Hookah Bars Research Articles

Microcrystal Tests for Detection of Nicotine in Hookah Bar Samples

Microcrystal Tests for Detection of Nicotine in Hookah Bar Samples

Systematic Review on International Practices in Controlling Waterpipe Tobacco Smoking

Waterpipe tobacco smoking has becoming popular especially among young people worldwide. Smokers are attracted by its sweeter, smoother smoke, social ambience and the misconception of reduced harm. The objective of this study was to systematically review the effects of waterpipe tobacco policies and practices in reducing its prevalence. A systematic review was conducted electronically using the PubMed, OVID, Science Direct, Proquest and Embase databases. All possible studies from 1980 to 2013 were initially screened based on titles and abstracts. The selected articles were subjected to data extraction and quality rating. Three studies met the inclusion criteria and were eligible for this review. Almost all of the waterpipe tobacco products and its accessories did not comply with the regulations on health warning labelling practices as stipulated under Article 11 of WHO FCTC. In addition, the grisly new warning labels for cigarettes introduced by Food and Drug Administration did not affect hookah tobacco smoking generally. Indoor air quality in smoking lounges was found to be poor and some hookah lounges were operated without smoke shop certification. Our findings revealed the availability of minimal information on the practices in controlling waterpipe smoking in reducing its prevalence. The lack of comprehensive legislations or practices in controlling waterpipe smoking warrants further research and policy initiatives to curb this burgeoning global epidemic, especially among the vulnerable younger population.

Understanding Attitudes, Beliefs, and Information Seeking Regarding Hookah Smoking in Parents of College Students: An Exploratory Qualitative Pilot Study.

Hookah smoking has become increasingly common among young adults in the United States. College students engage in hookah smoking due to the increased exposure and popularity of hookah bars surrounding college campuses. There is limited information on parental perceptions of college students' hookah smoking. Forty-four telephone interviews were recorded and transcribed with parents of college students using a structured interview guide to explore perceptions, beliefs, behaviors, and information seeking regarding hookah smoking. The transcripts were coded and categorized using NVivo software, and emerging themes were uncovered. Parents were lacking in awareness and knowledge of hookah smoking and health consequences. They often equated hookah smoking with bong use from their own college experiences. Although negative effects were equated with cigarette smoking, some parents reported beneficial effects of hookah smoking. Some parents disapproved of their college students smoking hookah, whereas others felt it was important that they try new behaviors in moderation. The varying responses indicate that parents were not receiving consistent messages, if any, regarding hookah tobacco smoking. Informing parents of current novel risky behaviors such as hookah smoking is necessary as they are trusted sources of information for young adult children. Delivering information and educational messages to both students and their parents may be a worthy approach when developing campaigns to deter hookah smoking. There is a need to deter hookah smoking, as it remains a public health concern.

Air nicotine levels in public places in Ahmedabad, India: Before and after implementation of the smoking ban

Aim:To compare air nicotine levels in public places in Ahmedabad, India, before (June 2008) and after (January, 2010) the implementation of a comprehensive smoking ban which was introduced in October 2008.Materials and Methods:Air nicotine concentrations were measured by sampling of vapor-phase nicotine using passive monitors. In 2008 (baseline), monitors were placed for 5-7 working days in 5 hospitals, 10 restaurants, 5 schools, 5 government buildings, and 10 entertainment venues, of which 6 were hookah bars. In 2010 (follow-up), monitors were placed in 35 similar venues for the same duration.Results:Comparison of the overall median nicotine concentration at baseline (2008) (0.06 μg/m3 Interquartile range (IQR): 0.02-0.22) to that of follow-up (2010) (0.03 μg/m3 IQR: 0.00-0.13), reflects a significant decline (% decline = 39.7, P = 0.012) in exposure to second-hand smoke (SHS). The percent change in exposure varied by venue-type. The most significant decrease occurred in hospitals, from 0.04 μg/m3 at baseline to concentrations under the limit of detection at follow-up (%decline = 100, P < 0.001). In entertainment venues, government offices, and restaurants, decreases in SHS exposure also appeared evident. However, in hookah bars, air nicotine levels appeared to increase (P = 0.160).Conclusion:Overall, SHS exposure was significantly reduced in public places after the smoke-free legislation came into force. However, nicotine concentrations were still detected in most of the venues indicating imperfect compliance with the comprehensive ban.

An emerging trend: Hookah smoking among youth smokers in Gurgaon, Haryana

Introduction: Hookah is becoming the favorite form of tobacco use by youth globally. This problem has received more attention in recent years. Aim: The aim was to investigate the characteristics, behavior, and perceptions related to hookah smoking among the youth smokers in Gurgaon, Haryana. Materials and Methods: Two hundred and fifteen established hookah smokers participated in this study. Data were collected using a 28-item questionnaire, constructed using three main domains: Characteristics (sociodemographic and personal), behavior and perceptions (about harmful effects in comparison to cigarette smoking). Descriptive and Chi-square test were performed, and P < 0.05 was considered as statistically significant value. Results: The mean age of starting hookah smoking in the present study was 17.3 years. Hookah smoking on a daily basis was reported by 37.7% participants. Another 44.7% participants smoke hookah in hookah cafes with friends and the total number of participants who informed that hookah is easily available and accessible are 83.3%. The participants who were addicted to hookah smoking; light-headedness, dizziness and headache, post hookah smoking are 63.3%. About 60.9% participants had attempted to quit but restarted. Most of the participants 60-70% had misperception about the safety of hookah smoking over cigarette smoking, and 36-82% participants were unaware of health effects. Conclusions: Compared to cigarettes, there appears to be a lack of knowledge about the harmfulness of smoking hookah among users regardless of their demographic background. Education about the harmfulness of smoking hookah and policies to limit its use should be implemented to prevent the spread of this new form of tobacco use.

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

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

Benzene uptake in Hookah smokers and non-smokers attending Hookah social events: regulatory implications.

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

P287 Measuring The Acute Cardiovascular Effects Of Shisha Smoking: A Cross-sectional Study

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 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.

Air quality in New York City hookah bars

BackgroundHookahs 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...

Hookah smoking among young adults in southern California.

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. 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. 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. 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. 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.

Nicotine and carcinogen exposure after water pipe smoking in hookah bars.

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. 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). 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. Water pipe smoking in a hookah bar is associated with significant nicotine intake and carcinogen exposure. 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); 1055-66. ©2014 AACR.

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

ObjectivesTo investigate the acute cardiovascular effects of smoking shisha.DesignA 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.SettingLondon, UK.ParticipantsParticipants 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 measuresBlood 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.ResultsMean 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.ConclusionThe 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.

Palestine: Children Laboring

Palestine: Children Laboring

Carbon Monoxide Toxicity after Lighting Coals at a Hookah Bar

Unintentional non-fire-related (UNFR) carbon monoxide (CO) poisonings continue to account for a significant health and economic burden in the United States. While most of these poisonings are related to faulty central heating or water heaters in private dwellings, less common sources should also be considered when a patient presents with any signs or symptoms suggestive of CO toxicity. The authors present a case where a patient was found to have severe CO poisoning, a COHgb level of 33.8%, after lighting coals for a water pipe called a hookah. The patient was initially unconscious and was found to have electrocardiogram (ECG) changes consistent with cardiac ischemia that resolved following treatment with hyperbaric oxygen therapy. In recent years, hookah bars have gained in popularity, especially in urban areas and around college campuses. This was the first case to identify the potential occupational exposure of employees working at hookah bars to CO. Furthermore, the patient's COHb level of 33.8% was higher than any previously reported in the literature with exposure via hookah pipe. The practitioner should consider CO poisoning in patients who smoke tobacco via a hookah and consider early hyperbaric oxygen therapy in those experiencing significant symptoms.

Social Context of Smoking Hookah Among College Students: Scale Development and Validation

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.

Hookah use among high school children in an Indian city

Use of hookah is on the rise among youngsters. A growing body of evidence suggests that these children are experimenting with this form of tobacco. The study was carried out to know prevalence estimates of hookah use and factors associated with it among high school students. This study adds to the current literature by providing prevalence estimates and factors associated with hookah use among high school students of Indore - a city in central India. A cross-sectional survey of 1000 students from high schools was conducted to find hookah users and factors associated with its use. Hookah users in this study population were 7.6%. Most of them first learned about hookah from friends (63.2%). They usually smoked in hookah lounges (85.5%). These children believed that hookah was safer and more socially acceptable than cigarettes. Misperceptions of safety and popularity of hookah among the younger generation are cause for concern. Presence of hookah lounges should be a target for further regulation. Prevention activities are necessary to prevent this rising public health concern.

A descriptive study of the perceptions and behaviors of waterpipe use by university students in the Western Cape, South Africa.

BackgroundWaterpipe smoking started as a cultural phenomenon but has become a social phenomenon. Hookah cafes are an increasingly popular venue for socializing. Studies suggest that waterpipe users perceive smoking the waterpipe as less addictive and harmful than cigarette smoking. The aim of this study was to assess the beliefs, and associated behaviours, regarding the health-risk of smoking the waterpipe.MethodsA cross-sectional descriptive study was conducted with a sample of first year students at a historically black university in the Western Cape, South Africa. A self-administered questionnaire was constructed from the College Health Behaviour Survey. The final sample was 389 university students, 64% (250) females and 36% (139) males. The sample had a mean age of 22.2 years (SD = 5.04).ResultsWaterpipe users perceived the health risks of smoking the waterpipe to be exaggerated (48%) and less addictive (58%) than non-users (13% and 17%, p<.001). Additionally, the findings confirm that waterpipe smoking is conducted in a social setting (61%). This social setting included smoking on campus (28%), in the family home (11%), at a party (9%), at a friend’s place (6%) and in a restaurant (1%). Of concern was the majority of users smoked the waterpipe on a daily basis (70%) and that the tobacco mix was easily available (90%). The most common self-reported reason for smoking the waterpipe was for relaxation.ConclusionAs with previous studies, the results of this study confirm the false perception that smoking the waterpipe is not a health risk and is socially acceptable. Additionally, the findings of the study raise concerns and an awareness of smoking the waterpipe in the family home and implications for children. The results of this study provide important information for tobacco control and substance abuse policies in South Africa. These findings highlight the need for further research to determine the extent of waterpipe smoking at other universities in South Africa.

Measuring Indoor Air Quality of Hookah Lounges

Many states have implemented smoke-free workplace laws to protect employees and customers from exposure to secondhand smoke. However, exemptions in these laws have allowed indoor tobacco smoking in hookah lounges to proliferate in recent years. To describe the amount of secondhand smoke in hookah lounges, we measured the indoor air quality of 10 hookah lounges in Oregon. Air quality measurements ranged from "unhealthy" to "hazardous" according to Environmental Protection Agency standards, indicating a potential health risk for patrons and employees.

Keeping the night going: The role of hookah bars in evening drinking behaviours

Keeping the night going: The role of hookah bars in evening drinking behaviours

Waterpipe smoking: a new tobacco pandemic entailing severe health risks?

Springer-Verlag 2012 The waterpipe (also named shisha, narghile, argileh, etc.) is a traditional aid for tobacco consumption in Asia and Northern Africa. In these countries, waterpipes differ considerably in shape and size. Although exact numbers are still missing to date, web blogs, ‘‘hookah bar’’ advertisements, and the advent of popular waterpipe stores in larger and smaller cities alike indicate that both the general interest and the number of young people smoking waterpipes have consid