ≥10). Results of the factor analysis in sample 1 showed that all LWDS-11 items were extracted following the factor analysis. Items converged over a solution of one factor; total variance explained = 70.45%, αCronbach = 0.96). The results of the confirmatory factor analysis were as follows: the Maximum Likelihood Chi-Square = 129.58 and Degrees of Freedom = 45, which gave a χ2/df = 2.88. For non-centrality fit indices, the Steiger-Lind Root Mean Square Error of Approximation (RMSEA) was 0.08 [0.071–0.106]. Moreover, the Comparative Fit Index (CFI) value was 0.77. Conclusion The preliminary results suggest that the LWDS-11 has good psychometric properties to measure waterpipe dependence among adolescents. We hope this tool would serve the benefit of research and epidemiology.
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Affiliation(s)
- Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon. .,INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie-Liban, Beirut, Lebanon. .,Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
| | - Sahar Obeid
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie-Liban, Beirut, Lebanon.,Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Hala Sacre
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie-Liban, Beirut, Lebanon
| | - Pascale Salameh
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie-Liban, Beirut, Lebanon.,Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus.,Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
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Malaeb D, Akel M, Sacre H, Haddad C, Obeid S, Hallit S, Salameh P. Association between cumulative cigarette and Waterpipe smoking and symptoms of dependence in Lebanese adults. BMC Public Health 2021; 21:1583. [PMID: 34425819 PMCID: PMC8381141 DOI: 10.1186/s12889-021-11626-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 08/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Waterpipe and cigarette smoking dependence are becoming increasingly prevalent forms of addiction globally. This study examined whether cumulative cigarette smoking and cumulative waterpipe smoking are associated with higher dependence on both cigarettes and waterpipe. METHODS This cross-sectional study conducted between February and April 2020, enrolled 363 participants drawn from all Lebanese districts. The mean age was 29.51 years, 64.8% were females, and 124 (34.2%) exclusive cigarette smokers, 189 (52.1%) exclusive waterpipe smokers, and 50 (13.8%) dual smokers (waterpipe and cigarette). We used the Hooked on Nicotine Checklist (HONC) as an indicator of decreased autonomy towards nicotine, in addition to the Lebanon Waterpipe Dependence Scale-11 (LWDS11) and the Lebanese Cigarette Dependence scale (LCD). A stepwise linear regression was performed taking the HONC scores due to cigarette and waterpipe smoking, LCD and LWDS-11 scores as dependent variables. RESULTS The results showed that in the total sample, higher cumulative cigarette smoking (B = 0.005 with a confidence interval of 0.004, 0.006) was significantly associated with higher HONC cigarette scores, whereas higher cumulative waterpipe smoking (B = -0.006 with a confidence interval of - 0.009, - 0.002) was significantly associated with lower HONC cigarette scores. Moreover, higher cumulative waterpipe smoking (B = 0.012 with a confidence interval of 0.009,0.015) was significantly associated with higher HONC waterpipe scores. The results showed that, in both sexes, higher cumulative cigarette smoking was associated with higher HONC cigarette scores and lower HONC waterpipe scores. Furthermore, higher cumulative waterpipe smoking was significantly associated with higher HONC waterpipe scores in both sexes. CONCLUSION Our study supports the fact that heavy nicotine consumption, related to both the increased frequency and smoking duration, can increase the risk of dependence. It raises the need for strategic plans to minimize and discourage the use of nicotine products in Lebanese community settings.
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Affiliation(s)
- Diana Malaeb
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Marwan Akel
- School of Pharmacy, Lebanese International University, Beirut, Lebanon.,INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
| | - Hala Sacre
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
| | - Chadia Haddad
- Univ. Limoges, UMR 1094, Neuroépidémiologie Tropicale, Institut d'Epidémiologie et de Neurologie Tropicale, GEIST, 87000, Limoges, France
| | - Sahar Obeid
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon.,Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Souheil Hallit
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon. .,Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
| | - Pascale Salameh
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon.,Faculty of Pharmacy, Lebanese University, Hadat, Lebanon.,University of Nicosia Medical School, Nicosia, Cyprus
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Kalan ME, Ghobadi H, Taleb ZB, Adham D, Cobb CO, Ward KD, Behaleh R, Fazlzadeh M. COVID-19 and beliefs about tobacco use: an online cross-sectional study in Iran. Environ Sci Pollut Res Int 2021; 28:40346-40354. [PMID: 33029777 PMCID: PMC7541093 DOI: 10.1007/s11356-020-11038-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 09/28/2020] [Indexed: 05/02/2023]
Abstract
There is mixed evidence surrounding the relationship between tobacco use and COVID-19 infection/progression. The current study investigates beliefs and tobacco use behaviors and COVID-19 infection among a sample of smokers and never-smokers. Data were collected using an online survey distributed through Telegram, a cloud-based social media networking application in Iran from April 1 to May 31, 2020. The study participants included never-smokers (n = 511), current (past-month) waterpipe smokers (n = 89), current cigarette smokers (n = 158), and ex-smokers (n = 172). Multinomial logistic regression was used to compare tobacco use groups with never- smokers on beliefs, controlling for potential confounders. The study participants (n = 944) was mostly male (64%), had > high school education (76%), and lived in an urban area (91%), with mean ± SD age of 35.3 ± 10.8. Key findings of this study are that compared with never-smokers: (1) cigarette smokers were less likely to believe that smoking cigarette can lead to spreading COVID-19; (2) waterpipe smokers were more likely to believe that smoking waterpipe at home was a safe practice, that waterpipe protects against COVID-19, and smoking waterpipe may lead to a more rapid recovery from COVID-19; (3) both waterpipe and cigarette smokers believed that using e-cigarettes in public places was a safe practice during the COVID-19 pandemic; and (4) more than half of the ex-smokers stopped smoking due to COVID-19 and most of them planned to continue abstaining from smoking after the pandemic. Our findings underscore the need to raise awareness about the unsupported claims of a lower hazard of using tobacco products or possible protective effects against COVID-19 and to promote cessation programs.
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Affiliation(s)
- Mohammad Ebrahimi Kalan
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | - Hassan Ghobadi
- Department of Internal Medicine, Pulmonary Division, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Ziyad Ben Taleb
- Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, USA
| | - Davoud Adham
- Department of Public Health, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran.
| | - Caroline O Cobb
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Kenneth D Ward
- School of Public Health, University of Memphis, Memphis, TN, USA
| | - Raed Behaleh
- School of Health Sciences, Baldwin Wallace University, Berea, OH, USA
| | - Mehdi Fazlzadeh
- Department of Environmental Health, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran.
- Department of Environmental Health, School of Health, Tehran University of Medical Sciences, Tehran, Iran.
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Hamadeh RR, Borgan SM, Khabsa J, Sibai AM. Tobacco Research in the Eastern Mediterranean Region: A Scoping Review of Published Studies from Seven Countries. J Community Health 2021; 46:225-31. [PMID: 32474805 DOI: 10.1007/s10900-020-00850-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
While surveillance on a global scale has been showing a decline in tobacco smoking in the past decade, rates in the Eastern Mediterranean Region (EMR) remained stable with some countries showing rising trends. This study aimed to analyze the landscape of tobacco research in the EMR, present data on publication trends, and identify research gaps and opportunities to guide future tobacco research in the region. We conducted a scoping review of tobacco research in seven countries from January 2000 to December 2013. Three hundred and forty eight studies were identified, the majority of which were published in international journals and in English language. There was an increase in publications over time, with a significant positive linear trend (p = 0.03). Descriptive cross-sectional and case-control studies were the most common study designs (67.0%), and only 8% were longitudinal studies. Papers that reported, in part or solely, on waterpipe tobacco smoking (WTS) constituted 25.6% of the total publication pool. Tobacco consumption was treated as an exposure variable in half of the papers and mostly in relation to cancer and cardiovascular diseases, as an outcome measure in 37.7%, and as a confounding variable in 14.7% of the papers. Studies that examined associations of tobacco with other behaviors (5.3%) were lacking. The scarcity of high-evidence tobacco research in the EMR, together with the relatively deficient data on WTS and associations with other factors warrant the need for discussions on research priority setting and guidance on funding allocations in the region.
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Hawash M, Qneibi M, Jaradat N, Abualhasan M, Amer J, Amer EH, Ibraheem T, Hindieh S, Tarazi S, Sobuh S. The impact of filtered water-pipe smoke on healthy versus cancer cells and their neurodegenerative role on AMPA receptor. Drug Chem Toxicol 2021; 45:2292-2300. [PMID: 34121557 DOI: 10.1080/01480545.2021.1935397] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Water pipe smoking is highly prevalent in developing countries, especially in Eastern Mediterranean regions. Research finds that more than 100 million people smoke a water pipe. Furthermore, tobacco smoking is one of the leading behavioral factors related to an increased risk of cancer, a leading cause of death globally. We aim to introduce a novel filtration system for water-pipe smoking and evaluate cytotoxic effects of common water pipe condensed smoke in comparison with our novel filtration system on normal (HEK293t) and cancer cell lines (Hep3B and MCF7) by MTS assay, alpha-fetoprotein (aFP), and apoptosis/necrosis effects. More so, the smoke substituents' neurotoxicity effect was evaluated by analyzing the depressive property on AMPA receptors (AMPARs). Our results showed that the silica filtration system was more effective than the water filtration system. The number of toxic compounds was reduced from 145 mg in distilled water extract (DWE) to 57.5 mg in silica solution extract (SSE). The SSE method also showed lower toxicity impacts on normal and cancerous cell lines (HEK293t, Hep3B, and MCF7) with CC50 values 149.9, 10.14, and 8.9 µg/ml, relative to the DWE method (CC50 values 77.1, 3.1, and 5.24 µg/ml, respectively). SSE extraction also reduced the α-FP (tumor marker test) to 2273.3 ng/ml which was closer in value to untreated cells (4066.7 ng/ml) in comparison with DWE which reduced it greatly to 1658.7 ng/ml, and the biophysical properties of AMPAR subunits demonstrate a reduced effect on desensitization rates of GluA2 homomer and GluA1/2 heteromer, using SSE relative to DWE. In conclusion, the condensed smoke of ordinary water pipe (DWE) has cytotoxic and neurotoxic impacts on various cell lines, while our newly developed system (SSE) was less toxic.
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Affiliation(s)
- Mohammed Hawash
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Mohammad Qneibi
- Department of Biomedical Sciences, Physiology, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Nidal Jaradat
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Murad Abualhasan
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Johnny Amer
- Department of Biomedical Sciences, Physiology, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - El-Hamouz Amer
- Department of Chemical Engineering, An-Najah National University, Nablus, Palestine
| | - Tasneem Ibraheem
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Siham Hindieh
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Sama Tarazi
- Department of Biomedical Sciences, Physiology, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Shorooq Sobuh
- Department of Biomedical Sciences, Physiology, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
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Jebai R, Asfar T, Nakkash R, Chehab S, Ben Romdhane H, Maziak W. Examining the effect of waterpipe specific pictorial health warning labels among young adults in Lebanon and Tunisia: Protocol of a factorial experiment study design. Contemp Clin Trials Commun 2021; 23:100797. [PMID: 34235290 DOI: 10.1016/j.conctc.2021.100797] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 05/23/2021] [Accepted: 06/03/2021] [Indexed: 02/06/2023] Open
Abstract
Waterpipe tobacco smoking (WTS) has increased substantially in the Eastern Mediterranean Region (EMR), affecting young adults who perceive waterpipe as safer than cigarette smoking. Applying pictorial health warning labels (HWLs) on tobacco products has been effective in communicating health risks associated with tobacco smoking. However, there are few experimental studies that examined pictorial HWLs specific to WTS. Methods/design: This report describes the design and protocol of the first factorial experimental study that aims to test the effectiveness of pictorial HWLs based on their placement on waterpipe device, tobacco, and charcoal packages among young adult smokers and non-smokers residing in Lebanon and Tunisia. After completing a baseline assessment, participants will be randomly assigned to 3 experimental conditions in a 3 (HWL: pictorial HWL on tobacco package vs. pictorial HWL on 3 placements [device, tobacco, and charcoal packages] vs. text-only HWL on tobacco package) x 4 (pictorial HWLs) x 2 (waterpipe smokers vs. non-smokers) factorial design. We will use a within/between-subject design, where pictorial HWLs and time (pre vs. post-exposure) are the within-subject factors and waterpipe smoking status as the between-subjects factor. Participants will complete post-exposure measures that include attention, perceived harm, intention to quit (smokers) or initiate smoking (non-smokers). Discussion: This is the first international study examining the placements of pictorial HWLs using efficient within/between subject design. Findings will provide additional evidence to convince policymakers to consider three placements of HWLs specific to WTS as a promising regulatory target to curb WTS.
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Jebai R, Ebrahimi Kalan M, Vargas-Rivera M, Osibogun O, Li W, Gautam P, Chao MR, Hu CW, Bursac Z, Maziak W. Markers of oxidative stress and toxicant exposure among young waterpipe smokers in the USA. Environ Sci Pollut Res Int 2021; 28:26677-26683. [PMID: 33491143 PMCID: PMC8165017 DOI: 10.1007/s11356-021-12520-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 01/13/2021] [Indexed: 05/05/2023]
Abstract
Waterpipe (aka hookah) tobacco smokers are exposed to toxicants that can lead to oxidative DNA and RNA damage, a precursor to chronic disease formation. This study assessed toxicant exposure and biomarkers of DNA [8-oxo-7, 8-dihydro-2'-deoxyguanosine (8-oxodG)] and RNA [8-oxo-7,8-dihydroguanosine (8-oxoGuo)] oxidative damage during smoking of flavored and non-flavored waterpipe tobacco. Thirty waterpipe smokers completed two counterbalanced 2-h lab waterpipe smoking sessions (flavored vs. non-flavored waterpipe tobacco). Urinary concentrations of 8-oxodG and 8-oxoGuo and expired carbon monoxide (eCO) were measured before and after the smoking sessions. A significant increase in the urinary concentrations of 8-oxodG (from 2.12 ± 0.83 to 2.35 ± 0.91 ng/mg creatinine, p = 0.024) and 8-oxoGuo (from 2.96 ± 0.84 to 3.45 ± 0.76 ng/mg creatinine, p = 0.003) were observed after smoking the non-flavored and flavored waterpipe tobacco, respectively. Our results also showed that the mean ± SD of eCO increased significantly after smoking the flavored (from 1.3 ± 1.1 to 20.3 ± 23.6 ppm, p < 0.001) and non-flavored waterpipe tobacco (from 1.8 ± 1.2 to 24.5 ± 26.1 ppm, p < 0.001). There were no significant differences in the means of 8-oxodG (p = 0.576), 8-oxoGuo (p = 0.108), and eCO (p = 0.170) between the flavored and non-flavored tobacco sessions. Smoking non-flavored and flavored waterpipe tobacco leads to oxidative stress and toxicant exposure. Our findings add to the existing evidence about the adverse effects of waterpipe tobacco smoking (WTS) and the need for strong policies to inform and protect young people from the risks of WTS.
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Affiliation(s)
- Rime Jebai
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Mohammad Ebrahimi Kalan
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Mayra Vargas-Rivera
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Olatokunbo Osibogun
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Wei Li
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Prem Gautam
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Mu-Rong Chao
- Department of Occupational Safety and Health, Chung Shan Medical University, Taichung, 402, Taiwan
| | - Chiung-Wen Hu
- Department of Public Health, Chung Shan Medical University, Taichung, 402, Taiwan
- Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung, 402, Taiwan
| | - Zoran Bursac
- Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA.
- Syrian Center for Tobacco Studies, Aleppo, Syria.
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Masjedi MR, Dobaradaran S, Keshmiri S, Taghizadeh F, Arfaeinia H, Fanaei F, Behroozi M, Nasrzadeh F, Joukar M. Use of toenail-bounded heavy metals to characterize occupational exposure and oxidative stress in workers of waterpipe/cigarette cafés. Environ Geochem Health 2021; 43:1783-1797. [PMID: 33098497 DOI: 10.1007/s10653-020-00751-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 10/09/2020] [Indexed: 06/11/2023]
Abstract
Tobacco smoke is known for releasing metals in indoor air of waterpipe/cigarette cafés. However, the worker exposure to metals, and its association with oxidative stress in these cafés are still unclear. To this end, 54 workers and 38 customers from waterpipe/cigarette cafés (the exposed group), 30 workers from non-smoking cafés (the control group 1 (CG_1)) and 32 individuals from the general population (the control group 2 (CG_2)) were selected and toenails samples were then taken from them. Our findings revealed a significant difference in terms of toenail-bounded metal levels between the exposure and control groups (CG_1 and CG_2) (Mann-Whitney U test, Pvalue < 0.05). This study has also indicated that "type of tobacco" could be considered as a predictor for toenail-bounded heavy metals. Furthermore, our research's results suggest that toenail-bounded heavy metals are positively and significantly correlated with urinary levels of 8- hydroxy-2'-deoxyguanosine (8-OHdG, as a biomarker for the degradation of deoxyribonucleic acid (DNA) oxidative stress). Therefore, it can be concluded that workers of waterpipe/cigarette cafés are at high risks of adverse health of DNA oxidative degradation.
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Affiliation(s)
- Mohammad Reza Masjedi
- Tobacco Control Research Center (TCRC), Iranian Anti-Tobacco Association, Tehran, Iran
| | - Sina Dobaradaran
- Systems Environmental Health and Energy Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
- Department of Environmental Health Engineering, Faculty of Health and Nutrition, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Saeed Keshmiri
- Systems Environmental Health and Energy Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
- Faculty of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Farhad Taghizadeh
- Department of Environmental Health Engineering, Faculty of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Hossein Arfaeinia
- Systems Environmental Health and Energy Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran.
- Department of Environmental Health Engineering, Faculty of Health and Nutrition, Bushehr University of Medical Sciences, Bushehr, Iran.
| | - Farzad Fanaei
- Department of Environmental Health Engineering, Faculty of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Behroozi
- Systems Environmental Health and Energy Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Farzaneh Nasrzadeh
- Systems Environmental Health and Energy Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Melika Joukar
- Systems Environmental Health and Energy Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
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Rezk-Hanna M, Holloway IW, Toyama J, Warda US, Berteau LC, Brecht ML, Sarna L. Transitions in hookah (Waterpipe) smoking by U.S. sexual minority adults between 2013 and 2015: the population assessment of tobacco and health study wave 1 and wave 2. BMC Public Health 2021; 21:445. [PMID: 33673824 PMCID: PMC7934533 DOI: 10.1186/s12889-021-10389-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 02/04/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Tobacco smoking using a hookah (i.e., waterpipe) is a global epidemic. While evidence suggests that sexual minorities (SM) have higher odds of hookah use compared to heterosexuals, little is known about their hookah use patterns and transitions. We sought to examine transitions between hookah smoking and use of other tobacco and electronic (e-) products among SM adults aged 18 years of age and older versus their heterosexual counterparts. METHODS We analyzed nationally representative data of ever and current hookah smokers from Wave 1 (2013-2014; ever use n = 1014 SM and n = 9462 heterosexuals; current use n = 144 SM and n = 910 heterosexuals) and Wave 2 (2014-2015; ever use n = 901 SM and n = 8049 heterosexuals; current use n = 117 SM and n = 602 heterosexuals) of the Population Assessment of Tobacco and Health Study. Comparisons between groups and gender subgroups within SM identity groups were determined with Rao-Scott chi-square tests and multivariable survey-weighted multinomial logistic regression models were estimated for transition patterns and initiation of electronic product use in Wave 2. RESULTS Ever and current hookah smoking among SM adults (ever use Wave 1: 29% and Wave 2: 31%; current use Wave 1: 4% and Wave 2: 3%) was higher than heterosexuals (ever use Wave 1: 16% and Wave 2: 16%; current use Wave 1: 1% and Wave 2: 1%; both p < 0.0001). Among SM adults who reported hookah use at Wave 1, 46% quit hookah use at Wave 2; 39% continued hookah use and did not transition to other products while 36% of heterosexual adults quit hookah use at Wave 2 and 36% continued hookah use and did not transition to other products. Compared with heterosexuals, SM adults reported higher use of hookah plus e-products (Wave 2 usage increased by 65 and 83%, respectively). CONCLUSIONS Compared to heterosexuals, in addition to higher rates of hookah smoking, higher percentages of SM adults transitioned to hookah plus e-product use between 2013 and 2015. Results have implications for stronger efforts to increase awareness of the harmful effects of hookah as well as vaping, specifically tailored among SM communities.
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Affiliation(s)
- Mary Rezk-Hanna
- School of Nursing, University of California, Los Angeles, 700 Tiverton Ave, 4-254 Factor Building, Los Angeles, CA, 90095, USA.
| | - Ian W Holloway
- Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles , Los Angeles, CA, USA
| | - Joy Toyama
- School of Nursing, University of California, Los Angeles, 700 Tiverton Ave, 4-254 Factor Building, Los Angeles, CA, 90095, USA
| | - Umme Shefa Warda
- School of Nursing, University of California, Los Angeles, 700 Tiverton Ave, 4-254 Factor Building, Los Angeles, CA, 90095, USA
| | - Lorree Catherine Berteau
- Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles , Los Angeles, CA, USA
| | - Mary-Lynn Brecht
- School of Nursing, University of California, Los Angeles, 700 Tiverton Ave, 4-254 Factor Building, Los Angeles, CA, 90095, USA
| | - Linda Sarna
- School of Nursing, University of California, Los Angeles, 700 Tiverton Ave, 4-254 Factor Building, Los Angeles, CA, 90095, USA
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Awad E, Sacre H, Haddad C, Akel M, Salameh P, Hallit S, Obeid S. Association of characters and temperaments with cigarette and waterpipe dependence among a sample of Lebanese adults. Environ Sci Pollut Res Int 2021; 28:8466-8475. [PMID: 33058065 DOI: 10.1007/s11356-020-11185-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 10/07/2020] [Indexed: 06/11/2023]
Abstract
It was discovered that the relation between certain personality traits and nicotine dependence differs among ethnicities and cultures; therefore, this study was conducted to determine which temperaments and personality traits are associated with smoking dependence in order to contribute to the development of effective and targeted interventions for smoking dependence within the Lebanese population. A cross-sectional study was carried out between March and April 2020 among a sample of Lebanese adults from all Lebanese governorates. The sample included (N = 501) divided as follows: 62 (12.4%) nonsmokers, 37 (7.4%) cigarette smokers, 266 (53.1%) waterpipe smokers, and 136 (27.1%) mixed smokers. Higher cooperativeness (B = - 0.03) was significantly associated with lower waterpipe dependence. High vs. low education level (B = - 0.97), female gender compared to males (B = - 1.07), higher cooperativeness (B = - 0.01), and higher self-transcendence (B = - 0.01) were significantly associated with lower cigarette dependence, whereas higher age (B = 0.03) was significantly associated with higher cigarette dependence. A multinomial regression analysis, taking the smoking group as the dependent variable, showed that higher harm avoidance (aOR = 0.97) and novelty seeking (aOR = 0.97) were significantly associated with lower cigarette smoking. A high level of education vs. a low one (aOR = 8.85) was significantly associated with higher cigarette smoking. Higher self-transcendence was significantly associated with lower mixed smoking. Being married vs. single (aOR = 2.46) was significantly associated with higher odds of being a mixed smoker, whereas female gender compared to males (aOR = 0.41) was significantly associated with lower odds of being a mixed smoker. These results are pivotal in understanding the relationship between personality and smoking dependence.
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Affiliation(s)
- Emmanuelle Awad
- Department of Psychology Faculty of Social Sciences, Lund University, Lund, Sweden
| | - Hala Sacre
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie-Liban, Beirut, Lebanon
| | - Chadia Haddad
- Research and Psychology Departments, Psychiatric Hospital of the Cross, Jal El Dib, Lebanon
- Université de Limoges, UMR 1094, Neuroépidémiologie Tropicale, Institut d'Epidémiologie et de Neurologie Tropicale, GEIST, 87000, Limoges, France
| | - Marwan Akel
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie-Liban, Beirut, Lebanon
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Pascale Salameh
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie-Liban, Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
- Faculty of Medicine, Lebanese University, Hadat, Lebanon
| | - Souheil Hallit
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie-Liban, Beirut, Lebanon.
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
| | - Sahar Obeid
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie-Liban, Beirut, Lebanon
- Research and Psychology Departments, Psychiatric Hospital of the Cross, Jal El Dib, Lebanon
- Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
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Al-Omoush TK, Alzoubi KH, Khabour OF, Alsheyab FM, Abu-Siniyeh A, Al-Sawalha NA, Mayyas FA, Cobb CO, Eissenberg T. The CHRNA5 Polymorphism (rs16969968) and its Association with Waterpipe Smoking Addiction among Jordanians. Arab J Basic Appl Sci 2021; 27:450-455. [PMID: 33511332 DOI: 10.1080/25765299.2020.1849491] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Waterpipe smoking is a form of tobacco use that causes nicotine/tobacco dependence and has become a global health problem. In the current study, the association of rs16969968 SNP in the CHRNA5 gene with waterpipe dependence was investigated. A total of 386 men and women who used a waterpipe to smoke tobacco were recruited and divided into less dependent and more dependent smokers based on their score on the Lebanon Waterpipe Dependence Scale (LWDS). Results showed a significant difference in the distribution of GG, GA, and AA genotypes by waterpipe dependence status (P<0.001). The more dependent group showed a higher frequency of the AA genotype than the less dependent smokers' group (38% versus 23% respectively). In addition, the more dependent smokers exhibited more A allele than less dependent smokers (53% versus 37% respectively, P<0.001). In conclusion, there is an association between the rs16969968 SNP and waterpipe dependence as assessed by the LWDS.
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Affiliation(s)
- Thaka'a K Al-Omoush
- Department of Applied Biology, Faculty of Science and Arts, Jordan University of Science and Technology, Irbid, Jordan
| | - Karem H Alzoubi
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Omar F Khabour
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Fawzi M Alsheyab
- Department of Applied Biology, Faculty of Science and Arts, Jordan University of Science and Technology, Irbid, Jordan
| | - Ahmed Abu-Siniyeh
- Department of Medical Laboratories, Faculty of Health Sciences, American University of Madaba, Madaba, Jordan
| | - Nour A Al-Sawalha
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Fadia A Mayyas
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Caroline O Cobb
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA.,Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
| | - Thomas Eissenberg
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA.,Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
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Vinnikov D, Tulekov Z, Romanova Z, Krugovykh I, Blanc PD. Smoking practices in relation to exhaled carbon monoxide in an occupational cohort. BMC Public Health 2020; 20:1894. [PMID: 33298031 PMCID: PMC7725030 DOI: 10.1186/s12889-020-09997-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 12/01/2020] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Exposure to carbon monoxide (CO) remains a leading occupational hazard in firefighters, but cigarette and waterpipe smoking likely contributes to the other sources of CO in such workers. The aim of this study was to estimate the contribution of self-reported active cigarette smoking, waterpipe use, and potential job-related sources of CO to the level of exhaled CO in firefighters. METHODS We surveyed the personnel of 18 fire stations (N = 842), median age 28 years, who participated at an annual screening not timed to coincide with recent firefighting. We surveyed smoking and waterpipe history, exposure to secondhand smoke (SHS), use of coal for health and biomass for cooking and time since last exposure to firefighting in the workplace. We measured exhaled CO with an instantaneous reading device (piCO Smokerlyzer). We used multivariable regression models to test the association of time since last smoked cigarette (≤12 h) and waterpipe (≤12 h) and time since last fire (≤6 h) with exhaled CO. RESULTS In analysis limited to men (93.5% of all surveyed), 42% were daily cigarette; 1% were waterpipe smokers; 94% were exposed to SHS, 29% used coal for heating and 4% used biomass for cooking. The median CO was 4 (interquartile range 3;8) ppm. Age (beta 0.74 per 10 years, p < 0.001), use of biomass fuel for cooking (beta 1.38, p = 0.05), cigarette smoked in the last 12 h (beta 8.22, p < 0.001), waterpipe smoked in the last 12 h (beta 23.10, p < 0.001) were statistically associated with CO, but not time since last fire (≤6 h) (beta 4.12, p = 0.12). There was a significant interaction between older age and firefighting for exhaled CO (p = 0.03). CONCLUSIONS Cigarette and recent waterpipe smoking are associated with increased exhaled CO in firefighters. Firefighting itself was a less potent contributor to exhaled CO when measured at an annual screening, but an age interaction was manifested.
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Affiliation(s)
- Denis Vinnikov
- Al-Farabi Kazakh National University, 71 Al-Farabi Avenue, Almaty, Kazakhstan 050040
- Peoples’ Friendship University of Russia (RUDN University), 6 Miklukho-Maklaya Street, Moscow, Russian Federation 117198
- National Research Tomsk State University, 36 Lenin Avenue, Tomsk, Russian Federation 634050
| | - Zhangir Tulekov
- Al-Farabi Kazakh National University, 71 Al-Farabi Avenue, Almaty, Kazakhstan 050040
| | - Zhanna Romanova
- Al-Farabi Kazakh National University, 71 Al-Farabi Avenue, Almaty, Kazakhstan 050040
| | - Ilya Krugovykh
- Al-Farabi Kazakh National University, 71 Al-Farabi Avenue, Almaty, Kazakhstan 050040
| | - Paul D. Blanc
- University of California San Francisco, Suite 609, 350 Parnassus Avenue, San Francisco, CA 94117 USA
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Klosterhalfen S, Kotz D, Boeckmann M, Kastaun S. Waterpipe use and associated consumer characteristics in the German population: Data from a national representative survey (DEBRA study). Addict Behav 2020; 110:106542. [PMID: 32688228 DOI: 10.1016/j.addbeh.2020.106542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 06/19/2020] [Accepted: 07/03/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Waterpipes (WP) have a long tradition in certain regions of the world, and their use has been increasing worldwide. Current data on the use of WP in different subgroups of the German population are missing. OBJECTIVE To estimate the current prevalence of WP use and associated socio-demographic characteristics, tobacco smoking status and e-cigarette usage behaviour in the German population aged ≥14 years; to describe the frequency of use and starting age in current WP users. METHODS We analysed data from waves 13-18 (June/July 2018-April/May 2019; N = 12,220) of the German Study on Tobacco Use (DEBRA) - a representative, computer-assisted national household survey. Associations of socio-demographic characteristics, tobacco smoking status and e-cigarette usage behaviour were assessed with multivariable logistic regression models. RESULTS A total of 1.8% (n = 217) (95% confidence interval (CI) = 1.5%-2.0%) of the population were current WP users, 13% (n = 1618) (95% CI = 12.3%-13.5%) were ever users. Adjusted multivariable logistic models showed that people with migration background, male sex, younger age, and those who were smokers or used e-cigarettes, were more likely to use a WP. Among current WP users, 15.2% (n = 33) (95% CI = 10.7%-20.7%) had started to use WP at the age of 26 or older, and 23.0% (n = 50) (95%CI = 17.6%-29.2%) had used WP at least once a week or almost daily in the last month. CONCLUSIONS In Germany, the use of WP is popular and most strongly associated with migration background and use of tobacco and e-cigarettes. These aspects should be considered when designing future target group-specific prevention strategies.
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Jaccard G, Tafin Djoko D, Korneliou A, Belushkin M. Analysis of waterpipe aerosol constituents in accordance with the ISO standard 22486. Toxicol Rep 2020; 7:1344-1349. [PMID: 33102137 PMCID: PMC7569180 DOI: 10.1016/j.toxrep.2020.10.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 10/05/2020] [Accepted: 10/06/2020] [Indexed: 12/23/2022] Open
Abstract
ISO 22486 to be complemented with real conditions for the evaluation of waterpipe. Charcoal is the main contributor to CO and BaP in waterpipe aerosols. Correlation between sugars content in tobaccos and formaldehyde yields in aerosols.
This study analyzed commercial waterpipe tobacco products in accordance with the newly developed ISO 22486 as well as with commercial waterpipes and charcoals using the ISO 22486 puffing regime for comparison. The aerosols from these products were analyzed for their nicotine, humectant, tobacco specific nitrosamine, carbonyl, benzo[a]pyrene, and metal yields. Significant differences were observed among the waterpipe tobacco products when analyzed in accordance with the ISO standard 22486 and with different commercial waterpipes and charcoals. The concentrations of CO and benzo[a]pyrene observed in the consumers’ configuration using the ISO 22486 puffing regime (with lit charcoal) were higher than those obtained with the ISO standard using electrical heating, with the yields for carbonyl compounds being lower or higher. The use of the recently published ISO standard for generating water pipe tobacco aerosols should be complemented with analysis by using the consumers’ configuration. The necessity for this was demonstrated by the differences in CO and benzo[a]pyrene yields in the present work. It appears that the temperature (280°C) selected for electrical heating of waterpipe tobacco products in ISO 22486 is somewhat lower than that obtained with commercial charcoals, resulting in a generally lower yield of nicotine and total collected matter. In addition, there is a need to evaluate the contribution of commercial charcoals to the concentration of constituents in waterpipe aerosols. This is particularly true for compounds resulting from charcoal combustion, such as CO and benzo[a]pyrene.
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Key Words
- Aldehydes
- BaP, benzo[a]pyrene
- Charcoals for waterpipe
- Formaldehyde
- HPHC, harmful and potentially harmful constituents
- ISO 22486
- NAB, N’-nitrosoanabasine
- NAT, N’-nitrosoanatabine
- NNK, 4-(methylnitrosamino)-1-(3-bipyridyl)-1-butanone
- NNN, N’-nitrosonornicotine
- PAH, polyaromatic hydrocarbons
- PG, propyleneglycol
- RS, reducing sugars
- TA, total alkaloids
- TCM, total collected matter
- TSNA, tobacco specific nitrosamines
- Waterpipe
- Waterpipe aerosols
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Affiliation(s)
- Guy Jaccard
- PMI R&D, Philip Morris Products SA, Quai Jeanrenaud 5, CH-2000, Neuchâtel, Switzerland
| | - Donatien Tafin Djoko
- PMI R&D, Philip Morris Products SA, Quai Jeanrenaud 5, CH-2000, Neuchâtel, Switzerland
| | - Alexandra Korneliou
- PMI R&D, Philip Morris Products SA, Quai Jeanrenaud 5, CH-2000, Neuchâtel, Switzerland
| | - Maxim Belushkin
- PMI R&D, Philip Morris Products SA, Quai Jeanrenaud 5, CH-2000, Neuchâtel, Switzerland
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Alam MM, Ward KD, Bahelah R, Kalan ME, Asfar T, Eissenberg T, Maziak W. The Syrian Center for Tobacco Studies-13 (SCTS-13): Psychometric evaluation of a waterpipe-specific nicotine dependence instrument. Drug Alcohol Depend 2020; 215:108192. [PMID: 32738447 PMCID: PMC7860966 DOI: 10.1016/j.drugalcdep.2020.108192] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/14/2020] [Accepted: 07/09/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Waterpipe tobacco smoking (WTS) has surged globally among young people and causes nicotine dependence (ND). No existing ND instruments are sensitive to waterpipe-specific features of ND and early stages of use. METHODS We conducted a psychometric scale evaluation among 192 current waterpipe smokers, initially averaging 15 years of age, recruited from schools in Beirut, Lebanon, and assessed 4 times, 6 months apart. Twenty eight self-report items tapping multiple features of ND were submitted to exploratory and confirmatory factor analyses (EFA and CFA) to reduce items and verify factor structure. Convergent validity was assessed with the Lebanese Waterpipe Dependence Scale and the Hooked on Nicotine Checklist, and discriminant validity with the Depressive Symptom Scale and Adolescent Life Events Stress Scale. Concurrent and predictive validity measures included smoking status and intensity (amount, frequency, session duration, and change in frequency), quitting interest and success, perceived addiction, and smoking alone. RESULTS The EFA yielded a single factor, 13 item solution (named the Syrian Center for Tobacco Studies [SCTS]-13) that explained 91% of variance in responses, was internally consistent (Cronbach's alpha and McDonald's omega = 0.87), and captured several positive reinforcement, negative reinforcement, and social/sensory-related features of ND. The CFA indicated good model fit. The SCTS-13 showed acceptable convergent and discriminant validity. Higher SCTS-13 scores predicted current waterpipe and dual (waterpipe and cigarette) smoking, greater intensity of use, less interest in quitting, shorter duration of abstinence, greater perceived addiction, and smoking alone (vs. socially). CONCLUSION The SCTS-13 is a promising brief, waterpipe-specific ND instrument.
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Affiliation(s)
- Mohammad Masudul Alam
- Center for the Study of Tobacco, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Kenneth D Ward
- School of Public Health, University of Memphis, Memphis, TN, United States; Syrian Center for Tobacco Studies, Aleppo, Syria.
| | - Raed Bahelah
- Department of Public Health & Prevention Science, School of Health Sciences, Baldwin Wallace University, Berea, OH, United States
| | - Mohammad Ebrahmi Kalan
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, United States
| | - Taghrid Asfar
- Syrian Center for Tobacco Studies, Aleppo, Syria; Department of Public Health Sciences, University of Miami Miller School of Medicine, and Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Thomas Eissenberg
- Syrian Center for Tobacco Studies, Aleppo, Syria; Department of Psychology and Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, United States
| | - Wasim Maziak
- Syrian Center for Tobacco Studies, Aleppo, Syria; Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, United States
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Ghosh B, Reyes-Caballero H, Akgün-Ölmez SG, Nishida K, Chandrala L, Smirnova L, Biswal S, Sidhaye VK. Effect of sub-chronic exposure to cigarette smoke, electronic cigarette and waterpipe on human lung epithelial barrier function. BMC Pulm Med 2020; 20:216. [PMID: 32787821 PMCID: PMC7425557 DOI: 10.1186/s12890-020-01255-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 08/05/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Taking into consideration a recent surge of a lung injury condition associated with electronic cigarette use, we devised an in vitro model of sub-chronic exposure of human bronchial epithelial cells (HBECs) in air-liquid interface, to determine deterioration of epithelial cell barrier from sub-chronic exposure to cigarette smoke (CS), e-cigarette aerosol (EC), and tobacco waterpipe exposures (TW). METHODS Products analyzed include commercially available e-liquid, with 0% or 1.2% concentration of nicotine, tobacco blend (shisha), and reference-grade cigarette (3R4F). In one set of experiments, HBECs were exposed to EC (0 and 1.2%), CS or control air for 10 days using 1 cigarette/day. In the second set of experiments, exposure of pseudostratified primary epithelial tissue to TW or control air exposure was performed 1-h/day, every other day, until 3 exposures were performed. After 16-18 h of last exposure, we investigated barrier function/structural integrity of the epithelial monolayer with fluorescein isothiocyanate-dextran flux assay (FITC-Dextran), measurements of trans-electrical epithelial resistance (TEER), assessment of the percentage of moving cilia, cilia beat frequency (CBF), cell motion, and quantification of E-cadherin gene expression by reverse-transcription quantitative polymerase chain reaction (RT-qPCR). RESULTS When compared to air control, CS increased fluorescence (FITC-Dextran assay) by 5.6 times, whereby CS and EC (1.2%) reduced TEER to 49 and 60% respectively. CS and EC (1.2%) exposure reduced CBF to 62 and 59%, and cilia moving to 47 and 52%, respectively, when compared to control air. CS and EC (1.2%) increased cell velocity compared to air control by 2.5 and 2.6 times, respectively. The expression of E-cadherin reduced to 39% of control air levels by CS exposure shows an insight into a plausible molecular mechanism. Altogether, EC (0%) and TW exposures resulted in more moderate decreases in epithelial integrity, while EC (1.2%) substantially decreased airway epithelial barrier function comparable with CS exposure. CONCLUSIONS The results support a toxic effect of sub-chronic exposure to EC (1.2%) as evident by disruption of the bronchial epithelial cell barrier integrity, whereas further research is needed to address the molecular mechanism of this observation as well as TW and EC (0%) toxicity in chronic exposures.
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Affiliation(s)
- Baishakhi Ghosh
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Hermes Reyes-Caballero
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Sevcan Gül Akgün-Ölmez
- Department of Environmental Health and Engineering, Center for Alternatives to Animal Testing, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Present Address: Department of Pharmaceutical Toxicology, Faculty of Pharmacy, Marmara University, Istanbul, Turkey
| | - Kristine Nishida
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Lakshmana Chandrala
- Department of Mechanical Engineering, Johns Hopkins Whiting School of Engineering, Baltimore, MD, USA
| | - Lena Smirnova
- Department of Environmental Health and Engineering, Center for Alternatives to Animal Testing, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Shyam Biswal
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Venkataramana K Sidhaye
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
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Inyang NA, Chang JT, Wang B. National Estimates of hospital emergency department visits due to acute injuries associated with hookah smoking, United States, 2011-2019. Inj Epidemiol 2020; 7:41. [PMID: 32772919 PMCID: PMC7416403 DOI: 10.1186/s40621-020-00267-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 06/16/2020] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Hookah (also known as waterpipe) smoking is associated with acute adverse health effects such as vomiting and fainting, symptoms related to carbon monoxide poisoning, and decreased pulmonary function, however, national estimates of hookah-related acute injuries are not currently available in the scientific literature. This study provides national estimates of United States hospital emergency department visits due to hookah-related acute injuries. METHODS We analyzed 2011-2019 data from the National Electronic Injury Surveillance System to calculate national estimates of emergency department visits due to hookah-related acute injuries. National Electronic Injury Surveillance System data were gathered from approximately 100 United States hospitals selected as a probability sample of approximately 5000 hospitals with emergency departments. Each case contains information abstracted from all emergency department records involving injuries associated with consumer products. All individuals admitted to emergency departments who sustained hookah-related acute injuries were included in the study. RESULTS During 2011-2019, an estimated 1371 (95% confidence interval: 505-2283) United States hospital emergency department visits were related to hookah-related acute injuries. The most common injuries were sustained from dizziness/light-headedness and syncopal episodes (54.8%), followed by burns (41.5%). Young adults aged 18-24 years accounted for 66.8% of hookah-related acute injuries admitted to United States emergency departments. CONCLUSIONS This study provides national estimates of hospital emergency department visits due to hookah-related acute injuries. We found that hookah smoking related AIs mostly occurred among young adults. Study findings may inform public health policy and educational intervention efforts to prevent these events and complement other acute injury surveillance systems, such as the National Poison Data System.
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Affiliation(s)
- Naa A Inyang
- US Food and Drug Administration, Center for Tobacco Products, Office of Science, 10903 New Hampshire Avenue, Silver Spring, MD, 20993-0002, USA.
| | - Joanne T Chang
- US Food and Drug Administration, Center for Tobacco Products, Office of Science, 10903 New Hampshire Avenue, Silver Spring, MD, 20993-0002, USA
| | - Baoguang Wang
- US Food and Drug Administration, Center for Tobacco Products, Office of Science, 10903 New Hampshire Avenue, Silver Spring, MD, 20993-0002, USA
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Abi-Gerges A, Dagher-Hamalian C, Abou-Khalil P, Chahine JB, Hachem P, Khalil C. Evaluation of waterpipe smoke toxicity in C57BL/6 mice model. Pulm Pharmacol Ther 2020; 63:101940. [PMID: 32889155 DOI: 10.1016/j.pupt.2020.101940] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 08/20/2020] [Accepted: 08/24/2020] [Indexed: 01/05/2023]
Abstract
Waterpipe smoking is a popular pastime worldwide with statistics pointing to an alarming increase in consumption. In the current paper, the evaluation of sub-chronic waterpipe smoke exposure was undertaken using C57BL/6 female mice using a dynamic exposure setting to emulate smoke exposure. Mice were daily subjected to either one (single exposure, SE) or two sessions (double exposure, DE) of waterpipe-generated smoke (two-apple flavor) for a period of two months. Although lungs histopathological examination pointed to a minor inflammation in smoke-exposed mice compared to control air-exposed (CON) group, the lung weights of the waterpipe-exposed mice were significantly higher (+72% in SE and +39% in DE) (p < 0.01) when compared to CON group. Moreover, changes in the protein expression of several proteins such as iNOS and JNK were noted in the lungs of smoke-exposed mice. However, no changes in p38 and EGFR protein levels were noted between the three groups of mice. Our results mainly showed a significant increase in urea serum levels (+28%) in SE mice along with renal pathological damage in both SE and DE mice compared to CON. Additionally, severe significant DNA damages (p < 0.05) were reported in the lungs, kidneys, bone marrow and liver of waterpipe-exposed animals, using MTS and COMET assays. These findings highlighted the significant risks posed by sub-chronic waterpipe smoke exposure in the selected animal model and the pressing need for future better management of waterpipe indoor consumption.
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Affiliation(s)
- Aniella Abi-Gerges
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Carole Dagher-Hamalian
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Pamela Abou-Khalil
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Joe Braham Chahine
- School of Arts and Sciences, Department of Natural Sciences, Lebanese American University, Byblos, Lebanon
| | - Pia Hachem
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Christian Khalil
- School of Arts and Sciences, Department of Natural Sciences, Lebanese American University, Byblos, Lebanon.
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Alomari MA, Khabour OF, Alzoubi KH, Eissenberg T. Puffing topography and physiological responses in men and women with low versus high waterpipe dependence during smoking: The WiHi Irbid project. Drug Alcohol Depend 2020; 212:108037. [PMID: 32417361 PMCID: PMC9271691 DOI: 10.1016/j.drugalcdep.2020.108037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 04/15/2020] [Accepted: 04/18/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Waterpipe smoking is spreading worldwide, and it is associated with many adverse effects. The aim of this study was to investigate the interaction of waterpipe smoking puffing topography, and related physiological measures, with both gender and level of dependence on waterpipe. METHOD Exclusive waterpipe smokers were asked to smoke a single waterpipe session in a specialized laboratory while their smoking topography, and in-breath CO level were recorded pre- and post- smoking. Waterpipe dependence was measured using the LWDS-11 scale. RESULTS In the high dependence group, the total number of puffs, was greater in men than women. In addition, the average flow rate was greater in men with high compared to low dependence. For inter-puffing intervals, greater values were recorded in men and women with low versus high dependence. No other differences were found between the subgroups in total session time, average puff duration, average puff volume, and maximum flow rate. Pre-smoking CO content and CO boost were greater in men versus women in both dependence groups. Post-smoking CO content was greater in women with high versus low dependence, whereas it was lower in women versus men with low dependence. CONCLUSIONS The current results indicate several effects for waterpipe smoking dependence on smoking topography. Many of these differences were gender dependent with men having higher exposure than women in most aspects.
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Affiliation(s)
- Mahmoud A. Alomari
- Department of Physical Education, Qatar University, Doha 2713, Qatar.,Division of Physical Therapy, Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Omar F. Khabour
- Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Karem H. Alzoubi
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Thomas Eissenberg
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
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Jafari AJ, Asl YA, Momeniha F. Determination of metals and BTEX in different components of waterpipe: charcoal, tobacco, smoke and water. J Environ Health Sci Eng 2020; 18:243-251. [PMID: 32399236 PMCID: PMC7203304 DOI: 10.1007/s40201-020-00459-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 02/10/2020] [Indexed: 05/12/2023]
Abstract
BACKGROUND The main objective of this study was to evaluate the concentrations of heavy metals and BTEX (benzene, toluene, ethylbenzene and xylene) in smoke and water bowl of 5-most commonly used tobacco brand in waterpipe in Tehran, the capital of Iran. METHODS Five types of conventional tobacco in Tehran were investigated. Heavy metals and BTEX were analyzed in waterpipe smoke, tobacco, charcoal and water bowl prior to and after smoking by using ICP-OES and GC-MS, respectively. RESULTS Our results indicated that Khansar and Al Fakher brands had the maximum and minimum concentrations of metals among tobacco consumed, respectively. The results showed that there was a significant difference between content of heavy metals in burned and unburned tobacco. The highest and lowest concentrations of metals were related to Fe and Hg, respectively. CONCLUSION Results showed that tobacco, charcoal and smoke of waterpipe contained significant contents of toxic metals and BTEX, and exposure to these components could be the main reason for the concerns about waterpipe smoking.
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Affiliation(s)
- Ahmad Jonidi Jafari
- Research Center for Environmental Health Technology, Iran University of Medical Sciences, Tehran, Iran
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | | | - Fatemeh Momeniha
- Research Center for Environmental Health Technology, Iran University of Medical Sciences, Tehran, Iran
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
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