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NCBI: db=pubmed; Term=((hookah) OR narghile) OR shisha
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[Severe recurrent carbon monoxide poisoning caused by smoking.]

Sat, 2015-01-24 06:28

[Severe recurrent carbon monoxide poisoning caused by smoking.]

Ugeskr Laeger. 2015 Jan 26;177(2A)

Authors: Rasmussen DB, Jacobsen VB

Abstract
Carbon monoxide (CO) is an odourless, colourless and toxic gas. Sources of CO include car exhaust, charcoal and tobacco smoke. CO binds to haemoglobin forming carboxyhaemoglobin (COHb). Heavy smokers have COHb levels up to 15%. There are reports of COHb levels of 24,2% caused by tobacco use and 28,7% after narghile smoking. A 54-year-old woman with schizophrenia was admitted at the intensive care unit with COHb levels as high as 35% caused by cigarillo smoking. She also presented with severe thiazide-induced hyponatriaemia and high haemoglobin levels.

PMID: 25612978 [PubMed - as supplied by publisher]

Pattern of shisha and cigarette smoking in the general population in malaysia.

Thu, 2015-01-22 15:42

Pattern of shisha and cigarette smoking in the general population in malaysia.

Asian Pac J Cancer Prev. 2014;15(24):10841-6

Authors: Al-Naggar RA, Bobryshev YV, Anil S

Abstract
BACKGROUND: Smoking is a primary risk factor for cancer development. While most research has focused on smoking cigarettes, the increasing popularity of shisha or water pipe smoking has received less attention. This study measured the prevalence and risk factors for shisha and cigarette smoking and related knowledge.
MATERIALS AND METHODS: This cross-sectional analytical study was conducted in Shah Alam, Malaysia. Participants aged ? 18 years were selected from restaurants. Data regarding demographic variables, smoking patterns, and knowledge about shisha smoking were collected in local languages. Logistic regression was performed to assess risk factors.
RESULTS: Of 239 participants, 61.9 % were male and 99.2% revealed their smoking status. Some 57.4% were smokers: 50.7% only cigarettes, 5.9% only shisha and 42% both. Mean age of starting cigarette smoking was 17.5 ± 2.4 years and for shisha smoking 18.7 ± 2.0 years. In a univariate model, male gender, age 33-52 years and monthly income > MYR 4,000 increased the risk and unemployment and being a student decreased the risk. In a multivariate model, male gender increased the risk of smoking, while being a student decreased the risk, adjusting for age and income. The perception of shisha being less harmful than cigarettes was present in 14.6% and 7.5% had the opinion that shisha is not harmful at all, while 21.7% said that it is less addictive than cigarettes, 39.7% said that shisha did not contain tar and nicotine, 34.3% said that it did not contain carbon monoxide and 24.3% thought that shisha did not cause health problems.
CONCLUSIONS: Prevalence of shisha and cigarette smoking is high in the general population in Malaysia and knowledge about shisha smoking is relatively low. The findings of our study might have implications for understanding similarities and differences in incidence of shisha and cigarette smoking in other cultural/geographic regions.

PMID: 25605187 [PubMed - in process]

Hookah use predicts cigarette smoking progression among college smokers.

Thu, 2015-01-15 06:30

Hookah use predicts cigarette smoking progression among college smokers.

Nicotine Tob Res. 2015 Jan 12;

Authors: Doran N, Godfrey KM, Myers MG

Abstract
Aims: Hookah use is increasingly common among US college students, but little is known regarding the relationship between hookah and cigarette use. The purpose of this study was to test the hypothesis that the added nicotine exposure from hookah use may accelerate the uptake of cigarettes. Methods: An ethnically diverse sample of college students (n = 256; 43% female) who had smoked cigarettes in the past month completed two in-person interviews over six months. This study was a secondary analysis of data collected for a longitudinal study of young adult cigarette smoking patterns. Analyses examined 6-month changes in past 30 day cigarettes smoked and number of days smoking, controlling for age, nicotine dependence, marijuana use, and the respective baseline variable for each outcome. Results: Current hookah use (any use in past 30 days) was endorsed by 34% of participants at baseline, while 94% reported lifetime use. Change in past 30 day number of cigarettes (p = .043) and number of smoking days (p = .040) differed significantly between those who did or did not report recent hookah use at baseline. Hookah users reported a greater number of cigarettes smoked at the 6-month follow-up, while non-users decreased their smoking quantity. For number of smoking days in the past 30, hookah users reported a smaller decrease than non-users. Conclusions: Recent hookah use predicted increased cigarette smoking over 6 months in a college sample. These are the first prospective data demonstrating this relationship, indicating the value of developing strategies to prevent hookah use among college students.

PMID: 25586774 [PubMed - as supplied by publisher]

Waterpipe Tobacco Smoking in the United States: Findings from the National Adult Tobacco Survey.

Wed, 2014-12-24 06:47

Waterpipe Tobacco Smoking in the United States: Findings from the National Adult Tobacco Survey.

Prev Med. 2014 Dec 20;

Authors: Salloum RG, Thrasher JF, Kates FR, Maziak W

Abstract
OBJECTIVE: To report prevalence and correlates of waterpipe tobacco smoking (WTS) use among U.S. adults.
METHODS: Data were from the 2009-2010 National Adult Tobacco Survey, a nationally representative sample of U.S. adults. Estimates of WTS ever and current use were reported overall, and by sex, age, race/ethnicity, educational attainment, annual household income, sexual orientation, and cigarette smoking status. State-level prevalence rates of WTS ever were reported using choropleth thematic maps for the overall population and by sex.
RESULTS: The national prevalence of WTS ever was 9.8% and 1.5% for current use. WTS ever was more prevalent among those who are male (13.4%), 18-24 years old (28.4%) compared to older adults, non-Hispanic White (9.8%) compared to non-Hispanic Black, with some college education (12.4%) compared to no high school diploma, and reporting sexual minority status (21.1%) compared to heterosexuals. States with highest prevalence included DC(17.3%), NV(15.8%), and CA(15.5%).
CONCLUSION: WTS is now common among young adults in the US and high in regions where cigarette smoking prevalence is lowest and smoke-free policies have a longer history. To reduce its use, WTS should be included in smoke-free regulations and state and federal regulators should consider policy development in other areas, including taxes, labeling, and distribution.

PMID: 25535678 [PubMed - as supplied by publisher]

Which Nicotine Products Are Gateways to Regular Use?: First-Tried Tobacco and Current Use in College Students.

Mon, 2014-12-22 06:42

Which Nicotine Products Are Gateways to Regular Use?: First-Tried Tobacco and Current Use in College Students.

Am J Prev Med. 2015 Jan;48(1S1):S86-S93

Authors: Meier EM, Tackett AP, Miller MB, Grant DM, Wagener TL

Abstract
BACKGROUND: The potential for emerging tobacco products (ETPs) to be gateway products for further tobacco use among youth is of significant concern.
PURPOSE: To examine use of various nicotine-containing products on a tobacco-free college campus and whether the first product tried predicts subsequent tobacco use.
METHODS: Undergraduate students (N=1,304) at a large university completed an online survey of past/current use of cigarettes; smokeless tobacco (SLT); hookah; ETPs (dissolvables, snus, and electronic cigarettes); and nicotine replacement therapy (NRT). Data were collected from September 2012 to May 2013 and analyses were conducted from June to September 2013. Students were classified as single, dual, or poly tobacco users.
RESULTS: The sample consisted of 79.5% non-users, 13.8% single, 4.4% dual, and 1.5% poly users. Overall, 49.4% of participants reported trying a tobacco product. Hookah was the most tried product (38%), but cigarettes were most often the first product ever tried (51%). First product tried did not predict current tobacco use and non-use, but individuals who first tried SLT or cigarettes (rather than hookah or ETPs) were more likely to be poly tobacco users. Current tobacco users who first tried ETPs or hookah were largely non-daily users of hookah; current tobacco users who first tried cigarettes or SLT were largely non-daily or daily users of cigarettes/SLT.
CONCLUSIONS: Hookah and ETPs are increasingly becoming the first tobacco product ever tried by youth; however, uptake of ETPs is poor, unlike cigarettes and SLT, and does not appear to lead to significant daily/non-daily use of cigarettes and SLT.

PMID: 25528714 [PubMed - as supplied by publisher]

Women and tobacco: A cross sectional study from North India.

Sat, 2014-12-20 06:55

Women and tobacco: A cross sectional study from North India.

Indian J Cancer. 2014 Dec;51(Supplement):S78-S82

Authors: Kathirvel S, Thakur JS, Sharma S

Abstract
Background: Tobacco is a leading risk factor for different types of diseases globally. Tobacco smoking by women is culturally unacceptable in India, but still women smoke tobacco at various times of their life. Aims: The aim was to estimate the prevalence and pattern of tobacco use among women and to study the associated sociodemographic factors. Settings And Design: This cross-sectional study was conducted among women aged 30 years or over in an urban resettlement colony for the migrant population at Chandigarh, India. Methodology: The study included women used tobacco products on one or more days within the past 30 days. Through systematic random sampling, 262 women were studied. As a part of the study 144 bidi smoking women were interviewed using detailed semi-structured questionnaire. Statistical Analysis: Descriptive statistics and hypothesis testing with Chi-squared test and logistic regression were done using SPSS 16.0 version. Results: Overall, the prevalence of tobacco use was 29.4% and that of bidi, zarda and hookah were 19.8%, 8.8%, and 2.7%, respectively. Around 6.2% women used tobacco during pregnancy. Teenage was the most common age of initiation of bidi smoking. Logistic regression analysis showed that the prevalence of tobacco use was high among Hindu unemployed women with no formal education belonged to scheduled caste, and those having grandchildren. Conclusions: This study highlighted high rates of tobacco use and explored both individual and family factors related to tobacco use among women. Affordable, culturally acceptable, sustainable and gender-sensitive individual and community-specific interventions will reduce the prevalence and effects of tobacco use.

PMID: 25526254 [PubMed - as supplied by publisher]

Prevalence of Hookah Smoking in Relation to Religiosity and Familial Support in College Students of Tabriz, northwest of Iran.

Wed, 2014-12-17 06:00

Prevalence of Hookah Smoking in Relation to Religiosity and Familial Support in College Students of Tabriz, northwest of Iran.

J Res Health Sci. 2014;14(4):268-271

Authors: MohammadPoorasl A, Abbasi Ghahramanloo A, Allahverdipour H, Modaresi Esfeh J

Abstract
BACKGROUND: Hookah smoking has increased worldwide especially among youth and young adults and has been identified as an emerging threat to public health. The aim of the present study was to determine the prevalence of hookah use and related factors in a sample of Iranian college students.METHODS: This study took place in Tabriz (northwest of Iran) in April and May 2011. The randomly selected sample consisted of 1837 college students. Data was collected in a survey. A self-administered questionnaire was used to measure religious belief, parental support and risk taking behaviors including hookah smoking. Logistic regression model was performed in data analysis.RESULTS: The prevalence of hookah smoking was 8.5% (CI95%: 7.3-9.9). After adjustment, being male (OR= 2.01), living in single house in comparison with living with parents (OR= 2.22), smoking (OR= 5.96) and ever drug abuse (OR= 3.02) were factors associated with students' hookah use.CONCLUSIONS: Our results showed a low prevalence of hookah smoking in Iranian college female students and revealed some of its associated factors. We demonstrated the co-occurrence of risky behaviors which emphasizes the importance of interventions aimed at reducing or preventing different high risk behaviors simultaneously.

PMID: 25503281 [PubMed - as supplied by publisher]

Waterpipe tobacco smoking: what is the evidence that it supports nicotine/tobacco dependence?

Thu, 2014-12-11 06:18

Waterpipe tobacco smoking: what is the evidence that it supports nicotine/tobacco dependence?

Tob Control. 2014 Dec 9;

Authors: Aboaziza E, Eissenberg T

Abstract
OBJECTIVE: Waterpipe tobacco smoking (WTS) involves passing tobacco smoke through water prior to inhalation, and has spread worldwide. This spread becomes a public health concern if it is associated with tobacco-caused disease and if WTS supports tobacco/nicotine dependence. A growing literature demonstrates that WTS is associated with disability, disease and death. This narrative review examines if WTS supports nicotine/tobacco dependence, and is intended to help guide tobacco control efforts worldwide.
DATA SOURCES: PUBMED search using: (("waterpipe" or "narghile" or "arghile" or "shisha" or "goza" or "narkeela" or "hookah" or "hubble bubble")) AND ("dependence" or "addiction").
STUDY SELECTION: Excluded were articles not in English, without original data, and that were not topic-related. Thirty-two articles were included with others identified by inspecting reference lists and other sources.
DATA SYNTHESIS: WTS and the delivery of the dependence-producing drug nicotine were examined, and then the extent to which the articles addressed WTS-induced nicotine/dependence explicitly, as well as implicitly with reference to criteria for dependence outlined by the WHO.
CONCLUSIONS: WTS supports nicotine/tobacco dependence because it is associated with nicotine delivery, and because some smokers experience withdrawal when they abstain from waterpipe, alter their behaviour in order to access a waterpipe and have difficulty quitting, even when motivated to do so. There is a strong need to support research investigating measurement of WTS-induced tobacco dependence, to inform the public of the risks of WTS, which include dependence, disability, disease and death, and to include WTS in the same public health policies that address tobacco cigarettes.

PMID: 25492935 [PubMed - as supplied by publisher]

Hookah pipes are associated with young people starting smoking, study finds.

Thu, 2014-12-11 06:18

Hookah pipes are associated with young people starting smoking, study finds.

BMJ. 2014;349:g7546

Authors: Wise J

PMID: 25491109 [PubMed - in process]

A review of air quality, biological indicators and health effects of second-hand waterpipe smoke exposure.

Sun, 2014-12-07 06:44

A review of air quality, biological indicators and health effects of second-hand waterpipe smoke exposure.

Tob Control. 2014 Dec 5;

Authors: Kumar SR, Davies S, Weitzman M, Sherman S

Abstract
OBJECTIVE: There has been a rapid increase in the use of waterpipe tobacco and non-tobacco based shisha in many countries. Understanding the impact and effects of second-hand smoke (SHS) from cigarette was a crucial factor in reducing cigarette use, leading to clean indoor air laws and smoking bans. This article reviews what is known about the effects of SHS exposure from waterpipes.
DATA SOURCES: We used PubMed and EMBASE to review the literature. Articles were grouped into quantitative measures of air quality and biological markers, health effects, exposure across different settings, different types of shisha and use in different countries.
STUDY SELECTION: Criteria for study selection were based on the key words related to SHS: waterpipe, hookah, shisha and third-hand smoke.
DATA EXTRACTION: Independent extraction with two reviewers was performed with inclusion criteria applied to articles on SHS and waterpipe/hookah/shisha. We excluded articles related to pregnancy or prenatal exposure to SHS, animal studies, and non-specific source of exposure as well as articles not written in English.
DATA SYNTHESIS: A primary literature search yielded 54 articles, of which only 11 were included based on relevance to SHS from a waterpipe/hookah/shisha.
CONCLUSIONS: The negative health consequences of second-hand waterpipe exposure have major implications for clean indoor air laws and for occupational safety. There exists an urgent need for public health campaigns about the effects on children and household members from smoking waterpipe at home, and for further development and implementation of regulations to protect the health of the public from this rapidly emerging threat.

PMID: 25480544 [PubMed - as supplied by publisher]

Prevalence, Knowledge, and Practices of Hookah Smoking Among University Students, Florida, 2012.

Fri, 2014-12-05 06:44

Prevalence, Knowledge, and Practices of Hookah Smoking Among University Students, Florida, 2012.

Prev Chronic Dis. 2014;11:E214

Authors: Rahman S, Chang L, Hadgu S, Salinas-Miranda AA, Corvin J

Abstract
INTRODUCTION: Although hookah smoking is becoming a source of tobacco use among college students in the United States, little is known of the students' knowledge, attitudes, and practices regarding hookah use. This cross-sectional study was aimed at determining the prevalence of hookah use and describing social and behavioral factors associated with hookah smoking among university students in a large urban university in Florida.
METHODS: A convenience sample of 478 undergraduate and graduate students was recruited. Lifetime use and current use was evaluated. Logistic regression modeling was used to assess the independent association between study covariates and hookah use.
RESULTS: Prevalence among students of having ever used hookah during their lifetime was 54.4%. Hookah use within the past 30 days was 16.3%. Hookah use was significantly associated with cigarette smoking (odds ratio [OR], 4.52; 95% confidence interval [CI], 2.13-9.60) and hookah ownership (OR, 10.67; 95% CI, 4.83-23.66) but not with alcohol use (OR, 1.73; 95% CI, 0.74-4.04). Findings also suggest hookah is perceived as a safer alternative to cigarette smoking. Almost 30% of those who never smoked hookah reported they would consider smoking hookah in the future.
CONCLUSION: Hookah smoking is popular among college students. Misperceptions associated with hookah use indicate a starting point for developing health behavior change interventions. Future studies should investigate social and behavioral determinants of hookah use and determine the incidence of hookah use among college and high school students. Tobacco control activities should include prevention of hookah tobacco use in university settings.

PMID: 25474386 [PubMed - as supplied by publisher]

Oral cancer in young Jordanians: potential association with frequency of narghile smoking.

Wed, 2014-12-03 06:12

Oral cancer in young Jordanians: potential association with frequency of narghile smoking.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2014 Nov;118(5):560-5

Authors: Al-Amad SH, Awad MA, Nimri O

Abstract
OBJECTIVE: The aim of this study was to investigate the relationship between narghile (water-pipe) smoking and the age of patients when diagnosed with oral cancer.
STUDY DESIGN: Patients with oral cancer registered in the Jordanian National Cancer Registry were asked about frequency of cigarette, narghile, and alcohol use. Relationship between age at diagnosis and risk factors was assessed using multiple regression analysis.
RESULTS: In this sample, 66% of patients were cigarette smokers, and 36% and 17% were narghile smokers and alcohol drinkers, respectively. The multivariate regression analysis adjusted for sex, cigarette smoking, and alcohol drinking found that narghile smokers were significantly younger when diagnosed with oral cancer compared with nonsmokers.
CONCLUSIONS: Narghile smoking is an independent risk factor associated with the development of oral cancer at a younger age. Prospective studies of its effect on the earlier development of oral cancer are needed to establish a cause-effect relationship.

PMID: 25442492 [PubMed - in process]

Patterns of combustible tobacco use in U.S. young adults and potential response to graphic cigarette health warning labels.

Tue, 2014-12-02 06:54

Patterns of combustible tobacco use in U.S. young adults and potential response to graphic cigarette health warning labels.

Addict Behav. 2014 Nov 21;42C:119-125

Authors: Villanti AC, Pearson JL, Cantrell J, Vallone DM, Rath JM

Abstract
In the evolving landscape of tobacco use, it remains unclear how tobacco control efforts should be designed and promoted for maximum impact. The current study links the identification of latent classes of young adult combustible tobacco users with anticipated responses to graphic health warning labels (HWLs). Data were collected in January 2012 using an online address-based panel as part of the Legacy Young Adult Cohort Study, and analyses were conducted in 2013. Latent class analyses identified five groups of tobacco users in a national sample of 4,236 young adults aged 18-34years: (1) little cigar/cigarillo/bidi (LCC) and hookah users (4%); (2) nonusers, open to smoking (3%); (3) daily smokers who self-identify as "smokers" (11%); (4) nondaily, light smokers who self-identify as "social or occasional smokers" (9%); and (5) nonusers closed to smoking (73%). Of the nonusers closed to smoking, 23% may be better characterized as at risk for tobacco initiation. Results indicate differences in the potential effectiveness of HWLs across classes. Compared to the daily "smokers," LCC and hookah users (RRR=2.35) and nonusers closed to smoking (RRR=2.33) were more than twice as likely to report that new graphic HWLs would make them think about not smoking. This study supports the potential of graphic HWLs to prevent young nonusers from using tobacco products. It suggests that the extension of prominent HWLs to other tobacco products, including LCCs and hookah tobacco, may also serve a prevention function.

PMID: 25437268 [PubMed - as supplied by publisher]

Benzene Uptake in Hookah Smokers and Non-smokers Attending Hookah Social Events: Regulatory Implications.

Tue, 2014-11-25 06:43

Benzene Uptake in Hookah Smokers and Non-smokers Attending Hookah Social Events: Regulatory Implications.

Cancer Epidemiol Biomarkers Prev. 2014 Nov 21;

Authors: Kassem NO, Kassem NO, Jackson SR, Liles S, Daffa RM, Zarth AT, Younis MA, Carmella SG, Hofstetter CR, Chatfield DA, Matt GE, Hecht SS, Hovell MF

Abstract
BACKGROUND: Benzene is a human hematotoxicant and a leukemogen that causes lymphohematopoietic cancers, especially acute myelogenous leukemia. We investigated uptake of benzene in hookah smokers and non-smokers attending hookah social events in naturalistic settings where hookah tobacco was smoked exclusively.
METHODS: We quantified S-phenylmercapturic acid (SPMA), a metabolite of benzene, in the urine of 105 hookah smokers and 103 non-smokers. Participants provided spot urine samples the morning of and the morning after attending an indoor hookah-only smoking social event at a hookah lounge or in a private home.
RESULTS: Urinary SPMA levels in hookah smokers increased significantly following a hookah social event (P < 0.001). This increase was 4.2 times higher after hookah lounge events (P < 0.001) and 1.9 times higher after home events (P = 0.003). In non-smokers, urinary SPMA levels increased 2.6 times after hookah lounge events (P = 0.055); however, similar urinary SPMA levels were detected before and after home events, possibly indicating chronic exposure to benzene (P = 0.933).
CONCLUSIONS: Our data provide the first evidence for uptake of benzene in hookah smokers and non-smokers exposed to hookah tobacco secondhand smoke at social events in private homes compared with their counterparts in hookah lounges. Hookah tobacco smoke is a source of benzene exposure, a risk factor for leukemia.
IMPACT: Because there is no safe level of exposure to benzene, our results call for interventions to reduce or prevent hookah tobacco use, regulatory actions to limit hookah-related exposure to toxicants including benzene, initiate labeling of hookah-related products, and include hookah smoking in clean indoor air legislation. Cancer Epidemiol Biomarkers Prev; 23(12); 1-17. ©2014 AACR.

PMID: 25416714 [PubMed - as supplied by publisher]

Association Between Electronic Cigarette Use and Openness to Cigarette Smoking Among U.S. Young Adults.

Sat, 2014-11-08 06:16

Association Between Electronic Cigarette Use and Openness to Cigarette Smoking Among U.S. Young Adults.

Nicotine Tob Res. 2014 Nov 4;

Authors: Coleman BN, Apelberg BJ, Ambrose BK, Green KM, Choiniere CJ, Bunnell R, King BA

Abstract
INTRODUCTION: Use of electronic nicotine delivery systems (ENDS), including electronic cigarettes (e-cigarettes), is increasing. One concern is the appeal of these products to youth and young adults and their potential to influence perceptions and use of conventional cigarettes.
METHODS: Using data from the 2012-2013 National Adult Tobacco Survey, characteristics of adults aged 18-29 who had never established cigarette smoking behavior were examined by ever use of e-cigarettes, demographics, and ever use of other tobacco products (smokeless tobacco, cigars, hookah, and cigarettes). Multivariate logistic regression was employed to examine the relationship between e-cigarette use and openness to cigarette smoking among young adults, defined as the lack of a firm intention not to smoke soon or in the next year.
RESULTS: Among young adults who had never established cigarette smoking behavior (unweighted n = 4,310), 7.9% reported having ever tried e-cigarettes-14.6% of whom reported current use of the product. Ever e-cigarette use was associated with being open to cigarette smoking (adjusted odds ratio = 2.4; 95% confidence interval = 1.7, 3.3), as was being male, aged 18-24, less educated, and having ever used hookah or experimented with conventional cigarettes.
CONCLUSIONS: Ever use of e-cigarettes, as well as other tobacco products, was associated with being open to cigarette smoking. This study does not allow us to assess the directionality of this association, so future longitudinal research is needed to illuminate tobacco use behaviors over time, as well as provide additional insight on the relationship between ENDS use and conventional cigarette use among young adult populations.

PMID: 25378683 [PubMed - as supplied by publisher]

Is There Evidence for Potential Harm of Electronic Cigarette Use in Pregnancy?

Wed, 2014-11-05 06:45

Is There Evidence for Potential Harm of Electronic Cigarette Use in Pregnancy?

Birth Defects Res A Clin Mol Teratol. 2014 Nov 4;

Authors: Suter MA, Mastrobattista J, Sachs M, Aagaard K

Abstract
BACKGROUND: Use of electronic cigarettes (e-cigarettes) and other nicotine containing products is increasing among women of reproductive age. The short- and long-term effects of these products on both mother and fetus are unknown.
METHODS: Because e-cigarettes are nicotine delivery systems, we sought to conduct a comprehensive review of the effects of nicotine on the fetus.
RESULTS: In utero nicotine exposure in animal models is associated with adverse effects for the offspring lung, cardiovascular system and brain. In the lung, this included reduced surface area, weight, and volume, as well as emphysema-like lesions. In adulthood, exposed offspring demonstrate elevated blood pressure and increased perivascular adipose tissue. In the brain, exposure alters offspring serotonergic, dopaminergic, and norepinephrine networks, which in turn are associated with behavioral and cognitive impairments. We also review current data on the lack of efficacy of nicotine replacement therapy in pregnant women, and highlight different nicotine containing products such as snuff, snus, and hookah.
CONCLUSION: We conclude that no amount of nicotine is known to be safe during pregnancy, and studies specifically addressing this risk are crucial and an imminent public health issue. Birth Defects Research (Part A), 2014. © 2014 Wiley Periodicals, Inc.

PMID: 25366492 [PubMed - as supplied by publisher]

Multiple tobacco product use among US adolescents and young adults.

Sun, 2014-11-02 15:35

Multiple tobacco product use among US adolescents and young adults.

Tob Control. 2014 Oct 31;

Authors: Soneji S, Sargent J, Tanski S

Abstract
OBJECTIVE: To assess the extent to which multiple tobacco product use among adolescents and young adults falls outside current Food and Drug Administration (FDA) regulatory authority.
METHODS: We conducted a web-based survey of 1596 16-26-year-olds to assess use of 11 types of tobacco products. We ascertained current (past 30?days) tobacco product use among 927 respondents who ever used tobacco. Combustible tobacco products included cigarettes, cigars (little filtered, cigarillos, premium) and hookah; non-combustible tobacco products included chew, dip, dissolvables, e-cigarettes, snuff and snus. We then fitted an ordinal logistic regression model to assess demographic and behavioural associations with higher levels of current tobacco product use (single, dual and multiple product use).
RESULTS: Among 448 current tobacco users, 54% were single product users, 25% dual users and 21% multiple users. The largest single use category was cigarettes (49%), followed by hookah (23%), little filtered cigars (17%) and e-cigarettes (5%). Most dual and multiple product users smoked cigarettes, along with little filtered cigars, hookah and e-cigarettes. Forty-six per cent of current single, 84% of dual and 85% of multiple tobacco product users consumed a tobacco product outside FDA regulatory authority. In multivariable analysis, the adjusted risk of multiple tobacco use was higher for males, first use of a non-combustible tobacco product, high sensation seeking respondents and declined for each additional year of age that tobacco initiation was delayed.
CONCLUSIONS: Nearly half of current adolescent and young adult tobacco users in this study engaged in dual and multiple tobacco product use; the majority of them used products that fall outside current FDA regulatory authority. This study supports FDA deeming of these products and their incorporation into the national media campaign to address youth tobacco use.

PMID: 25361744 [PubMed - as supplied by publisher]

Carbon monoxide poisoning following use of a water pipe/hookah.

Tue, 2014-10-28 06:08

Carbon monoxide poisoning following use of a water pipe/hookah.

Dtsch Arztebl Int. 2014 Oct 3;111(40):674-9

Authors: von Rappard J, Schönenberger M, Bärlocher L

Abstract
BACKGROUND: Water pipe (hookah) smoking has become a common activity in Germany, particularly among adolescents and young adults; in 2011, its lifetime prevalence was as high as 68.8%. Similar trends can be seen in other European countries. Water-pipe smokers are exposed to the same health-endangering substances as cigarette smokers, and the inhaled amount of carbon monoxide (CO) can be as much as ten times as high. In CO intoxication, carboxyhemoglobin is formed and causes direct injury at the cellular level, leading to hypoxia and nonspecific neuro logical manifestations. There have only been ten reported cases around the world of CO intoxication due to the use of a water pipe, and none of these were fatal. It should be recalled, however, that accidental CO intoxica - tion is common and is associated with high morbidity and mortality.
CASE PRESENTATION AND COURSE: We present a series of four young adults, aged 16 to 21, three of whom were hospitalized because of transient unconsciousness. The carboxy - hemoglobin (CO-Hb) content of the blood in the symp - tomatic patients ranged from 20.1% to 29.6%, while the asymptomatic patient had a CO-Hb content of 16.7%. Water-pipe smoking was the cause of CO intoxication in all four cases. The CO-Hb values were successfully brought down by the administration of highly concentrated oxygen and all patients were discharged in asymptomatic condition.
CONCLUSION: This case series reveals that CO intoxication due to water-pipe smoking is probably more common than is generally realized. Emergency room staff should be aware of this problem and inquire specifically about water-pipe smoking in patients with nonspecific neuro - logical manifestations.

PMID: 25346357 [PubMed - in process]

Waterpipes and Electronic Cigarettes: Increasing Prevalence and Expanding Science.

Thu, 2014-10-23 06:27

Waterpipes and Electronic Cigarettes: Increasing Prevalence and Expanding Science.

Chem Res Toxicol. 2014 Aug 18;27(8):1336-1343

Authors: Pepper JK, Eissenberg T

Abstract
The prevalence of noncigarette tobacco product use is on the rise across the globe, especially for waterpipes (also known as hookah, narghile, and shisha) and electronic cigarettes (e-cigarettes). The scientific literature reveals that waterpipe tobacco smoking is associated with exposure to a variety of toxicants that can cause short- and long-term adverse health events. In contrast, there is far less evidence of health harms related to e-cigarette use, although the variety of products in this category makes it difficult to generalize. We searched the PubMed database for all publications on waterpipes and e-cigarettes from January 2000 to March 2014. The number of publications on waterpipes rose in a slow, linear pattern during this time, while the number of publications on e-cigarettes showed exponential growth. The different trends suggest there may be more interest in studying a novel nicotine product (the e-cigarette) over a traditional tobacco product (the waterpipe). We posit that, although the specific research needs for these products are different, public health would be served best by a more equitable research approach. Scientists should continue to devote attention to understanding the unknown long-term health effects of e-cigarettes and their potential to serve as harm reduction or smoking cessation tools while simultaneously investigating how to reduce waterpipe smoking given that it exposes users to toxicants known to cause harm to health. Recent regulatory action in the United States, which proposes to include waterpipes and e-cigarettes under some of the same regulations as tobacco cigarettes, makes such research particularly timely.

PMID: 25338174 [PubMed - as supplied by publisher]

A Case of Eosinophilic Pneumonia Following Recent Onset of Hookah Smoking.

Wed, 2014-10-22 15:23

A Case of Eosinophilic Pneumonia Following Recent Onset of Hookah Smoking.

Chest. 2014 Oct 1;146(4_MeetingAbstracts):406A

Authors: Dyal H, Singhvi A, Patel R, Mendez M, Thavarajah K, Jennings J

Abstract
SESSION TITLE: ILD Student/Resident Case Report PostersSESSION TYPE: Medical Student/Resident Case ReportPRESENTED ON: Tuesday, October 28, 2014 at 01:30 PM - 02:30 PMINTRODUCTION: We report a case of acute eosinophilic pneumonia (AEP) following recent onset of hookah smoking. Various inhalational exposures have been associated with AEP, however to our knowledge, this is the first report of AEP in conjunction with hookah smoking.CASE PRESENTATION: A 26-year-old Middle Eastern female was admitted with cough, dyspnea, pleuritic chest pain and fever for two days. She had no significant medical history. She denied smoking, toxic exposures or use of illicit drugs. On admission, she was afebrile, tachycardic, normotensive, tachypneic and had normal oxygen saturation on ambient air. She had rhonchi and bibasilar crackles. Erythrocyte sedimentation rate was 47mm/hr. The following tests had normal or negative results: hemoglobin level, white blood cell count and differential, platelet count, levels of anti-neutrophil cytoplasmic antibody and antinuclear antibody, HIV ELISA and legionella serology. Initial chest radiograph was unremarkable. Spiral computed tomography of the chest revealed multiple tiny nodular opacities in the right lower lobe adjacent to peribronchovascular bundles (Fig 1). The patient continued to deteriorate and was also febrile, despite antibiotics. Chest radiograph on day 3 showed bilateral pulmonary opacities (Fig 2). She was hypoxic requiring supplemental oxygen necessitating transfer to the intensive care unit where she admitted to smoking hookah for the past month. Following intubation on day 4, bronchoscopy was performed and bronchoalveolar lavage revealed 261/ mm3 white blood cells with 61% eosinophils. She was diagnosed with AEP. Antibiotics were discontinued and treatment with prednisone was started with good response. She was discharged on a prednisone taper for thirteen weeks.DISCUSSION: AEP is characterized by acute febrile illness, hypoxemia, diffuse pulmonary infiltrates and pulmonary eosinophilia1. It is hypothesized to be an acute hypersensitivity reaction to an inhaled antigen in an otherwise healthy individual. A number of drugs and toxins have been associated with AEP. Antibiotics and non-steroidal anti-inflammatory drugs are the most commonly reported drugs. Toxins suspected to cause AEP include cigarette smoke, marijuana and cocaine. AEP has also been noted to develop after exposure to smoke from fireworks, dust from collapse of the World Trade Center and in military personnel deployed in Iraq. However, to our knowledge, hookah smoking leading to development of AEP has not been described.CONCLUSIONS: In patients who present with respiratory failure and pulmonary in?ltrates after recent exposure to inhaled toxins, AEP should be considered as a possible diagnosis. As hookah use becomes increasingly prevalent, this will become a more frequently identi?ed cause of AEP.Reference #1: Allen JN, Pacht ER, Gadek JE, Davis WB. Acute eosinophilic pneumonia as a reversible cause of noninfectious respiratory failure. N Engl J Med 1989; 321:569DISCLOSURE: The following authors have nothing to disclose: Herman Dyal, Aditi Singhvi, Ruchir Patel, Michael Mendez, Krishna Thavarajah, Jeffery JenningsNo Product/Research Disclosure Information.

PMID: 25334431 [PubMed - as supplied by publisher]

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