Hookah Science News

Social norms of cigarette and hookah smokers in Iranian universities.

ARYA Atheroscler. 2013 Jan;9(1):45-50

Authors: Roohafza H, Sadeghi M, Shahnam M, Shokouh P, Teimori S, Amirpour A, Sarrafzadegan N

Abstract
BACKGROUND: First experiences of tobacco use usually occur in adolescence. The recognition of social norms leading to youth smoking is hence necessary. We tried to assess the social norms among Iranian young cigarette and hookah smokers.
METHODS: This cross-sectional study was conducted on 451 girls and 361 boys aging 20-25 years old who entered Isfahan and Kashan Universities (Iran) in 2007. Demographic factors (age, gender, and age at smoking onset) cigarette and hookah smoking status, having a smoking father or smoking friends and four related social norms were recorded. Binary logistic regression analysis was used to separately determine associations between hookah and cigarette smoking and the four social norm variables.
RESULTS: CIGARETTE AND HOOKAH SMOKERS HAD SIGNIFICANT DIFFERENCES WITH NONSMOKERS IN TWO SOCIAL NORMS: "Perceived smoking by important characters" [odds ratio (OR) = 1.35 in cigarette smokers and 1.58 in hookah smokers; P < 0.001] and "smoking makes gatherings friendly" (OR = 3.62 in cigarette smokers and 6.16 in hookah smokers; P < 0.001). Furthermore, cigarette and hookah smoking were significantly associated with having smoking friends.
CONCLUSION: Highlighting the social norms leading to cigarette and hookah smoking may help policy makers develop comprehensive interventions to prevent smoking among adolescents.

PMID: 23696759 [PubMed - in process]

Are The Predictors of Hookah Smoking Differ From Those of Cigarette Smoking? Report of a population-based study in Shiraz, Iran, 2010.

Int J Prev Med. 2013 Apr;4(4):459-66

Authors: Abdollahifard G, Vakili V, Danaei M, Askarian M, Romito L, Palenik CJ

Abstract
BACKGROUND: The aim of this study was to determine the prevalence of tobacco use and effect of lifestyle factors on cigarette and hookah use among adult residents of Shiraz, Iran.
METHODS: In 2010, 1,000 participants were recruited in a multistage, random sampling cross-sectional population-based survey.
RESULTS: Response rate was 98%. Prevalence of cigarette smoking was 9.7%. Among cigarette users, 12.6% reported smoking <1 year; 13.4% smoked 1-2 years and 73.9% smoked>2 years. Almost half of those surveyed (48.9%) smoked <10 cigarettes per day (cpd); 28.4% smoked 10-15 cpd; 14.8% smoked 16-19 cpd, and 8%>20 cpd. Almost a quarter (20.4%) of the cigarette smokers tried to quit in the past year. Being male, married, aged 37-54, having higher perceived levels of stress, a non-manual occupation, and sedentary lifestyle were positively associated with cigarette smoking. Manual labor occupations, housewife/jobless status, and going frequently to restaurants were positive predictors of hookah smoking.
CONCLUSIONS: Compared to cigarettes, hookah smoking was more prevalent among Iranian adults. Approximately, the prevalence of hookah smoking in women is the same as men, whereas cigarette use was 31 times more common in men. Cigarette and hookah smoking were associated with less healthy lifestyle habits in both men and women.

PMID: 23671779 [PubMed - in process]

Social context of smoking hookah among college students: scale development and validation.

J Am Coll Health. 2013;61(4):204-11

Authors: Sharma E, Beck KH, Clark PI

Abstract
Abstract Objective: To develop an instrument that measures the social context of hookah use among college students. Participants: A pool of 50 potential items, based on 44 in-depth interviews with regular college hookah smokers, was administered to a sample of 274 hookah users between October and December 2011. Methods: Participants were approached in hookah bars and asked to complete the survey. Results: A principle components analysis revealed 3 reliable factors: social facilitation, family/cultural influence, and alternative to smoking cigarettes and drinking. These were examined across different categories of hookah use: Weekly hookah users were more likely to smoke in a context of social facilitation than the other 2 groups. Similar effects were observed for family/cultural influence. Asians were more likely to smoke in a context of family and cultural influence than non-Asians. Conclusions: This scale has potential for identifying situation-specific contexts of hookah use that may help in designing effective interventions for college students.

PMID: 23663124 [PubMed - in process]

Bidi and hookah use among canadian youth: findings from the 2010 canadian youth smoking survey.

Prev Chronic Dis. 2013;10:E73

Authors: Czoli CD, Leatherdale ST, Rynard V

Abstract
INTRODUCTION: Although cigarette use among Canadian youth has decreased significantly in recent years, alternative forms of tobacco use are becoming increasingly popular. Surveillance of youth tobacco use can help inform prevention programs by monitoring trends in risk behaviors. We examined the prevalence of bidi and hookah use and factors associated with their use among Canadian youth by using data from the 2010-2011 Youth Smoking Survey (YSS).
METHODS: We analyzed YSS data from 28,416 students (2006-2007) and 31,396 students (2010-2011) in grades 9 through 12 to examine prevalence of bidi and hookah use. We conducted multivariate logistic regression analyses of 2010-2011 YSS data to examine factors associated with bidi and hookah use.
RESULTS: From 2006 through 2010, prevalence of hookah use among Canadian youth increased by 6% (P = .02). Marijuana use emerged as a consistent predictor of bidi and hookah use. Males, youth of black, Latin, or other descent, and youth of Asian descent were more likely to use bidis (odds ratio [OR], 1.5; OR, 15.6; OR, 14.9) or hookah (OR, 1.3; OR, 2.4; OR, 1.5). Current cigarette smokers were more likely than nonsmokers to be current users of bidis (OR, 6.7) and hookahs (OR, 3.0), and occasional and frequent alcohol drinkers were also more likely than nondrinkers to be current hookah users (OR, 2.8; OR, 3.6).
CONCLUSION: Although bidi use has not changed significantly among Canadian youth, the increase in hookah use warrants attention. Understanding the factors associated with use of bidis and hookahs can inform the development of tobacco use prevention programs to address emerging at-risk youth populations.

PMID: 23660115 [PubMed - in process]

Blood nickel and chromium levels in association with smoking and occupational exposure among head and neck cancer patients in Tunisia.

Environ Sci Pollut Res Int. 2013 Apr 28;

Authors: Khlifi R, Olmedo P, Gil F, Feki-Tounsi M, Chakroun A, Rebai A, Hamza-Chaffai A

Abstract
Chronic exposure to chromium (Cr) and nickel (Ni) has long been recognized as being capable to increase head and neck cancer (HNC) incidence among exposed human populations. This study represents the first biomonitoring of Cr and Ni exposure in Tunisia and focuses on a possible association with HNC risk. The aim of the present study was to evaluate the concentrations of Cr and Ni in the blood of HNC patients and controls. Metals blood levels of 169 HNC patients and 351 controls were determined using a Perkin-Elmer Analyst 800 Atomic Absorption Spectrometer. Mean blood levels of Cr and Ni in HNC cases (52.15 and 111.60 ?g/L, respectively) were significantly higher than those of controls (37.04 and 30.50 ?g/L, respectively). Cases' blood levels of Cr and Ni were significantly higher than those of controls after controlling for the other risk factors of HNC, including smoking, shisha consumption, occupational exposure, and nearby environment (P?<?0.05). Among these risk factors, smoking and occupational exposure presented the most significant association with HNC (odds ratio (OR)?=?6.54 and 7.66, respectively, P?<?0.001). Cr and Ni levels in blood sample of cases and controls that are smoker/occupationally exposed were higher than that of non-smoker/non-occupationally exposed (P?<?0.05). Smokers who are occupationally exposed present the most significant association with HNC (OR?=?25.08, P?<?0.0001). High levels of blood Cr (OR?=?2.09) and high levels of blood Ni (OR?=?8.87) were strongly associated with HNC after other potential confounders were controlled (P?=?0.004 and P?<?0.0001, respectively). This study suggested a potential role of Cr and Ni in the mechanism of HNC development.

PMID: 23625117 [PubMed - as supplied by publisher]

Syncope associated with water pipe smoking.

BMJ Case Rep. 2013;2013

Authors: Karaca Y, Eryigit U, Aksut N, Turkmen S

Abstract
The water pipe (narghile) in particular is widely used in the Arabian Peninsula and the Turkish world, and has also recently become an increasingly popular way of consuming tobacco in Europe. Contrary to popular belief, it contains more tar, carbon monoxide (CO) and toxic gases than cigarettes. This report describes a patient presenting to the emergency department with syncope as a result of water pipe use, with tests revealing toxically high CO levels.

PMID: 23606397 [PubMed - in process]

Hookah smoking, nass chewing, and oesophageal squamous cell carcinoma in Kashmir, India.

Br J Cancer. 2013 Apr 16;108(7):1552

Authors: Dar NA, Bhat GA, Shah IA, Iqbal B, Makhdoomi MA, Nisar I, Rafiq R, Iqbal ST, Bhat AB, Nabi S, Shah SA, Shafi R, Masood A, Lone MM, Zargar SA, Najar MS, Islami F, Boffetta P

PMID: 23591269 [PubMed - as supplied by publisher]

Syncope Associated with Carbon Monoxide Poisoning due to Narghile Smoking.

Case Rep Emerg Med. 2013;2013:796857

Authors: Ozkan S, Ozturk T, Ozmen Y, Durukan P

Abstract
Narghile smoking is a traditional method of tobacco use, and it has been practiced extensively for 400 years. Traditionally, narghile smoking is a matter of culture mainly in Middle East, Asia, and Africa. In recent years, its use as a social activity has increased worldwide, especially among young people. Narghile smoking is an unusual cause of carbon monoxide poisoning. Narghile smoking, compared to cigarette smoking, can result in more smoke exposure and greater levels of carbon monoxide. We present an acute syncope case of a 19-year-old male patient who had carbon monoxide poisoning after narghile smoking.

PMID: 23585971 [PubMed - in process]

Risk Factors for Hookah Smoking Among Arabs and Chaldeans.

J Immigr Minor Health. 2013 Apr 12;

Authors: Jamil H, Geeso SG, Arnetz BB, Arnetz JE

Abstract
Hookah smoking is more prevalent among individuals of Middle Eastern descent. This study examined general and ethnic-specific risk factors for hookah smoking among Arabs and Chaldeans. A self-administered anonymous questionnaire was conducted among 801 adults residing in Southeast Michigan. Binary logistic regression modeling was used to predict risk factors for hookah smoking. Hookah smoking was significantly more prevalent among Arabs (32 %) than Chaldeans (26 %, p < 0.01) and being Arab was a risk factor for lifetime hookah use. Younger age (<25 years), being male, higher annual income, and having health insurance were significant risk factors for hookah use. Chaldeans believed to a greater extent than Arabs that smoking hookah is less harmful than cigarette smoking (75 vs. 52 %, p < 0.001). Hookah smoking is prevalent in both ethnic groups, but significantly higher among Arabs. Results indicate that prevention efforts should target younger males with higher incomes.

PMID: 23579963 [PubMed - as supplied by publisher]

Asking the shisha question.

Br J Gen Pract. 2013 Mar;63(608):127

Authors: Rawaf D, Elgindi A, Ismail S

PMID: 23561766 [PubMed - in process]

Evidence of emerging hookah use among university students: a cross-sectional comparison between hookah and cigarette use.

BMC Public Health. 2013 Apr 5;13(1):302

Authors: Barnett TE, Smith T, He Y, Soule EK, Curbow BA, Tomar SL, McCarty C

Abstract
BACKGROUND: The emergence of hookah is being noted on college campuses and in large U.S. cities and evidence points to an increasing trend for college students. The purpose of this study was to assess hookah use and identify associations with cigarette smoking and demographic factors. METHODS: An intercept sampling method was used at various locations on a large university campus in the southeastern United States, yielding a high participation rate (52%). A total of 1,203 participants completed a computer-aided survey that assessed the use of tobacco products. The sample characteristics were then weighted to match the University population of students enrolled during the same semester. Bivariate (chi-square and t-test) and multivariate (logistic regression) tests of association were conducted to assess differences between cigarette and hookah users. RESULTS: Hookah smoking exceeded cigarette smoking for both ever use (46.4% vs 42.1%) and past year use (28.4% vs 19.6%). Females and males used hookah at similar rates. Hispanic respondents had the highest prevalence of current use of hookah (18.9%) and cigarettes (16.4%). CONCLUSIONS: As hookah surpasses cigarette use, efforts need to be made to slow the increase in new tobacco products that are attractive to young adults and that pose many of the same health risks as those related to traditional tobacco products. Prevalence of all emerging tobacco products, including hookah, and the relationship with cigarette use needs to be monitored on an ongoing basis.

PMID: 23560649 [PubMed - as supplied by publisher]

Risk-Taking Behaviors and Subgrouping of College Students: A Latent Class Analysis.

Am J Mens Health. 2013 Mar 28;

Authors: Mohammadpoorasl A, Abbasi Ghahramanloo A, Allahverdipour H

Abstract
Risk-taking behaviors have negative consequences on adolescent and young adult's health. The aim of this study was to identify the subgroups of college students on the basis of risk-taking behaviors and to assess the role of demographic characteristics, religious beliefs, and parental support on membership of specific subgroup. The cross-sectional study took place in Tabriz (northwest of Iran) in April and May of 2011. The randomly selected sample consisted of 1,837 college students. A survey questionnaire was used to collect data. Latent class analysis was performed to achieve the study's objectives. Four latent classes were identified: (a) low risk, (b) cigarette and hookah smoker, (c) sexual and drinking risk-takers (for males)/sexual risk takers (for females), and (d) high risk. Notably, 13.3% of the males and 4.3% of the females were in the high-risk class. The results identified evidence of protective influence of familial support and religiosity on risky behaviors. A fair number of college students, males in particular, were identified as high risk-takers. Design and implementation of preventive interventions for this segment of the population are necessary. Higher level of familial support and religiosity may serve as preventive factors in risk-taking behaviors.

PMID: 23539632 [PubMed - as supplied by publisher]

A prospective study of tobacco smoking and mortality in bangladesh.

PLoS One. 2013;8(3):e58516

Authors: Wu F, Chen Y, Parvez F, Segers S, Argos M, Islam T, Ahmed A, Rakibuz-Zaman M, Hasan R, Sarwar G, Ahsan H

Abstract
BACKGROUND: Limited data are available on smoking-related mortality in low-income countries, where both chronic disease burden and prevalence of smoking are increasing.
METHODS: Using data on 20, 033 individuals in the Health Effects of Arsenic Longitudinal Study (HEALS) in Bangladesh, we prospectively evaluated the association between tobacco smoking and all-cause, cancer, and cardiovascular disease mortality during ?7.6 years of follow-up. Cox proportional hazards models were used to estimate hazard ratios (HRs) and their 95% confidence intervals (CIs) for deaths from all-cause, cancer, CVD, ischemic heart disease (IHD), and stroke, in relation to status, duration, and intensity of cigarette/bidi and hookah smoking.
RESULTS: Among men, cigarette/bidi smoking was positively associated with all-cause (HR 1.40, 95% CI 1.06 1.86) and cancer mortality (HR 2.91, 1.24 6.80), and there was a dose-response relationship between increasing intensity of cigarette/bidi consumption and increasing mortality. An elevated risk of death from ischemic heart disease (HR 1.87, 1.08 3.24) was associated with current cigarette/bidi smoking. Among women, the corresponding HRs were 1.65 (95% CI 1.16 2.36) for all-cause mortality and 2.69 (95% CI 1.20 6.01) for ischemic heart disease mortality. Similar associations were observed for hookah smoking. There was a trend towards reduced risk for the mortality outcomes with older age at onset of cigarette/bidi smoking and increasing years since quitting cigarette/bibi smoking among men. We estimated that cigarette/bidi smoking accounted for about 25.0% of deaths in men and 7.6% in women.
CONCLUSIONS: Tobacco smoking was responsible for substantial proportion of premature deaths in the Bangladeshi population, especially among men. Stringent measures of tobacco control and cessation are needed to reduce tobacco-related deaths in Bangladesh.

PMID: 23505526 [PubMed - in process]

False positive result in study on hookah smoking and cancer in Kashmir: measuring risk of poor hygiene is not the same as measuring risk of inhaling water filtered tobacco smoke all over the world.

Br J Cancer. 2013 Mar 7;

Authors: Chaouachi K

PMID: 23470468 [PubMed - as supplied by publisher]

Reply: False positive result in study on hookah smoking and cancer in Kashmir: measuring risk of poor hygiene is not the same as measuring risk of inhaling water-filtered tobacco smoke all over the world.

Br J Cancer. 2013 Mar 7;

Authors: Dar NA, Islami F, Boffetta P

PMID: 23470467 [PubMed - as supplied by publisher]

Why do GDPs fail to recognise oral cancer? The argument for an oral cancer checklist.

Br Dent J. 2013 Mar 8;214(5):223-5

Authors: Dave B

Abstract
Delays in the diagnosis of oral cancer have been the subject of several cases recently reported in the media. Different types of delays include patient delays, doctor delays and system delays. Although diagnostic delays in primary care constitute a minority of these cases they are potentially modifiable and therefore an important aspect of care to address. GDPs need to be aware of several different factors when assessing the risk for oral cancer including the changing epidemiology of oral cancer and new trends in tobacco consumption, for example the increasing use of waterpipes (shishah/hookah). However several problems in fully assessing patients for oral cancer have been reported. These include time constraints, a lack of remuneration and little training in assessing risk factors and conducting a soft tissue examination. This article reviews these issues and puts forward the case for oral cancer detection as a compulsory CPD topic and a national oral cancer checklist as a tool to ensure all aspects of the oral cancer assessment are considered, which can then be audited and remunerated.

PMID: 23470377 [PubMed - in process]

Comparison of Nicotine and Carcinogen Exposure with Water pipe and Cigarette Smoking.

Cancer Epidemiol Biomarkers Prev. 2013 Mar 5;

Authors: Jacob P, Abu Raddaha AH, Dempsey D, Havel C, Peng M, Yu L, Benowitz NL

Abstract
Background Smoking tobacco preparations in a water pipe (hookah) is widespread in many places of the world and is perceived by many as relatively safe. We investigated biomarkers of toxicant exposure with water pipe compared to cigarette smoking. Methods We conducted a cross-over study to assess daily nicotine and carcinogen exposure with water pipe and cigarette smoking in 13 people who were experienced in using both products. Results While smoking an average of 3 water pipe sessions compared to smoking 11 cigarettes per day, water pipe use was associated with a significantly lower intake of nicotine, greater exposure to carbon monoxide and a different pattern of carcinogen exposure compared to cigarette smoking, with greater exposure to benzene and high molecular weight PAHs, but less exposure to tobacco-specific nitrosamines, 1,3-butadiene and acrolein, acrylonitrile, propylene oxide, ethylene oxide, and low molecular weight PAHs. Conclusions A different pattern of carcinogen exposure might result in a different cancer risk profile between cigarette and water pipe smoking. Of particular concern is the risk of leukemia related to high levels of benzene exposure with water pipe use. Impact Smoking tobacco in water pipes has gained popularity in the United States and around the world. Many believe that water pipe smoking is not addictive and less harmful than cigarette smoking. We provide data on toxicant exposure that will help guide regulation and public education regarding water pipe health risk.

PMID: 23462922 [PubMed - as supplied by publisher]