Hookah Smoking Research Articles

Secondary polycythaemia with elevated carbon monoxide levels due to hookah pipe smoking: A public health concern.

Hookah pipe (HP) smoking is perceived as a harmless activity, enjoyed by young adults and high school-going children. Awareness of the health impact of recreational habits, and their intersection with new social norms in the COVID-era, requires critical review. We describe a case series of young HP smokers presenting with secondary polycythaemia with significant clinical sequelae necessitating extensive work-up. HP smoking may lead to acute and chronic carbon monoxide intoxication, with resultant secondary polycythaemia and complications including provoked thrombosis.

The Effect of Waterpipe Tobacco Smoking on Bone Healing Following Femoral Fractures in Male Rats.

Background: Given the increasing use of waterpipe tobacco smoking in the world and its unknown effects on bone healing, this study investigated the repairing of femoral bone fractures in rats exposed to waterpipe tobacco smoking (WTS).Main Methods: This study involved 40 male Wistar rats that were divided into two groups, including the femoral fracture (Fx) and the Fx + WTS groups. Each group was divided into two subgroups that were evaluated for bone healing 28 and 42 days after femoral fracture. After fixing the fractured femur, the healing process was evaluated by radiography, pathological indicators, and a measurement of the blood levels of vascular endothelial growth factor (VEGF), parathyroid hormone (PTH), Ca ++, transforming growth factor-beta (TGF-β), and insulin-like growth factor 1 (IGF-1). Additionally, the density of VEGF and CD34 in fracture tissue was investigated by immunohistochemistry.Key Findings: Radiographic findings showed that factors related to the earlier stages of bone healing had higher scores in the Fx + WTS28 and 42 subgroups in comparison to the Fx groups. The density of VEGF and CD34 showed that the angiogenesis processes were different in the bone fracture area and callus tissue in the Fx +WTS subgroups. The serum levels of VEGF, TGF-β, and IGF-1 were significantly lower in the Fx +WTS42 group, and PTH in the Fx +WTS28 group was higher than that in the other groups.Significance: The findings showed the disturbance and delay in the femoral fracture union in rats exposed to hookah smoke. This is partly due to the reduction of molecular stimuli of bone synthesis and the attenuation of quantitative angiogenesis.

Hookah smoking and COVID-19 in India

In recent years, hookah smoking has gained popularity in India, especially among youth. However, its abuse increases the risk of COVID-19. The present letter discusses the harmful effects of hookah smoking, international policies for the cessation of hookah smoking, and the pressing need to have policies to mitigate hookah use and curb the spread of COVID-19 in India.

The Effect of a Web-based Educational Program on Perevention of Hookah Smoking among Adolescent Girls: Application of Theory of Planned Behavior.

BackgroundThe prevalence of hookah is increasing worldwide and in all age groups, especially among women. Therefore, this study was conducted to determine the effect of web-based educational program in the prevention of hookah smoking among girls in Kermanshah, Iran, using theory of planned behavior (TPB).MethodsThis study was a randomized controlled trial performed on 110 adolescent girls in Kermanshah City in 2020. Multistage random sampling was used in this study. The data collection tool included a researcher-made questionnaire. Designed intervention was implemented for the intervention group in 5 educational sessions according to analysis of pre-test results. Data were collected 3 months after the end of the training intervention. Data analysis was carried out using SPSS software.FindingsThe presented interventions significantly improved the structures of attitude (P < 0.001), subjective norms (P < 0.001), and intention (P < 0.001) in the intervention group compared with the control group. However, the difference between perceived behavioral control score in the two groups was not significant (P = 0.131). There was also a significant difference in reducing the behavior of hookah smoking between the intervention and control groups after the educational intervention.ConclusionUsing web-based interventions is a good educational strategy for prevention of hookah smoking in adolescent girls.

Üniversite öğrencilerinde alkollü araç kullanma davranışı ve ilişkili riskli davranışlar

Introduction and purpose: It has been reported that driving and non-compliance with the rules are common in young adulthood. Consequently, millions of people experience serious injuries secondary to traffic accidents and live with long-term negative health consequences. The aim of this study is to find an answer to the question of what are the alcoholic driving behavior and related socio-behavioral factors in university students. Method: In the study, 2508 students selected by the stratified cluster sampling method among the students studying at the faculties and colleges in the central district of Çanakkale Onsekiz Mart University were collected with a 41-question questionnaire prepared by the researchers. The data related to traffic safety, substance use and some violent behaviors were selected for this article. Results: Smoking in drunk drivers rate (32.7%), hookah smoking rate (61.7%), alcohol use rate (25.2%), substance use rate (2.8%), physical fight in the last year to those who do not have a mixing ratio (26.2%), a weapon carrying ratio (15.3%) was significantly higher than those who did not. Discussion and conclusion: These findings suggest that showing risky behavior also triggers risky behaviors. Family Physicians also have a preventive health service role in matters such as traffic and security and should be developed.

Social media: An opportunity to reduce hookah smoke during an outbreak of COVID-19

The tobacco epidemic is one of the biggest public health warnings in the world, and 8 million people die every year due to smoking, of which 7 million die due to direct smoking and 2.1 million due to exposure to secondhand smoke [1].

The prevalence of denture stomatitis in cigarette and hookah smokers and opium addicts: findings from Rafsanjan Cohort Study

BackgroundThe aim of this study was to investigate the association of denture stomatitis prevalence with cigarette, hookah and opium consumption and also dose–response relationship between the cigarette smoking duration and odds of denture stomatitis in population of Rafsanjan cohort center.MethodsThis cross-sectional study based on data of Rafsanjan Cohort Study (RCS) with 10,000 participants. After applying inclusion and exclusion criteria, 1619 participants were included in the analysis. Data were collected by oral examination and completion of pre-designed questionnaires to assess denture hygiene, smoking behavior, opium use and some other exposure variables. Multivariable logistic regression models were fitted to investigate possible association of cigarette, hookah and opium consumption and denture stomatitis.ResultsPrevalence of denture stomatitis among all 1619 denture wearers was 21.6%. Cigarette smoking was associated with a higher odds of denture stomatitis, with the adjusted odds ratio (95% CI) of 2.29 (1.53–3.41). Also, dose–response increases were observed with the highest odds ratio in the 4th quartile for denture stomatitis (p-value < 0.001). Opium consumption was associated with a decreased odds of denture stomatitis (adjusted OR; 0.81, 95% CI 0.58–1.13) which was not statistically significant. Also interaction between opium consumption and cigarette smoking was not associated with higher odds of denture stomatitis (adjusted OR: 1.65, 95% CI 0.85–3.22).ConclusionsBased on the findings of the present study, while cigarette smoking had a dose–response relationship with the increased odds of denture stomatitis; this association was not found with opium consumption.

Failure to Quit Smoking Extent and Determinants among Attendees of Tobacco Cessation Clinic

Smoking is a global health risk factor despite the efforts to control and the existance of tobacco cessation program. The objective of this study was to measure the proportion of people who failed to quit smoking at the end of six months after attending the smoking cessation clinic and to identify the factors associated with failure to quit. We used an analytical cross-sectional design which was conducted at Taif city, Saudi Arabia between January 2019 and March 2020. The attendees of smoking cessation clinic were invited to participate in the study. We used a questionnaire as the data collection too. The statistical package for the social sciences (IBM Corp. Released 2020. IBM SPSS Statistics for Windows, Version 27.0. Armonk, NY: IBM Corp ) was used to analyze the data. The total responses was 393, out of them 201 (51.1%) failed to quit smoking after six months. Age, marital status, income, and occupation were significantly associated with the outcome variable (quit or not). Even before attending the clinic (62.3%) have indicated previous failed attempts. Among the different types of smoking, hookah showed a significant association with failure, while nicotine dependence did not showed any significance. Failure to quit was associated with advanced age, smoking hookah, while those who indicated the price of tobacco products as a reason to quit were more prone to fail in quitting smoking. In conclusion, smoking cessation can be influenced by a sociodemographic factors, willingness and family support. Smoking hookah is associated with higher rates of failure to quit smoking.

Assessing BTEX concentrations emitted by hookah smoke in indoor air of residential buildings: health risk assessment for children

Hookah smoke is one of the major indoor sources of Volatile Organic Compounds (VOCs), including Benzene, Toluene, Ethylbenzene, and Xylenes (BTEX). The present study aimed to investigate potential exposure to BTEX compounds among primary school children whose parents smoked hookah at home. BTEX concentrations in indoor air were measured in 60 residential buildings of Khesht, southwestern Iran (case = 30 and control = 30). Target compounds were sampled by charcoal tubes, and the samples were then analyzed by GC-FID. Monte Carlo simulation was used to assess the carcinogenic and non-carcinogenic risks of BTX exposure for the children aged 7-13years. The concentrations of benzene (7.19 ± 3.09 vs. 0.82 ± 0.5μg/m3), toluene (1.62 ± 0.69 vs. 0.3 ± 0.22μg/m3), and xylenes (2.9 ± 1.66 vs. 0.31 ± 0.22μg/m3) were considerably higher in the indoor air of the case houses compared with the control houses (p < 0.05). The Incremental Lifetime Cancer Risk (ILCR) of benzene for non-smoking and smoking houses were estimated 1.8 × 10-6 and 15 × 10-6, respectively, exceeding the recommendations of the World Health Organization (WHO) and the Environmental Protection Agency (EPA) (1 × 10-6). Moreover, Hazard Quotients (HQs) of all BTX compounds were < 1. The indoor benzene concentration was significantly influenced by the floor at which families lived and type of the kitchen. In order to prevent children's exposure to BTX emitted by hookah, banning indoor smoking is the only way to eliminate these compounds in the indoor air.

Factors associated with medical complications after body art among Israeli adults: a retrospective study

IntroductionBody-art, including tattoos and piercings, is steadily increasing world-wide but with relatively limited reporting of adverse outcomes. The objective of the present study was to identify correlates that would facilitate a preventative strategy to minimize adverse effects of body-art.MethodsWe examined patterns of body-art, health risk and perceptions among 921 participants (54% female, mean age of 35; SD = 10.8) through in-person questionnaire.ResultsA significantly lower frequency of those with body-art acknowledged that not all venues (parlors, clinics, etc.) are safe in terms of health and hygiene (84.7%t vs. 96.6%, p < .001) as compared to those without body-art. Similarly, knowledge of the need for a Ministry of Health certification was reported with lower frequency (77.2% vs. 94.5%, p < .001) among those with body-art. Those who experienced medical complications reported higher frequencies of smoking cigarettes and hookah as well as using ecstasy (MDMA). The risk of medical complication after body-art was 4 times higher in those who used ecstasy (OR = 3.97; CI 1.0–14.4; p < 0.05). In addition, it was more than 3 times higher for street or home tattooing as compared to studio or a licensed medical center (OR = 3.59; CI 1.32–9.76; p < .01), as well as almost 3 times higher among those who did not receive information before performing body-art (OR = 2.70; CI 1.05–6.92; p < .05) and who had somebody other than themselves decide on the body-art design (OR = 2.68; CI 1.00–7.19; p < .05).ConclusionsA targeted informational-preventative program should be developed, informed by the risks highlighted in this study. In addition, it would be necessary to draft policies related to regulation and enforcement in order to more effectively manage body-art service provision. The Ministry of Health should supervise and guide tattooists and practitioners regarding the health risks of body-art and offer training and raise awareness among potential clients.

Abstract 126: Exposure To Thirdhand Hookah Smoke Elevates The Risk Of Thrombogenesis By Enhancing Platelet Function

While the rate of smoking has been on the decline, the popularity of other forms of tobacco, including hookah/waterpipe continues to rise. While hookahs are thought to be safe, our recent studies have documented that exposure to waterpipe smoke (WPS) produces detrimental cardiovascular health effects, including thrombotic events; similar to what was observed with traditional cigarette smoking. In this connection, we have also documented that the new risk, termed thirdhand smoke (THS)-which is the residual tobacco smoke contaminant that remains after a cigarette is extinguished- increases the risk of thrombosis, much like both active/first hand smoke (FHS) and passive/second hand smoke (SHS) exposure. However, whether Thirdhand Hookah Smoke (THHS) exposure produces similar negative health effects remains to be determined. By employing a novel exposure protocol, mice were exposed to THHS starting at 10 weeks of age for three months, as per the golad standard Beirut protocol, which is as follows: one-hour session of 171 puffs of 530 mL volume, each puff is 2.6 s duration, and there are a 17 s interpuff interval. Our data shows that THHS exposed platelets exhibited enhanced agonist-induced aggregation, as well as dense and alpha granules secretion responses. Moreover, we also found that integrin activation, and phosphatidylserine exposure are increased as a result of THHS exposure. Consistent with these findings, we also obtained biochemical evidence of enhanced platelet reactivity, namely increased activation/phosphorylation of Akt. Notably, we observed high levels of the tobacco marker cotinine in the urine of the THHS mice, but not from the controls. Finally, and in terms of its in vivo impact, we observed that THHS enhances hemostasis and increases the risk of thrombosis in comparison to controls as documented by the shortened bleeding and occlusion times. Our results demonstrate, for the first time, that exposure to THHS results in a prothrombotic phenotype, which is attributed, at least in part, to a potentiated state of platelet reactivity. Thus, the negative health consequences of THHS should not be underestimated, and warrant further investigation. These findings should also guide policy development for regulating exposure to this form of tobacco.

Dietary and lifestyle habits among university students at different academic years.

College serves as a transitionary period into adulthood where students begin making independent dietary and lifestyle choices and begin forming possibly detrimental habits. Such habits may persist into adulthood and negatively affect their long-term health and risk of disease. This study aimed at exploring the dietary and lifestyle habits among the Hashemite University students at different academic years. A cross-sectional design was used to study dietary and lifestyle habits as well as the occurrence of obesity among a convenient sample of undergraduate students at the Hashemite University during the academic year 2015-2016. Five hundred and forty students (184 males: 356 females) were enrolled in this study. Bodyweight and height were measured and body mass index was calculated. Personal information, dietary habits and physical activity data were collected using constructed questionnaires. Around 36% of the students were overweight and obese. The percentage of overweight among the freshmen was about 31% and 26.5% among the seniors. Additionally, 8.6% of freshmen and 16.3% of seniors were found to be obese. One-third (30.2%) of the study sample was hookah smokers, while 15.4% were cigarette smokers. The students showed similar physical activity levels in the four academic years. The majority of students at different academic levels consumed fruits 1-2 times/week and 5 times cereals, grains, and starchy vegetables/day. Our results show that approximately one-third of students are overweight or obese, and practicing unhealthy dietary and lifestyle habits. This indicates a need to address this problem, possibly through implementing a nutrition and health education programs at the university in addition to improving the quality of food available on campus.

Psychological Factors of Metabolic Syndrome

Several factors are involved in the etiology of metabolic syndrome, the most important of which are insulin resistance, obesity (especially abdominal obesity), lipid abnormalities, impaired glucose tolerance, hypertension, pre-inflammatory status, genetic factors, unhealthy lifestyle, trend Rapid urbanization, nutritional factors, inactivity, smoking and hookah smoking, social, economic and cultural factors, level of education, psychosocial stresses and environmental pollution. But psychological factors such as meta-cognitive beliefs, life orientation (optimism, pessimism) and positive and negative emotions, Hypothalamic-Pituitary-Adrenal (HPA) axis activity, type D personality, depression and anxiety also play a role in causing it.

Differential Effects of Electronic Hookah Vaping and Traditional Combustible Hookah Smoking on Oxidation, Inflammation, and Arterial Stiffness

BackgroundTraditional hookah smoking has grown quickly to become a global tobacco epidemic. More recently, electronic hookahs (e-hookahs)—vaped through traditional water pipes—were introduced as healthier alternatives to combustible hookah. With combustible tobacco smoking, oxidative stress, inflammation, and vascular stiffness are key components in the development and progression of atherosclerosis. The comparable effects of hookah are unknown.Research QuestionWhat is the differential acute effect of e-hookah vaping vs combustible hookah smoking on oxidation, inflammation, and arterial stiffness?Study Design and MethodsIn a randomized crossover design study, among a cohort of 17 healthy young adult chronic hookah smokers, we investigated the effect of e-hookah vaping and hookah smoking on measures of conduit arterial stiffness, including carotid-femoral pulse wave velocity (PWV), augmentation index-corrected for heart rate before and after a 30-min exposure session. We assessed a panel of circulating biomarkers indicative of inflammation and oxidants and measured plasma nicotine and exhaled carbon monoxide (CO) levels before and after the sessions.Resultse-Hookah vaping tended to lead to a larger acute increase in PWV than hookah smoking (mean ± SE: e-hookah, +0.74 ± 0.12 m/s; combustible hookah, +0.57 ± 0.14 m/s [P < .05 for both]), indicative of large artery stiffening. Compared with baseline, only e-hookah vaping induced an acute increase in augmentation index (e-hookah, +5.58 ± 1.54% [P = .004]; combustible hookah, +2.87 ± 2.12% [P = not significant]). These vascular changes were accompanied by elevation of the proinflammatory biomarkers high-sensitivity C-reactive protein, fibrinogen, and tumor necrosis factor α after vaping (all P < .05). No changes in biomarkers of inflammation and oxidants were observed after smoking. Compared with baseline, exhaled CO levels were higher after smoking than after vaping (+36.81 ± 6.70 parts per million vs –0.38 ± 0.22 parts per million; P < .001), whereas plasma nicotine concentrations were comparable (+6.14 ± 1.03 ng/mL vs +5.24 ± 0.96 ng/mL; P = .478).InterpretationAlthough advertised to be “safe,” flavored e-hookah vaping exerts injurious effects on the vasculature that are, at least in part, mediated by inflammation.Trial RegistryClinicalTrials.gov; No.: NCT03690427; URL: www.clinicaltrials.gov

Prevalence of hookah smoking and associated factors among male high school students in Iraq

BackgroundThe use of the hookah-smoking device is increasing at a large scale in the Eastern Mediterranean region. Hookah users are exposed to an array of chemical compounds and may suffer several chronic diseases as a result. The purpose of this study was to determine the prevalence of hookah use among male high school students in the region and to study different associated factors in order to provide local tobacco control officials with an understanding of this public health problem.MethodsA convenient non-probability sampling study was conducted among students in three high schools in Al-Karkh district, Baghdad. The study period was from October 2017 till January 2019 and included 847 male students aged 15–18 years old. Using a simple random technique to select the high schools from a list of schools we chose one school from each directorate. Descriptive, chi-square test of significance, bivariate, and multivariate logistic regression analyses of data were carried out for identifying the risk factors associated with hookah smoking among these high school adolescent males.ResultsThe overall prevalence of hookah smoking in the last 30 days among male high school students was 46.1% while in the past 6 months it was as high as 85.7%. More than two-thirds (70.6%) of the students thought that hookah smoking was more socially acceptable than cigarette smoking. Factors such as having first heard about it from friends, the media, or the presence of a hookah café near their residence were significantly associated (p > 0.05) with hookah smoking among the students. Similarly, being surrounded by friends who used hookah was also found to be significantly associated with hookah smoking, with an odds ratio of 0.18, 95% CI (0.087–0.394). Hookah smokers were less likely than non-hookah smokers to report its use as forbidden in Islam and more likely to say it is allowed in Islam.ConclusionsWe found an alarmingly high use of hookah smoking among male high school students in this study. Family members and peers had an important role in the prevention of hookah smoking among these students. There is a need for students to be educated about the toxicity of hookah tobacco smoking and its direct effect on their health.

Predicting Tobacco Use Based on the Theory of Planned Behavior in Adolescent Girls

Introduction: Tobacco use poses a serious threat to global health. The tobacco epidemic is spreading in low- and middle-income countries, where the tobacco industries mainly target young people and women. Objective: This study aims to determine the predictors of tobacco use based on the theory of planned behavior (TPB) in female high school students. Materials and Methods: This cross-sectional study was conducted on 340 female high school students aged 14-18 years in Rasht City, Iran, who were selected using a multi-stage sampling method. The data collection tool was the TPB questionnaire for tobacco use in Persian. The obtained data were analyzed using the Mann-Whitney U test, Kolmogorov-Smirnov test, Spearman correlation test and logistic regression analysis. Results: The TPB constructs of attitude (OR = 0.91, 95% CI: 0.85-0.97, P = 0.007) and behavioral intention (OR=0.75, 95% CI; 0.64-0.88, P = 0.001) could predict cigarette smoking. Also, constructs of perceived behavioral control (OR = 0.92, 95%CI; 0.87-0.97, P = 0.007), subjective norms (OR = 0.83, 95%CI; 0.70-0.97, P = 0.02), and behavioral intention (OR = 0.88, 95% CI; 0.78 - 0.99, P = 0.03) could predict hookah smoking in girls students. Conclusion: Considering the predictive power of the TPB constructs in tobacco use by adolescent girls, it is possible to plan to reduce its rate in this group by a focus on the TPB constructs.

Feasibility of Using the Hexoskin Smart Garment for Natural Environment Observation of Respiration Topography.

Background: Limited research has been done to measure ambulatory respiratory behavior, in particular those associated with tobacco use, in the natural environment due to a lack of monitoring techniques. Respiratory topography parameters provide useful information for modeling particle deposition in the lung and assessing exposure risk and health effects associated with tobacco use. Commercially available Wearable Respiratory Monitors (WRM), such as the Hexoskin Smart Garment, have embedded sensors that measure chest motion and may be adapted for measuring ambulatory lung volume. Methods: Self-reported “everyday” and “some days” Hookah and Cigarette smokers were recruited for a 3-day natural environment observation study. Participants wore the Hexoskin shirt while using their preferred tobacco product. The shirt was calibrated on them prior to, during, and after the observation period. A novel method for calculating the calibration parameters is presented. Results: NH = 5 Hookah and NC = 3 Cigarette participants were enrolled. Calibration parameters were obtained and applied to the observed chest motion waveform from each participant to obtain their lung volume waveform. Respiratory topography parameters were derived from the lung volume waveform. Conclusion: The feasibility of using the Hexoskin for measuring ambulatory respiratory topography parameters in the natural environment is demonstrated.

Relationship between platelet indices and lipid status in chronic hookah consumption

Hookah smoking is a growing trend, both in the world and in Bosnia and Herzegovina. The aim of this study was to determine the value of platelet indices in hookah smokers and find out associations with lipid profile. Cross-sectional study included 60 students (30 chronic hookah smokers and 30 non-smokers). The complete blood count (erythrocytes, leukocytes, platelets, hemoglobin, hematocrit, erythrocyte and platelet indices), lipid parameters (total cholesterol, triglycerides, LDL-C, HDL-C) were determined. The platelet count, mean platelet volume and MPV/Platelets ratio were statistically significantly higher in chronic hookah consumers in the student population than in the control group (p &lt;0.001). In addition, platelet count was in significant positive correlation with values of total cholesterol, LDL-C and negative correlation with value of HDL-C, while there was a significant negative correlation between mean platelets volume, and MPV/Platelets ratio with HDL cholesterol levels in chronic hookah smokers (p &lt;0.05). These findings suggest that chronic hookah consumption could be associated with the development of atherosclerotic changes in blood vessels, which could lead to the development of long-term consequences on the cardiovascular system's function.

Unexpected Arrhythmia in a Young Patient: Hookah Smoking Triggered Atrial Fibrillation

Unexpected Arrhythmia in a Young Patient: Hookah Smoking Triggered Atrial Fibrillation

Predictors of Shisha Consumption among Students in Tertiary Institutions: A Systematic Review

Tobacco use is a risk factor for several diseases, disabilities and premature deaths. Shisha is specially flavoured tobacco and majority of the users perceive hookah smoking to be safer than cigarette. Shisha use has become rampant and trendy among students in tertiary institutions. This review aims to evaluate predictors of shisha consumption among students in tertiary institutions. We reviewed references of authentic databases and journals including Web of Science, PubMed, Iranian Databases, National Agency for the Campaign against Alcohol and Drug Abuse, CDC and WHO. The review focused on data documented from 2010 up to 2020.Predictors of shisha use were: shisha availability and accessibility, flavouring ,gender, awareness level, parental factors, marital status, social acceptability, peer pressure, birth order, monthly stipend, course enrolled in, internet and legal framework on hookah smoking. Most students using shisha reported to be poly drug users with marijuana, tobacco products, alcohol and khat. Most students consume shisha either singly or concurrently or simultaneously alongside other drugs. However, it is not possible to tell if shisha use preceded use of other drugs or was an aftermath. There is need to strengthen laws and policies regulating waterpipe industry. Since nearly all the reviewed literature was based on self-reported history which is prone to both social desirability bias and memory recall bias there is need to have confirmed incidence of shisha use in this sub-population.