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NCBI: db=pubmed; Term=((hookah) OR narghile) OR shisha
Updated: 16 min 22 sec ago

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

7 hours 42 min ago

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]

Alternative Tobacco Product Use and Smoking Cessation Among Homeless Youth in Los Angeles County.

Tue, 2014-08-26 06:02
Related Articles

Alternative Tobacco Product Use and Smoking Cessation Among Homeless Youth in Los Angeles County.

Nicotine Tob Res. 2014 Aug 21;

Authors: Tucker JS, Shadel WG, Golinelli D, Ewing B

Abstract
INTRODUCTION: Approximately 70% of homeless youth smoke cigarettes, but their use of alternative tobacco products (ATPs) is unknown. This paper reports on ATP use among past month smokers in Los Angeles County, including whether it differs by demographic characteristics, homelessness severity, past year quit attempts, and readiness to quit smoking. Given the growing popularity of e-cigarettes, we also report on perceptions of harm and reasons for using this product.
METHODS: We surveyed 292 unaccompanied homeless youth who were randomly sampled from street sites. Participants smoked at least 100 cigarettes in lifetime and 1 cigarette in the past month.
RESULTS: Seventy-two percent of youth reported past month ATP use (e-cigarettes = 51%; little cigars/cigarillos = 46%; hookah = 31%; other smokeless tobacco product = 24%; chewing tobacco/moist snuff = 19%). Current ATP use was unrelated to most demographic characteristics or having a past year quit attempt. However, youth who planned to quit smoking in the next 30 days were significantly less likely to report current use of hookahs, other smokeless tobacco products, or e-cigarettes. Among lifetime e-cigarette users, the most common reasons for use included not having to go outside to smoke (38%) and to deal with situations or places where they cannot smoke (36%); it was less common to report using e-cigarettes to quit smoking (17%-18%).
DISCUSSION: Dual use of ATPs among homeless youth smokers is common, and more likely among those who have no immediate plans to quit smoking. Effective and easily disseminable strategies for reducing all forms of tobacco use among homeless youth are urgently needed.

PMID: 25145375 [PubMed - as supplied by publisher]

Intentions to smoke cigarettes among never-smoking U.S. middle and high school electronic cigarette users, National Youth Tobacco Survey, 2011-2013.

Fri, 2014-08-22 06:45

Intentions to smoke cigarettes among never-smoking U.S. middle and high school electronic cigarette users, National Youth Tobacco Survey, 2011-2013.

Nicotine Tob Res. 2014 Aug 20;

Authors: Bunnell RE, Agaku IT, Arrazola R, Apelberg BJ, Caraballo RS, Corey CG, Coleman B, Dube SR, King BA

Abstract
INTRODUCTION: Electronic cigarette (e-cigarette) use is increasing rapidly and their impact on youth is unknown. We assessed associations between e-cigarette use and smoking intentions among U.S. youth who had never smoked conventional cigarettes.
METHODS: We analyzed data from the nationally representative 2011, 2012, and 2013 National Youth Tobacco Surveys of students in grades 6-12. Youth reporting they would definitely not smoke in the next year or if offered a cigarette by a friend were defined as not having an intention to smoke, while all others were classified as having positive intention to smoke conventional cigarettes. Demographics, pro-tobacco advertisement exposure, ever use of e-cigarettes, and ever use of other combustibles (cigars, hookah, bidis, kreteks, and pipes) and non-combustibles (chewing tobacco, snuff, dip, snus, and dissolvables) were included in multivariate analyses assessing associations with smoking intentions among never-cigarette-smoking youth.
RESULTS: Between 2011-2013, the number of never-smoking youth who used e-cigarettes increased three-fold, from 79,000 to over 263,000. Intention to smoke conventional cigarettes was 43.9% among ever e-cigarette users and 21.5% among never users. Ever e-cigarette users had higher adjusted odds of having smoking intentions than never users (Adjusted Odds Ratio: 1.70, 95% Confidence Interval: 1.24-2.32). Those who ever used other combustibles, ever used non-combustibles, or reported pro-tobacco advertisement exposure also had increased odds of smoking intentions.
CONCLUSION: In 2013, over a quarter million never-smoking youth had used e-cigarettes. E-cigarette use was associated with increased intentions to smoke cigarettes. Enhanced prevention efforts for youth are important for all forms of tobacco, including e-cigarettes.

PMID: 25143298 [PubMed - as supplied by publisher]

Unconventional materials and substances used in water pipe (narghile) by smokers in central western region of Saudi Arabia.

Tue, 2014-08-19 06:19
Related Articles

Unconventional materials and substances used in water pipe (narghile) by smokers in central western region of Saudi Arabia.

Saudi Med J. 2014 Aug;35(8):890-3

Authors: Baboor AS, Alnazzawi AA, Abu-Hammad OA, Dar-Odeh NS

Abstract
OBJECTIVES: To investigate the use of unconventional substances and materials in water pipe among café water pipe smokers.
METHODS: This was a questionnaire-based survey among subjects attending coffee shops in the region of Al Madinah, Saudi Arabia between February and March  2013.
RESULTS: We invited 110 subjects, only 90 consented to participate in the study. A percentage of 1.1% used fluids other than water in the water pipe tank, 18.9% added other soft drinks to the tank, and 7.8% added flowers, spices or drugs to the tobacco mix placed in the head of the water pipe.  A proportion of participants used fruits to replace the water pipe head (12.2%), or to replace water pipe tank (4.4%). Higher number of children the smokers had and cafe smoking were all significantly associated with unconventional practices.
CONCLUSION: A substantial percentage of sample of water pipe smokers in Al Madinah, Saudi Arabia use unusual materials and/or substances in the water pipe and this is probably encouraged by cafe smoking. 

PMID: 25129195 [PubMed - in process]

Recent advances in oesophageal diseases.

Fri, 2014-08-15 15:47

Recent advances in oesophageal diseases.

Gastroenterol Hepatol Bed Bench. 2014;7(3):186-9

Authors: Al Dulaimi D

Abstract
Dong Y, Qi B, Feng XY, Jiang CM. Meta-analysis of Barrett's esophagus in China. World J Gastroenterol 2013;19(46):8770-8779 The disease pattern of Barrett's esophagus (BE) in China is poorly characterised particularly in comparison with other developed countries. This meta-analysis of 3873 cases of BE collated from 69 clinical studies conducted in 25 provinces between 2000 and 2011 investigated the epidemiology and characteristics of BE in China compared to Western countries. The total endoscopic detection rate of BE was 1.0% (95%CI: 0.1%-1.8%) with an average patient age of 49.07 ± 5.09 years, lower than many Western countries.The authors postulate this may be attributed to environmental risk factor variation, distinct genetics and different medical practice including diagnostic criteria for BE and expertise in endoscopy. This study identified a 1.781 male predominancefor BE in China, consistent with Western reports. Short-segment BE accounted for 80.3% of cases with island type and cardiac type the most common endoscopic (44.8%) and histological (40.0%) manifestations respectively. Of the 1283 BE cases followed up for three to 36 months the incidence of esophageal cancer was 1.418 per 1000 person-years, lower than the incidence reported in Western countries. Lee HS, Jeon SW. Barrett esophagus in Asia: same disease with different pattern. ClinEndosc 2014;47(1):15-22 Barrett's esophagus (BE) is a common, pre-cancerous condition characterised by intestinal metaplasia of squamous esophageal epithelium usually attributed to chronic gastric acid exposure. This review article explores important differences in the disease pattern of BE between Asian and the Western countries. Overall the prevalence of BE is lower in Asia compared to the West with a greater proportion of short-segment type. The authors identify great variability in the endoscopic and pathologic diagnostic criteria for BE. Many of the studies in Asian countries did not use a standardised four-quadrant biopsy protocol which may have led to an underestimation of BE prevalence. The review highlights an increasing incidence of esophageal adenocarcinoma in the West but unclear disease trend in Asia with inter-country variability. Similarly in Asian and Western countries BE is associated with the presence of hiatus hernia, advancing age, male gender, alcohol consumption, smoking, abdominal obesity and longer duration of gastro-esophageal reflux disease. The authors postulate that Helicobacter pylori infection, more prevalent in Asia than the West, may have a protective effect on BE. There is a need for larger, prospective studies to further clarify the disease pattern of BE in Asian countries. Clearly standardisation of the diagnostic process for BE is important to validate the differences in disease trends between Asian and Western countries. Kiadaliri AA. Gender and social disparities in esophagus cancer incidence in Iran, 2003-2009: a time trend province-level study.Asian Pac J Cancer Prev 2014;15(2):623-7 Esophageal cancer (EC) is a major cause of morbidity and mortality particuarly in Iran where the incidence rate exceeds the global average. An understanding of the factors influencing the province-specific incidence of EC in Iran is important to inform disease-prevention strategies and address health inequalities. This ecological study used cancer registry data to investigate the relationship between gender and social class and the incidence of EC in Iran at province-level between 2003 and 2009. The age standardised incidence rates (ASIR) of EC were greatest in the Northern provinces of Iran, specifically Razavi Khorasan in males and Kordestan in females. Overall the EC incidence did not significantly differ according to gender. Interestingly, during the study period the ASIR increased by 4.6% per year in females (p=0.08) and 6.5% per year in males (p=0.02). This may reflect increasing rates of establised risk factors for EC including obsesity and gastro-esophageal reflux disease alongside more vigilant recording of new cases. Social class was inversely associated with the ASIR of EC regardless of gender which may be attributed to class differences in risk factor distribution particularly smoking, diet and obesity. An appreciation for the limitations of an epidemiological study is important when interpreting results which should be further evaluated in future studies. Islami F et al.Determinants of gastroesophageal reflux disease, including hookah smoking and opium use- A cross-sectional analysis of 50,000 individuals. PLoS One 2014;9(2):e89256 Gastroesophageal reflux disease (GERD) is a highly prevalent cause of gastrointestinal symptoms worldwide incurring great cost to the primary and secondary healthcare sectors. An improved understanding of the factors which influence GERD symptoms in low- to medium- income countries may inform public health initiatives. This study analysed prospective data from the Golestan cohort study, primarily established to investigate determinants of upper gastrointestinal cancers, toexplore the risk factors influencing GERD symptoms (regurgitation and/or heartburn) in 50,045 individuals aged 40-75 years in Golestan Province, Iran enrolled between 01/2004 and 06/2008.Of note, 39.12% of individuals denied ever experiencing GERD symptoms. A further 19.89% reported at least once weekly GERD symptoms with 11.83% experiencing daily symptoms. Severe symptoms, defined as disturbing daily work or sleep, were recorded by 11.33% of individuals. Separately the occurrence of daily GERD symptoms and severe symptoms were inversely associated with male gender (OR 0.36, 95% CI 0.33-0.39 both), level of formal education (p=0.01 and p=0.001 respectively), wealth score (p<0.001 both) and regular nass chewing (OR 0.86, 95% CI 0.75-0.98 and OR 0.87, 95% CI 0.76-0.99 respectively)and were positively associated with body mass index (p<0.001 both), intensity of physical activity (p=0.04 both), cigarette pack years (p<0.001 both), alcohol consumption (OR 1.36, 95% CI 1.13-1.64 and OR 1.53, 95% CI 1.28-1.83 respectively) and opium use (OR 1.82, 95% CI 1.67-1.99 and OR 1.70, 95% CI 1.55-1.87 respectively).In addition hookah smoking had a borderline significant correlation with mild and moderate severity GERD symptoms in individuals who had never smoked cigarettes (OR 1.41, 95% CI 1.00-1.99 and OR 1.25, 95% CI 0.99-1.57 respectively). Overall this large study contributes useful data to inform the prevention and management of GERD symptoms particularly regarding the use of hookah, opium and nass which was previously unclear. Barbera M et al. The human squamous oesophagus has widespread capacity for clonal expansion from cells at diverse stages of differentiation. Gut 2014;0:1-9. doi:10.1136/gutjnl-2013-306171 Current knowledge on human esophageal tissue homeostasis and injury repair is derived predominantly from murine models and hence may be inaccurate due to cellular and architectural differences. This study used 3D imaging in conjunction withstaining for cell lineage markers to investigate the cellular mechanisms involved in homeostasis of the normal human squamous esophagus in 10 participants undergoing esophagectomy for esophageal cancer. The self-renewal potential of cell subpopulations was also assessed using in vitro and in vivo assays. A decreasing gradient of cell proliferation was observed from the inter-papillary basal layer to the tip of the papilla where there was no evidence of mitosis. The expression of?1-integrin, a putative stem cell marker, was consistent throughout the basal layer and therefore the entire basal layer can be considered undifferentiated. Quiescent ?1-integrin/CD34-positive cells which failed to stain for CD45, S-100 or F4-80were identified at the tip of the papilla suggesting this is an extension of the basal layer. Contrary to previous data, this study found progenitor cells widely distributed in human esophageal tissue and included already differentiated epithelial cells. This insight into esophageal homeostasis may inform future studies exploring the pathological mechanisms underpinning homeostatic disruption in disease states such as Barrett's esophagus. Papers were prepared by: Drs Ishfaq Ahmad and Luke Materacki, Department of Medicine, Alexandra Hospital, Redditch, UK.

PMID: 25120902 [PubMed]

The hookah experience: Stop them before it's too late!!!!

Fri, 2014-08-15 06:31

The hookah experience: Stop them before it's too late!!!!

Indian J Public Health. 2014 Jul-Sep;58(3):204-5

Authors: Khandelwal V, Nayak UA, Nayak PA, Khandelwal S

PMID: 25116829 [PubMed - in process]

Predictors of non- hookah smoking among high-school students based on prototype/willingness model.

Thu, 2014-08-07 06:39

Predictors of non- hookah smoking among high-school students based on prototype/willingness model.

Health Promot Perspect. 2014;4(1):46-53

Authors: Abedini S, MorowatiSharifabad M, Chaleshgar Kordasiabi M, Ghanbarnejad A

Abstract
BACKGROUND: The aim of the study was to determine predictors of refraining from hookah smoking among high-school students in Bandar Abbas, southern Iran based on Prototype/Willingness model.
METHODS: This cross- sectional with analytic approach was performed on 240 high-school students selected by a cluster random sampling. The data of demographic and Prototype-Willingness Model constructs were acquired via a self-administrated questionnaire. Data were analyzed by mean, frequency, correlation, liner and logistic regression statistical tests.
RESULTS: Statistically significant determinants of the intention to refrain from hookah smoking were subjective norms, willingness, and attitude. Regression model indicated that the three items together explained 46.9% of the non-smoking hookah intention variance. Attitude and subjective norms predicted 36.0% of the non-smoking hookah intention variance. There was a significant relationship between the participants' negative prototype about the hookah smokers and the willingness to avoid from hookah smoking (P=0.002). Also willingness predicted non-smoking hookah better than the intention (P<0.001).
CONCLUSION: Deigning intervention to increase negative prototype about the hookah smokers and reducing situations and conditions which facilitate hookah smoking, such as easy access to tobacco products in the cafés, beaches can be useful results among adolescents to hookah smoking prevention.

PMID: 25097836 [PubMed]

The Relationship Between Waterpipe Smoking and Body Weight: Population-Based Findings From Syria.

Thu, 2014-08-07 06:39

The Relationship Between Waterpipe Smoking and Body Weight: Population-Based Findings From Syria.

Nicotine Tob Res. 2014 Aug 5;

Authors: Ward KD, Ahn S, Mzayek F, Al Ali R, Rastam S, Asfar T, Fouad F, Maziak W

Abstract
INTRODUCTION: Cigarette smoking has well known effects on body weight, with current smokers weighing less than never-smokers, and cessation producing weight gain. Use of waterpipe (or "hookah") is increasing in many parts of the world but its effects on body weight are not known.
METHODS: We compared body mass index (BMI) among 2,536 adults (age ?18 years old), who were never, former, current nondaily, or current daily waterpipe smokers, drawn from 2 representative, population-based household surveys of adults in Aleppo, Syria.
RESULTS: Overall, 84.1% (n = 2,134) never-smoked waterpipe, 4.6% (n = 116) were former smokers, 9.9% (n = 251) were current nondaily smokers, and 1.4% (n = 35) were current daily smokers. Mean BMI of the sample was 30.2kg/m(2) (SD = 6.3). Adjusted for cigarette smoking, number of chronic diseases, age, gender, income, and marital status, daily waterpipe users were 2.26 BMI units greater than never-smokers (beta = 2.26, 95% CI = 0.79-3.72), and had nearly threefold odds of being obese (odds ratio = 2.87, 95% CI = 1.06-7.76). Nondaily and former waterpipe users were similar to never-smokers in terms of BMI and obesity risk.
CONCLUSION: Results indicate that daily waterpipe users, compared to never-users, have higher BMI, translating into 6 extra kilograms of weight on average, and are 3 times as likely to be obese.

PMID: 25096252 [PubMed - as supplied by publisher]

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