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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]

Alternate Tobacco Product and Drug Use Among Adolescents Who Use Electronic Cigarettes, Cigarettes Only, and Never Smokers.

Sun, 2014-08-03 06:46

Alternate Tobacco Product and Drug Use Among Adolescents Who Use Electronic Cigarettes, Cigarettes Only, and Never Smokers.

J Adolesc Health. 2014 Jul 29;

Authors: Camenga DR, Kong G, Cavallo DA, Liss A, Hyland A, Delmerico J, Cummings KM, Krishnan-Sarin S

Abstract
PURPOSE: To determine whether use of alternative tobacco products (i.e., cigars, blunts, hookah, smokeless tobacco), alcohol, and marijuana differs among adolescents who currently use (1) electronic cigarettes (e-cigarettes); (2) cigarettes only; and (3) never smokers.
METHODS: Analysis of a self-reported survey from four high schools in 2010-2011 (n = 3,102) with a subsample (n = 1,556) surveyed on alcohol and marijuana. Analyses were conducted with multinomial logistic regression models accounting for clustering by schools.
RESULTS: The sample contained 2.4% (n = 76) e-cigarette users, 12.4% (n = 386) cigarette smokers, and 85.1% (n = 3,197) never smokers. E-cigarette users were more likely than cigarette-only smokers to report blunt (adjusted odds ratio, 1.81; 95% confidence interval, 1.21-2.71) and hookah use (adjusted odds ratio, 3.12; 95% confidence interval, 1.90-5.13), but not cigar, smokeless tobacco, alcohol, or marijuana use.
CONCLUSIONS: E-cigarette users are more likely than cigarette smokers to use hookah and blunts.

PMID: 25085648 [PubMed - as supplied by publisher]

Measuring the acute cardiovascular effects of shisha smoking: a cross-sectional study.

Sat, 2014-07-26 06:30

Measuring the acute cardiovascular effects of shisha smoking: a cross-sectional study.

JRSM Open. 2014 Jun;5(6):2054270414531127

Authors: Kadhum M, Jaffery A, Haq A, Bacon J, Madden B

Abstract
OBJECTIVES: To investigate the acute cardiovascular effects of smoking shisha.
DESIGN: A cross-sectional study was carried out in six shisha cafes. Participants smoked shisha for a period between 45?min (minimum) and 90?min (maximum). The same brand of tobacco and coal was used.
SETTING: London, UK.
PARTICIPANTS: Participants were those who had ordered a shisha to smoke and consented to have their blood pressure, heart rate and carbon monoxide levels measured. Excluded subjects were those who had smoked shisha in the previous 24?h, who smoke cigarettes or who suffered from cardiorespiratory problems.
MAIN OUTCOME MEASURES: Blood pressure was measured using a sphygmomanometer. Pulse was measured by palpation of the radial artery. Carbon monoxide levels were obtained via a carbon monoxide monitor. These indices were measured before the participants began to smoke shisha and after they finished or when the maximum 90?min time period was reached.
RESULTS: Mean arterial blood pressure increased from 96?mmHg to 108?mmHg (p?<?0.001). Heart rate increased from 77 to 91?bpm (p?<?0.001). Carbon monoxide increased from an average of 3 to 35?ppm (p?<?0.001). A correlation analysis showed no relationship between carbon monoxide and the other indices measured.
CONCLUSION: The acute heart rate, blood pressure and carbon monoxide levels were seen to rise significantly after smoking shisha. The weak correlation between carbon monoxide levels and the other variables suggests that carbon monoxide levels had not contributed to their significant increase.

PMID: 25057403 [PubMed]

Smoking among dental students at King Saud University: Consumption patterns and risk factors.

Sat, 2014-07-26 06:30

Smoking among dental students at King Saud University: Consumption patterns and risk factors.

Saudi Dent J. 2014 Jul;26(3):88-95

Authors: AlSwuailem AS, AlShehri MK, Al-Sadhan S

Abstract
OBJECTIVE: To assess smoking prevalence among dental students at King Saud University (KSU) and to determine possible risk factors of tobacco use.
METHODS: A self-addressed invitation letter was sent to all dental students (males and females) at KSU requesting participation in this study. Data on smoking habits, associated risk factors, and demographic factors, such as age, marital status, residency status, the student's year of study, and grade point average, were collected by an electronic self-administered questionnaire sent via email. Data were analyzed using SPSS. Significant differences between different groups were assessed with a Pearson Chi-Square test at ? = 0.05. Logistic regression analysis was used to calculate the odds ratio (OR) and 95% confidence interval (95% CI) and to determine the effect of different risk factors on students' smoking habits.
RESULTS: Of the 600 registered dental students, 400 students responded (230 males, 170 females), representing a response rate of 67%. More male than female students were current smokers (27.6% vs. 2.4%, p < 0.001). Most smokers used shisha tobacco only (N = 35, 51.5%), followed by both shisha tobacco and cigarettes (N = 17, 25%), or cigarettes only (N = 16, 23.5%). Male students were about 4 times more likely to be smokers if all or most of their friends were smokers compared to students who had some friends who smoked (OR = 3.9, 95% CI = 1.9-7.7). A high proportion of current smokers (47.8%) reported stress as the main reason for smoking. Twenty-six percent of dental students (N = 87) who are currently nonsmokers reported that they have used tobacco at some point in their lives. Over two thirds of sampled students (63%) believed that public tobacco usage is not well addressed in the current college curriculum.
CONCLUSION: Approximately one in every four male dental students at KSU is a smoker. Having friends who are smokers was the most important risk factor associated with smoking. There is a general belief among dental students that public tobacco use is not well addressed in the dental college curriculum.

PMID: 25057228 [PubMed]

Experimentation and use of cigarette and other tobacco products among adolescents in the Brazilian state capitals (PeNSE 2012).

Thu, 2014-07-24 06:44

Experimentation and use of cigarette and other tobacco products among adolescents in the Brazilian state capitals (PeNSE 2012).

Rev Bras Epidemiol. 2014;17(Suppl 1):62-76

Authors: Barreto SM, Giatti L, Oliveira-Campos M, Andreazzi MA, Malta DC

Abstract
INTRODUCTION: Nicotine dependence establishes itself more rapidly among adolescents than among adults. Tobacco occupies the fourth place in the rank of main risk factors for non-communicable diseases in the continent. Studies reveal that other forms of tobacco use have increased among adolescents.
METHODS: Were included the 9th grade students from the 26 State Capitals and the Federal District. who were participants of the National Adolescent School-based Health Survey (PeNSE), in 2012. Factors independently associated with experimentation and regular use of cigarettes were investigated by means of multinomial logistic regression, using as reference "never tried a cigarette". The use of other tobacco products included cigar, pipe, narghile and others.
RESULTS: Of the in the 61,037 participants in the 26 Brazilian capitals and the Federal District, 22.7% (95%CI 21.7 - 23.5) had experimented cigarettes, 6.1% (95%CI 5.6 - 6.6) are regular smokers and 7.1% (95%CI 6.5 - 7.7) had used other tobacco products, with half of them also being regular smokers. The chances of experimenting and being a regular smoker increased with age and according to the frequency of weekly exposure to other smokers. These chances were also higher among students who worked, who lived in monoparental families or without their parents, and those who felt that their parents would not mind if they smoked.
CONCLUSION: Results reinforce the association between social disadvantages and experimenting and regular smoking. In addition, the use of other tobacco products is worthy of attention and may lead to regular smoking.

PMID: 25054254 [PubMed - as supplied by publisher]

Awareness and Use of Non-conventional Tobacco Products Among U.S. Students, 2012.

Tue, 2014-07-22 06:49

Awareness and Use of Non-conventional Tobacco Products Among U.S. Students, 2012.

Am J Prev Med. 2014 Aug;47(2 Suppl 1):S36-52

Authors: Wang B, King BA, Corey CG, Arrazola RA, Johnson SE

Abstract
BACKGROUND: Increasing diversity of the tobacco product landscape, including electronic cigarettes (e-cigarettes), hookah, snus, and dissolvable tobacco products (dissolvables), raises concerns about the public health impact of these non-conventional tobacco products among youth.
PURPOSE: This study assessed awareness, ever use, and current use of non-conventional tobacco products among U.S. students in 2012, overall and by demographic and tobacco use characteristics.
METHODS: Data from the 2012 National Youth Tobacco Survey, a nationally representative survey of U.S. middle and high school students, were analyzed in 2013. Prevalence of awareness, ever use, and current use of e-cigarettes, hookah, snus, and dissolvables were calculated overall and by sex, school level, race/ethnicity, and conventional tobacco product use, including cigarettes, cigars, or smokeless tobacco (chewing tobacco, snuff, or dip).
RESULTS: Overall, 50.3% of students were aware of e-cigarettes; prevalence of ever and current use of e-cigarettes was 6.8% and 2.1%, respectively. Awareness of hookah was 41.2% among all students, and that of ever and current use were 8.9% and 3.6%, respectively. Overall awareness; ever; and current use of snus (32%, 5.3%, 1.7%, respectively) and dissolvables (19.3%, 2.0%, 0.7%, respectively) were generally lower than those of e-cigarettes or hookah. Conventional tobacco product users were more likely to be aware of and to use non-conventional tobacco products.
CONCLUSIONS: Many U.S. students are aware of and use non-conventional tobacco products. Evidence-based interventions should be implemented to prevent and reduce all tobacco use among youth.

PMID: 25044194 [PubMed - in process]

Youth tobacco cessation: quitting intentions and past-year quit attempts.

Tue, 2014-07-22 06:49

Youth tobacco cessation: quitting intentions and past-year quit attempts.

Am J Prev Med. 2014 Aug;47(2 Suppl 1):S15-27

Authors: Tworek C, Schauer GL, Wu CC, Malarcher AM, Jackson KJ, Hoffman AC

Abstract
BACKGROUND: Despite declining use of conventional tobacco products, youth use of non-cigarette tobacco has become prevalent; however, quitting behaviors remain largely unexplored.
PURPOSE: To examine nationally representative data on quit intentions and past-year attempts to quit all tobacco use among current youth tobacco users.
METHODS: In 2013, data were analyzed from the 2012 National Youth Tobacco Survey (NYTS). Weighted prevalence estimates of quit intentions and past-year quit attempts for current youth tobacco users are presented.
RESULTS: Prevalence of quit intentions and past-year attempts to quit all tobacco use were 52.8% and 51.5%, respectively, among current youth tobacco users. Among non-mutually exclusive groups, current cigarette smokers had the highest prevalence of quit intentions (56.8%) and past-year quit attempts (52.5%), whereas current hookah users had the lowest prevalence of quit intentions (41.5%) and past-year quit attempts (43.7%). Quit intentions among black, non-Hispanics (65.0%) and Hispanics (60.4%) were significantly higher versus white, non-Hispanics (47.5%). Youth reporting parental advice against tobacco had significantly higher prevalence of quit intentions (56.7%) and past-year quit attempts (55.0%) than those not reporting parental advice. Youth who agreed all tobacco products are dangerous (58.5%) had significantly higher prevalence of quit intentions than those who disagreed (37.0%).
CONCLUSIONS: Continued efforts are needed to better understand youth motivation for quitting all tobacco products. Public health messaging about the dangers of all tobacco and cessation efforts should be aimed at the full range of tobacco products, not just cigarettes, and tailored to meet the needs of youth polytobacco users.

PMID: 25044192 [PubMed - in process]

Investigation of Exclusive Narghile Smokers: Deficiency and Incapacity Measured by Spirometry and 6-Minute Walk Test.

Thu, 2014-07-10 06:37

Investigation of Exclusive Narghile Smokers: Deficiency and Incapacity Measured by Spirometry and 6-Minute Walk Test.

Respir Care. 2014 Jul 8;

Authors: Ben Saad H, Babba M, Boukamcha R, Ghannouchi I, Latiri I, Mezghenni S, Zedini C, Rouatbi S

Abstract
BACKGROUND: Studies on the submaximal aerobic capacity of exclusive narghile smokers (ENS) seem necessary in view of effective prevention of cardiorespiratory diseases. The goal of the study was to assess, by 6-min walk test (6MWT) data, the submaximal aerobic capacity of ENS, to identify factors influencing their 6-min walk distance (6MWD), and to compare their data with those of a healthy non-smoker (HNS) group.
METHODS: Seventy 20-60-y-old male ENS were included. Narghile use (narghile-years) and anthropometric, clinical, spirometric, and 6MWT data were collected. Univariate and multivariate analyses were used to identify factors influencing 6MWD. Data of a subgroup of 40-60-y-old ENS (n = 25) were compared with those of an age-matched HNS group (n = 53).
RESULTS: The median (first to third quartile) for age and narghile use were 32 (26-43) and 17 (8-32) narghile-years, respectively. The profile of ENS performing the 6MWT was as follows: at the end of the 6MWT, 34% and 9% had a low heart rate (< 60% of maximum predicted) and high dyspnea scores (> 5/10, visual analog scale), respectively; 3% had an oxyhemoglobin saturation decrease of > 5 points during the test; and 20% had an abnormal 6MWD (less than the lower limit of the normal range). The factors that significantly influenced the 6MWD, explaining 38% of its variability, are included in the following equation: 6MWD (m) = 742.63 - 5.20 × body mass index (kg/m(2)) + 25.23 × FEV1 (L) - 0.44 × narghile use (narghile-years). Compared with HNS, the subgroup of ENS had a significantly lower 6MWD (98 ± 7 vs 87 ± 9% predicted, respectively).
CONCLUSIONS: Narghile use may play a role in reducing submaximal aerobic capacity. The present study suggests that a program of pulmonary rehabilitation is an excellent axis to follow.

PMID: 25006270 [PubMed - as supplied by publisher]

Hookah Use Among US High School Seniors.

Wed, 2014-07-09 14:35

Hookah Use Among US High School Seniors.

Pediatrics. 2014 Jul 7;

Authors: Palamar JJ, Zhou S, Sherman S, Weitzman M

Abstract
OBJECTIVES: Prevalence of hookah use is increasing significantly among adolescents. This study aimed to delineate demographic and socioeconomic correlates of hookah use among high school seniors in the United States. We hypothesized that more impoverished adolescents and those who smoked cigarettes would be more likely to use hookahs.METHODS: Data were examined for 5540 high school seniors in Monitoring the Future (years 2010-2012), an annual nationally representative survey of high school students in the United States. Using data weights provided by Monitoring the Future, we used multivariable binary logistic regression to delineate correlates of hookah use in the last 12 months.RESULTS: Eighteen percent of students reported hookah use in the past year. Compared with white students, black students were at lower odds for use (adjusted odds ratio [AOR] = 0.27, P < .0001). High parent education increased the odds for use (AOR = 1.58, P < .001), and student weekly income from a job of >$50/week (AOR = 1.26, P < .05) or $11 to $50 per week from other sources (AOR = 1.35, P < .01) also increased odds for use. Males and urban students were also at higher odds for use, as were users of alcohol, marijuana, and other illicit substances. Former cigarette smokers were at higher risk, and current smokers were at highest risk for use.CONCLUSIONS: Adolescents of higher socioeconomic status appear to be at particularly high risk for hookah use in the United States. Prevention efforts must target this group as prevalence continues to increase.

PMID: 25002664 [PubMed - as supplied by publisher]

Hookah Smoking Among Young Adults in Southern California.

Tue, 2014-07-01 06:59

Hookah Smoking Among Young Adults in Southern California.

Nurs Res. 2014 July/August;63(4):300-306

Authors: Rezk-Hanna M, Macabasco-O?Connell A, Woo M

Abstract
BACKGROUND: Hookah (water pipe) smoking is a form of tobacco use, historically from the Middle East and India that is fueling a contemporary epidemic of tobacco abuse and a nationwide public health crisis, particularly among young adults. There is little information on factors influencing hookah smoking and health beliefs of hookah smokers.
OBJECTIVES: Guided by the health belief model, the purpose of this study was to assess young adult hookah smokers' perceptions, attitudes, beliefs, and preferences toward hookah smoking and identify factors that may influence heavy (>3 times per week) versus light hookah smoking.
METHODS: A cross-sectional design was used for this study. Participants were recruited at hookah lounges in southern California. A sample of participants who smoke hookah and were between 18 and 30 years of age completed a short survey about their perceptions, attitudes, beliefs, initiation, and frequency of hookah smoking. Characteristics of light and heavy hookah smokers were compared using t tests and chi-square tests. Content analysis was used to analyze qualitative data.
RESULTS: Participants (N = 91) had a mean age of 24 (SD = 2.7), and 65% were men; 24% reported smoking before the age of 18, and 73.6% of participants smoked more than once a week. Men were heavier smokers in comparison to women (p = .006), 57% believed that hookah was not harmful to their health, and 60% reported socialization as the main reason why they smoked hookah.
DISCUSSION: It is critical to advocate for greater research on the health effects of hookah smoking and dissemination of these findings to the public, particularly to young adults.

PMID: 24977727 [PubMed - as supplied by publisher]

Hookah use among college students: Prevalence, drug use, and mental health.

Tue, 2014-06-03 06:57

Hookah use among college students: Prevalence, drug use, and mental health.

Drug Alcohol Depend. 2014 May 14;

Authors: Goodwin RD, Grinberg A, Shapiro J, Keith D, McNeil MP, Taha F, Jiang B, Hart CL

Abstract
BACKGROUND: There is consistent evidence that hookah use is as, if not more, harmful than cigarette use. Yet, hookah users underestimate the potential deleterious effects of hookah use. This study examined the rates of hookah use and associated demographic characteristics in a sample of undergraduates at a small Northeastern university. This study also examined the relationships between hookah use and other substance use, mental health problems, and perceived levels of stress.
METHODS: Data were drawn from the Spring 2009 American Health Association-National College Health Assessment (ACHA-NCHA) at one small, Northeastern university (N=1799). The relationships between hookah use and other substance use, mental health problems, and perceived stress levels were examined using logistic regression analyses.
RESULTS: Hookah use (in the past month) was reported among 14.1% (253/1799) of this sample of undergraduates. Hookah users were more likely to use other substances, including cigarettes, cannabis, alcohol, cocaine, and amphetamines. The strongest associations emerged between hookah use and alcohol and cigarette use. There were no significant associations found between hookah use and any mental health problems or perceived stress levels.
CONCLUSIONS: Hookah users are significantly more likely to use other substances, including alcohol, cigarettes, cannabis, cocaine, and amphetamines compared with non-hookah users. In contrast to cigarette smoking, hookah use does not appear to be associated with mental health problems or perceived stress levels in this sample of undergraduates. Further investigation into the prevalence and correlates of hookah use is needed in representative population samples.

PMID: 24882367 [PubMed - as supplied by publisher]

Hookah Smoking in High School Students and Its Determinants in Iran: A Longitudinal Study.

Sat, 2014-05-24 06:38

Hookah Smoking in High School Students and Its Determinants in Iran: A Longitudinal Study.

Am J Mens Health. 2014 May 22;

Authors: Fakhari A, Mohammadpoorasl A, Nedjat S, Sharif Hosseini M, Fotouhi A

Abstract
Hookah smoking has increased worldwide, especially among youth, and has been identified as an emerging threat to public health. The aim of the present study was to estimate the prevalence and transition rates in hookah smoking statuses and predictors of transitions among a representative sample of Iranian high school students. In this longitudinal study, a representative sample (n = 5197) of students in the northwest of Iran was assessed thrice with a 6-month interval in 2010 and 2011. A self-administered questionnaire was used to measure hookah smoking, demographic characteristics, and personal and environmental factors. In total, the prevalence of hookah use (at least once a month) in this study was 6.0% (95% confidence interval [CI] = 5.1, 6.9). Results indicated that 44.9% (95% CI = 43.0, 46.7) of the students in the sample at least tried hookah smoking. During 1 year, 18.5% and 1.5% of students who have never used hookah before had transitioned to experimenter and regular hookah smoking, respectively, and notably, 7.8% of experimenters had transitioned to regular hookah smoking. Adjusted for other factors, being male, regular cigarette smoking, and positive attitude toward smoking were factors associated with students' transition to hookah smoking status. The incidence rate of hookah smoking in adolescents is notable. The findings identified the co-occurrence of risky behaviors that support programs aimed at reducing or preventing high-risk behaviors simultaneously.

PMID: 24855098 [PubMed - as supplied by publisher]

Nicotine and Carcinogen Exposure after Water Pipe Smoking in Hookah Bars.

Tue, 2014-05-20 07:14

Nicotine and Carcinogen Exposure after Water Pipe Smoking in Hookah Bars.

Cancer Epidemiol Biomarkers Prev. 2014 May 16;

Authors: Helen GS, Benowitz NL, Dains KM, Havel C, Peng M, Jacob P

Abstract
BACKGROUND: Water pipe tobacco smoking is spreading globally and is increasingly becoming popular in the United States, particularly among young people. Although many perceive water pipe smoking to be relatively safe, clinical experimental studies indicate significant exposures to tobacco smoke carcinogens following water pipe use. We investigated biomarkers of nicotine intake and carcinogen exposure from water pipe smoking in the naturalistic setting of hookah bars.
METHODS: Fifty-five experienced water pipe users were studied before and after smoking water pipe in their customary way in a hookah bar. Urine samples were analyzed for nicotine, cotinine, the tobacco-specific nitrosamine, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), and mercapturic acid metabolites of volatile organic compounds (VOC).
RESULTS: We found an average 73-fold increase in nicotine, 4-fold increase in cotinine, 2-fold increase in NNAL, and 14% to 91% increase in VOC mercapturic acid metabolites immediately following water pipe smoking. We saw moderate to high correlations between changes in tobacco-specific biomarkers (nicotine, cotinine, and NNAL) and several mercapturic acid metabolites of VOCs.
CONCLUSION: Water pipe smoking in a hookah bar is associated with significant nicotine intake and carcinogen exposure.
IMPACT: Given the significant intake of nicotine and carcinogens, chronic water pipe use could place users at increased risk of cancer and other chronic diseases. Cancer Epidemiol Biomarkers Prev; 23(6); 1-12. ©2014 AACR.

PMID: 24836469 [PubMed - as supplied by publisher]

Shisha versus cigarette smoking and endothelial function.

Wed, 2014-05-14 06:45

Shisha versus cigarette smoking and endothelial function.

Anadolu Kardiyol Derg. 2014 May 6;

Authors: Wiwanitkit S, Wiwanitkit V

PMID: 24818978 [PubMed - as supplied by publisher]