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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]

Water pipes and E-cigarettes: new faces of an ancient enemy.

Tue, 2014-10-21 06:37

Water pipes and E-cigarettes: new faces of an ancient enemy.

J Assoc Physicians India. 2014 Apr;62(4):324-8

Authors: Dagaonkar RS, Udwadi ZF

Abstract
In a world grappling with tobacco addiction, the hookah (water-pipe) and the electronic cigarette (e-cigarette) are creating new problems. Apart from posing the inherent danger of nicotine addiction, they both seem to be wolves cloaked in the sheep-skin of consumer-perceived safety, at least in comparison to the cigarette. However it seems that the e-cigarette may have a role in a nicotine-replacement therapy. There has been a wave of interest around the world in analysing these phenomena. The following review discusses the current data regarding the hookah and the e-cigarette. A PubMed, Medline and Google search using the keywords'sheesha', 'hookah', water-pipe', 'electronic cigarette', 'e-cigarette', 'vapers' was carried out.The studies carried out between 2007-2013 were included in this review. Information available in the public domain on internet websites was included to study the perception of the lay consumer regarding the hookah and the e-cigarette.

PMID: 25327035 [PubMed - in process]

The Changing Face of Tobacco Use Among United States Youth.

Sat, 2014-10-18 06:47

The Changing Face of Tobacco Use Among United States Youth.

Curr Drug Abuse Rev. 2014 Oct 15;

Authors: Lauterstein D, Hoshino R, Gordon T, Watkins BX, Weitzman M, Zelikoff J

Abstract
Tobacco use, primarily in the form of cigarettes, is the leading cause of preventable morbidity and mortality in the United States (U.S.). The adverse effects of tobacco use began to be recognized in the 1940's and new hazards of active smoking and secondhand smoke (SHS) exposure from cigarettes continue to be identified to this day. This has led to a sustained and wide-ranging array of highly effective regulatory, public health, and clinical efforts that have been informed by extensive scientific data, resulting in marked decreases in the use of cigarettes. Unfortunately, the dramatic recent decline in cigarette use in the U.S., has been accompanied by an upsurge in adolescent and young adult use of new, non-cigarette tobacco and nicotine-delivery products, commonly referred to as alternative tobacco products (ATPs). Commonly used ATPs include hookah, cigars, smokeless tobacco, and electronic cigarettes. While there have been a number of review articles that focus on adult ATP use, the purpose of this review is to provide an overview of what is, and is not known about emerging ATP use among U.S. adolescents on a national scale; as well as to identify research gaps in knowledge, and discuss future health and policy needs for this growing public health concern. This paper is not meant to systemically review all published survey data, but to present clear depiction of selected ATP usage in youth populations using national survey data.

PMID: 25323124 [PubMed - as supplied by publisher]

Respiratory effects in children from passive smoking of cigarettes and narghile: ISAAC Phase Three in Syria.

Fri, 2014-10-10 16:57

Respiratory effects in children from passive smoking of cigarettes and narghile: ISAAC Phase Three in Syria.

Int J Tuberc Lung Dis. 2014 Nov;18(11):1279-1284

Authors: Mohammad Y, Shaaban R, Hassan M, Yassine F, Mohammad S, Tessier JF, Ellwood P

Abstract
BACKGROUND: The association between environmental tobacco smoke (ETS) and asthma symptoms is well documented, but a causal relationship is inconclusive. International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three was the first to report a dose-response relationship between current wheezing and exposure to parental cigarette smoke. As exposure of children to water pipe (narghile) smoke is of concern in Syria, in the ISAAC Phase Three Tartous Centre we also examined the role of parental smoking of the narghile.
METHODS: Parents of children aged 6-7 years completed core written questionnaires about the prevalence of symptoms, and an environmental questionnaire for other risk factors, including parental cigarette smoking. We added questions about narghile to the questionnaire.
RESULTS: Among 2?734 pupils (49% females) surveyed, we found an association between exposure to ETS of the mother smoking cigarette or narghile and ever wheezing, nocturnal cough and severe wheeze; however, the strongest association was found when the mother smoked narghile. Mother smoking narghile was also associated with exercise wheeze. Father smoking narghile, but not cigarettes, was associated with nocturnal cough, severe wheeze and exercise wheeze. The association with current wheeze became significant when mother smoked both cigarettes and narghile; however, the effect was addititive and not synergic.
CONCLUSION: We recommend that international studies investigating ETS include questions on narghile smoking.

PMID: 25299858 [PubMed - as supplied by publisher]

The global epidemiology of waterpipe smoking.

Fri, 2014-10-10 06:14

The global epidemiology of waterpipe smoking.

Tob Control. 2014 Oct 8;

Authors: Maziak W, Taleb ZB, Bahelah R, Islam F, Jaber R, Auf R, Salloum RG

Abstract
OBJECTIVES: In the past decade, waterpipe smoking (a.k.a. hookah, shisha, narghile) has become a global phenomenon. In this review, we provide an updated picture of the main epidemiological trends in waterpipe smoking globally.
DATA SOURCES: Peer-reviewed publications indexed in major biomedical databases between 2004 and 2014. Search keywords included a combination of: waterpipe, hookah, shisha along with epidemiology, patterns, prevalence and predictors. We also used different spellings of waterpipe terms commonly used.
STUDY SELECTION: The focus was on studies with large representative samples, national data or high-quality reports that illuminated aspects of the epidemiology and trends in waterpipe smoking.
DATA EXTRACTION: Multiple researchers extracted the data independently and collectively decided on the most important and pertinent studies to include in the review.
DATA SYNTHESIS: Waterpipe smoking has become a global phenomenon among youth. The global waterpipe epidemic is likely driven by (1) the introduction of manufactured flavoured tobacco (Maassel); (2) the intersection between waterpipe's social dimension and thriving café culture; (3) the evolution of mass communication media; (4) the lack of regulatory/policy framework specific to the waterpipe. Waterpipe smoking is becoming the most popular tobacco use method among youth in the Middle East, and is quickly gaining popularity elsewhere. Important patterns of waterpipe smoking include the predominance among younger, male, high socioeconomic, and urban groups. Intermittent and social use are also noted patterns.
CONCLUSIONS: Waterpipe smoking has become a global public health problem. Developing surveillance, intervention and regulatory/policy frameworks specific to the waterpipe has become a public health priority.

PMID: 25298368 [PubMed - as supplied by publisher]

Shisha..... modern society killer.

Fri, 2014-10-03 06:38

Shisha..... modern society killer.

J Pak Med Assoc. 2014 May;64(5):604

Authors: Khan MS, Shahid N, Qurrat-ul-Ain

PMID: 25272559 [PubMed - in process]

Perceived Harm, Addictiveness, and Social Acceptability of Tobacco Products and Marijuana Among Young Adults: Marijuana, Hookah, and Electronic Cigarettes Win.

Wed, 2014-10-01 06:48

Perceived Harm, Addictiveness, and Social Acceptability of Tobacco Products and Marijuana Among Young Adults: Marijuana, Hookah, and Electronic Cigarettes Win.

Subst Use Misuse. 2014 Sep 30;

Authors: Berg CJ, Stratton E, Schauer GL, Lewis M, Wang Y, Windle M, Kegler M

Abstract
Background: There has been an increase in non-daily smoking, alternative tobacco product and marijuana use among young adults in recent years. Objectives: This study examined perceptions of health risks, addictiveness, and social acceptability of cigarettes, cigar products, smokeless tobacco, hookah, electronic cigarettes, and marijuana among young adults and correlates of such perceptions. Methods: In Spring 2013, 10,000 students at two universities in the Southeastern United States were recruited to complete an online survey (2,002 respondents), assessing personal, parental, and peer use of each product; and perceptions of health risks, addictiveness, and social acceptability of each of these products. Results: Marijuana was the most commonly used product in the past month (19.2%), with hookah being the second most commonly used (16.4%). The least commonly used were smokeless tobacco products (2.6%) and electronic cigarettes (4.5%). There were high rates of concurrent product use, particularly among electronic cigarette users. The most positively perceived was marijuana, with hookah and electronic cigarettes being second. While tobacco use and related social factors, related positively, influenced perceptions of marijuana, marijuana use and related social factors were not associated with perceptions of any tobacco product. Conclusions/Importance: Marketing efforts to promote electronic cigarettes and hookah to be safe and socially acceptable seem to be effective, while policy changes seem to be altering perceptions of marijuana and related social norms. Research is needed to document the health risks and addictive nature of emerging tobacco products and marijuana and evaluate efforts to communicate such risks to youth.

PMID: 25268294 [PubMed - as supplied by publisher]

Cadmium and nickel in blood of Tunisian population and risk of nasosinusal polyposis disease.

Fri, 2014-09-26 12:52

Cadmium and nickel in blood of Tunisian population and risk of nasosinusal polyposis disease.

Environ Sci Pollut Res Int. 2014 Sep 26;

Authors: Khlifi R, Olmedo P, Gil F, Hammami B, Hamza-Chaffai A

Abstract
Nasosinusal polyposis (NSP) is a chronic inflammatory disease of the nasal mucosa. Although the pathophysiology underlying NSP formation is not fully understood, environmental factors appear to be contributed the development of this disease. A case-control study of Tunisian patients was examined to assess the levels of cadmium (Cd) and nickel (Ni) in blood and reparse the association between the exposure to these metals and the risk of nasosinusal polyposis disease. Mean blood levels of Cd in patients (2.2?±?12.8 ?g/L) were significantly higher than those of controls (0.5?±?0.7 ?g/L). Levels of blood Cd were positively correlated with tobacco smoking and chewing among controls. The Cd and Ni concentrations among control (p?=?0.001) and patient (p?=?0.018) tobacco consumers (smoking, chewing, and shisha) were significantly higher than those nonconsumers. Additionally, Ni blood levels of patient and control smokers were significantly higher than those of nonsmokers. Cd levels in blood samples of NSP patients occupationally exposed for more than 14 years were eight times higher than that of nonexposed. Drinking water was also found to be incriminated as exposure sources. Among risk factors, shisha consumption, environmental exposure, and occupational exposure presented the most significant association with NSP disease (odds ratio (OR)?=?14.1, 10.1, and 1.7, respectively). High levels of blood Cd (OR?=?3.5) were strongly associated with NSP disease (p?=?0.027). Ni blood levels were shown to be associated with the four stages of polyps in both nasal cavities (right and left) (p?<?0.05). This investigation suggested a potential role of toxic metals in the mechanism of NSP disease development. Exposure assessment investigations encompassing a wider population are needed.

PMID: 25253060 [PubMed - as supplied by publisher]

Effect of Shisha (Waterpipe) Smoking on Lung Functions and Fractional Exhaled Nitric Oxide (FeNO) among Saudi Young Adult Shisha Smokers.

Fri, 2014-09-19 06:04

Effect of Shisha (Waterpipe) Smoking on Lung Functions and Fractional Exhaled Nitric Oxide (FeNO) among Saudi Young Adult Shisha Smokers.

Int J Environ Res Public Health. 2014;11(9):9638-9648

Authors: Meo SA, AlShehri KA, AlHarbi BB, Barayyan OR, Bawazir AS, Alanazi OA, Al-Zuhair AR

Abstract
Shisha (waterpipe) smoking is becoming a more prevalent form of tobacco consumption, and is growing worldwide, particularly among the young generation in the Middle East. This cross-sectional study aimed to determine the effects of shisha smoking on lung functions and Fractional Exhaled Nitric Oxide (FeNO) among Saudi young adults. We recruited 146 apparently healthy male subjects (73 control and 73 shisha smokers). The exposed group consisted of male shisha smokers, with mean age 21.54 ± 0.41 (mean ± SEM) range 17-33 years. The control group consisted of similar number (73) of non-smokers with mean age 21.36 ± 0.19 (mean ± SEM) range 18-28 years. Between the groups we considered the factors like age, height, weight, gender, ethnicity and socioeconomic status to estimate the impact of shisha smoking on lung function and fractional exhaled nitric oxide. Lung function test was performed by using an Spirovit-SP-1 Electronic Spirometer. Fractional Exhaled Nitric Oxide (FeNO) was measured by using Niox Mino. A significant decrease in lung function parameters FEV1, FEV1/FVC Ratio, FEF-25%, FEF-50%, FEF-75% and FEF-75-85% was found among shisha smokers relative to their control group. There was also a significant reduction in the Fractional Exhaled Nitric Oxide among Shisha smokers compared to control group.

PMID: 25233010 [PubMed - as supplied by publisher]

Air quality in New York City hookah bars.

Fri, 2014-09-19 06:04

Air quality in New York City hookah bars.

Tob Control. 2014 Sep 16;

Authors: Zhou S, Weitzman M, Vilcassim R, Wilson J, Legrand N, Saunders E, Travers M, Chen LC, Peltier R, Gordon T

Abstract
BACKGROUND: Hookahs are increasingly being used in the USA and elsewhere. Despite the popularity of hookah bars, there is a paucity of research assessing the health effects of hookah smoke, and although New York City (NYC) bans indoor tobacco smoking, hookah lounges claim that they only use herbal products without tobacco. This study investigated levels of multiple indices of indoor air pollution in hookah bars in NYC.
METHODS: Air samples were collected in 8 hookah bars in NYC. Along with venue characteristics, real-time measurements of fine particulate matter (PM2.5), black carbon (BC), and carbon monoxide (CO), and total gravimetric PM, elemental carbon (EC), organic carbon (OC), and nicotine were collected in 1-2 hour sessions.
RESULTS: Overall, levels of indoor air pollution increased with increasing numbers of active hookahs smoked. The mean (SD) real time PM2.5 level was 1179.9 (939.4) µg/m(3), whereas the filter-based total PM mean was 691.3 (592.6) µg/m(3). The mean real time BC level was 4.1 (2.3) µg/m(3), OC was 237.9 (112.3) µg/m(3), and CO was 32 (16) ppm. Airborne nicotine was present in all studied hookah bars (4.2 (1.5) µg/m(3)).
CONCLUSIONS: These results demonstrate that despite the ban on smoking tobacco products, at the very least, some NYC hookah bars are serving tobacco-based hookahs, and have elevated concentrations of indoor air pollutants that may present a health threat to visitors and employees. Therefore, there is an urgent need for better air quality monitoring in such establishments and policies to combat this emerging public health threat.

PMID: 25232045 [PubMed - as supplied by publisher]

Smoking, awareness of smoking-associated health risks, and knowledge of national tobacco legislation in Gaza, Palestine.

Fri, 2014-09-19 06:04

Smoking, awareness of smoking-associated health risks, and knowledge of national tobacco legislation in Gaza, Palestine.

Cent Eur J Public Health. 2014 Jun;22(2):80-9

Authors: Abu Shomar RT, Lubbad IK, El Ansari W, Al-Khatib IA, Alharazin HJ

Abstract
AIMS: To assess university students' extent of smoking, knowledge of smoking health risks, and awareness of existing national anti-smoking laws.
METHODS: Self-administered questionnaire was employed across 7 universities (1,104 students, equal proportions of males and females) located in Gaza Strip, Palestine.
RESULTS: About 55% of participants reported ever smoking, 31% were current cigarette smokers, and 36% were 'strictly' (only) narghile (water pipe) smokers. Mean age of smoking initiation was 17 +/- 3.15 years. Smokers had less knowledge of smoking associated health risks than nonsmokers. Students' knowledge of existing anti-smoking laws was generally low (11.3-25.5%), and significantly more smokers had knowledge about existing laws (ban of advertisement of smoking, ban of smoking in public places, and ban of selling cigarettes to minors) than non-smokers. About 81% of current smokers tried to quit smoking at least once during their life, 53% felt ready to quit smoking if cessation assistance was provided, 17% were not ready to quit, and 30% were reluctant/felt unsure if they were ready to quit. Most students (94.3%) reported that there were no smoking cessation centres in Palestine, or did not know if such centres existed. Males were associated with almost all categories of smoking (e.g. smoking both cigarettes and narghile, or smoking narghile only).
CONCLUSIONS: There is a lack of knowledge about the existing national anti-smoking legislation among university students in Gaza, Palestine. Smoking cessation centres also seem non-existent in Gaza. Multi-level interventions and actions are required by policy makers, educators and non-governmental agencies to prevent smoking among university students in Gaza, and to educate them on tobacco cessation counselling, on the dangers of tobacco use, and about effective stress management strategies to help them to cope with stressors. Smoking cessation interventions are required to address both cigarette and narghile use. Efforts need to be invested in ensuring compliance with legislation and for follow-up activities to enforce the anti-smoking laws through coordinated actions across ministries and departments.

PMID: 25230536 [PubMed - in process]

Comparison of end tidal carbon monoxide (eCO) levels in shisha (water pipe) and cigarette smokers.

Thu, 2014-09-11 08:31

Comparison of end tidal carbon monoxide (eCO) levels in shisha (water pipe) and cigarette smokers.

Tob Induc Dis. 2014;12(1):10

Authors: Akhter S, Ali Warraich U, Rizvi N, Idrees N, Zaina F

Abstract
BACKGROUND: Measuring eCo is rapid, non-invasive and inexpensive tool and correlate correctly with carboxyhemoglobin levels in blood. The aim of this study was to evaluate and compare the increase in end tidal carbon monoxide (eCO) levels in exhaled breath of passive smokers and healthy smokers after cigarette and shisha smoking.
FINDINGS: In a cross sectional study eCO levels were measured in 70 subjects (24 cigarette smokers, 20 shisha smoker, 26 passive smokers) by use of portable device. Smokers were asked to smoke shisha for 30 mins in shisha cafe or to smoke 5 cigarettes in 30 mins in a restaurant. eCo levels were measured at baseline (30 mins), 35 mins, 60 mins and 90 mins in all groups after entry to the venue. The baseline mean eCO level among cigarette smokers was 3.5 +/- 0.6 ppm (part per million), passive cigarette smokers 3.7+/-1.0 ppm, shisha smokers 27.7+/-4.9 ppm and passive shisha smokers 18.3+/-8.4 ppm .The mean increase in eCO after 90 min among smokers was 9.4+/-4.6 (p?<?0.005), passive cigarette smokers 3.5+/-2.5 (p?<?0.05), shisha smokers 57.9+/-27.4 (p <0.005) and passive shisha smokers 13.3+/-4.6 (p?=?0.03).
CONCLUSION: Exposure to shisha smoke is a cause of elevated eCO in smokers and passive smokers and due to in-door pollution, sitting in shisha bar causes significant increase in eCO levels.

PMID: 25206319 [PubMed]

Prevalence of tobacco smoking among health-care physicians in Bahrain.

Wed, 2014-09-10 06:12

Prevalence of tobacco smoking among health-care physicians in Bahrain.

BMC Public Health. 2014 Sep 8;14(1):931

Authors: Borgan SM, Jassim G, Marhoon ZA, Almuqamam MA, Ebrahim MA, Soliman PA

Abstract
BACKGROUND: There is a clear shift in smoking habits among the Middle Eastern population with a recent and alarming increase in the prevalence of waterpipe (shisha) smoking. This phenomenon has not yet been studied sufficiently across the physician population. Therefore, we set out to establish the smoking status of primary healthcare physicians in the kingdom of Bahrain.
METHODS: A self-administered questionnaire was distributed to a random sample of 175 out of the total 320 primary care physicians. Descriptive analysis was performed on all data and associations between variables were tested using Fishers Exact t test with statistical significance set as P-value < 0.05.
RESULTS: One hundred and fifty two physicians agreed to participate in the study. Sixty seven percent of physicians were females and the mean (SD) age was 45 (10) years. The majority of the physicians were married (93%) and of Bahraini nationality (76%). Ever-smokers were 11% of the population while current smokers corresponded to 8.6%. Waterpipe was the most common method of tobacco smoking followed by cigarettes. Among male physicians, the prevalence of current 'waterpipe only' smokers was 12%, followed by 4% and 2% corresponding to 'cigarette only' smokers and both, respectively. There were only three female smokers in the population, two 'waterpipe only' smokers and one cigar smoker. Of those who smoked waterpipe (n = 9; 6%), 33% smoked daily, 44% smoked weekly and 22% smoked at least once a month. Current smoking status was associated with male gender (P < 0.001) and showed a male to female smoking ratio of (10:1).
CONCLUSION: Waterpipe smoking rates exceeded cigarette smoking among the population of physicians in Bahrain. Prevalence of smoking remains unacceptably high among male physicians. Assessment of physicians' knowledge of the harmful effects of waterpipe tobacco smoking is warranted to plan future interventions.

PMID: 25200373 [PubMed - as supplied by publisher]

The waterpipe: a new way of hooking youth on tobacco.

Fri, 2014-09-05 07:05

The waterpipe: a new way of hooking youth on tobacco.

Am J Addict. 2014 Mar;23(2):103-7

Authors: Maziak W

Abstract
BACKGROUND: Tobacco smoking continues to be the number one preventable cause of morbidity and mortality worldwide. Several evidence-based interventions and policies have been successful in reducing cigarette smoking in developed countries. Globally, however, many beginning smokers are introduced to tobacco by means other than cigarettes. In particular, waterpipe smoking (a.k.a. hookah, narghile, shisha) has been dramatically increasing among youth worldwide.
METHODS: In this short review, I will introduce the reader to this emerging tobacco use method and focus on its addictive properties, and how this pertains to the development of effective interventions to curb its spread.
RESULTS AND CONCLUSIONS: Waterpipe smoking is likely to be associated with much of the harmful effects of cigarette smoking, is addictive, and can serve as a bridge to cigarettes. Due to its unique features, waterpipe-specific interventions and policies are needed to curb the global waterpipe epidemic. (Am J Addict 2014;23:103-107).

PMID: 25187045 [PubMed - in process]

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