Hookah Research Articles

Understanding of Health literacy among Healthcare students in Saudi Arabia: a cross-sectional study

Background and objectiveHealth literacy is the cognitive and social abilities that influence a person’s motivation and capacity to learn, comprehend, and use information to improve and maintain good health. We aimed to investigate Healthcare Students’ knowledge, attitudes, and practices regarding Health Literacy in the Riyadh Province of Saudi Arabia.MethodsThis study used prevalidated electronic questionnaires among healthcare undergraduates from colleges affiliated with Saudi University in Riyadh, Saudi Arabia, from December to April 2024. Healthcare students were asked to answer a self-designed online questionnaire sent to them through social media platforms.ResultsThe response rate was 560 out of 600 (93.3%); 293 of the 560 students (52.3%) were aged between 23 and 24 years (mean age was 21.29 SD = 1.852). The mean GPA among the students was 4.31(± 0.682). The average overall score for health literacy among healthcare students was 100.92 ± 11.80. The mean scores for knowledge were 24.17 ± 4.67, attitudes were 38.65 ± 4.20, and practice in health literacy was 38.09 ± 5.09. Among all healthcare students, 50.2% reported good knowledge, 54.1% had good attitudes, and 50.1% exhibited good practices in health literacy. However, students’ knowledge (p = 0.019) and training (p = 0.024) in health literacy were significantly associated with smoking cigarettes. Additionally, smoking shisha was significantly associated with students’ knowledge (p = 0.022), attitudes (p = 0.001), and practices (p = 0.001) in health literacy.ConclusionOur study highlights that half of the healthcare students reported limited knowledge, attitude, and practice in health literacy. Age, gender, and course of study did not show significant differences. Rather, students who did not smoke cigarettes or shisha were found to have higher knowledge, attitudes, and practice in health literacy compared to smokers. However, to improve health literacy, additional education and increased awareness are needed. Further investigation is warranted to address the factors related to poor health literacy.

E-cigarettes and vaping, new spotlight on smoking as an old cardiovascular risk factor?

Smoking is one of the leading causes of chronic non-communicable diseases and asignificant risk factor for cardiovascular and respiratory diseases. While global tobacco consumption has decreased over the past two decades, the use of e‑cigarettes and water pipes (shisha) has surged at an alarming rate, particularly among younger individuals. E‑cigarettes do not offer acompletely risk-free alternative to traditional cigarettes, as the vast array of flavors and ease of use contribute to agrowing number of dependent users. Furthermore, they are not necessarily effective in overcoming nicotine addiction. This contribution provides an overview of the cardiovascular health impacts associated with shisha smoking and e‑cigarette vaping, with aparticular emphasis on the detrimental effects on endothelial function. The harmful biological effects of the toxic substances in these products, especially oxidative stress and inflammatory responses, are also discussed. Finally, the current state of recommendations, legal regulations, and commercial advertising are summarized.

Assessment the Combining Medications with Tobacco during Water-Pipe Smoking among the University Students in Jordan.

Water-pipe smoking, popularly known as "hookah" or "shisha," is a widespread social activity in the Middle East, involving the use of a water-filtered device to vaporize flavored tobacco. A concerning trend has emerged as individuals add various drugs to the tobacco mixture, complicating the health implications. This study aimed to explore the prevalence, demographic factors, and motivations behind drug mixing with tobacco in shisha among university students in Jordan. In this descriptive cross-sectional study, a structured questionnaire was used to collect data on participants' demographics, shisha smoking habits, drug mixing practice and the motivations behind it. Four hundred and sixty-nine (469) students, aged 18-30 years, including medical and non-medical students, from two universities in Jordan participated in this study. Approximately 18% of participants reported mixing drugs with tobacco in shisha, with paracetamol being the predominant choice (80%). Motivations varied, with 42% seeking euphoric effects, 46% a relaxing experience, and 12% a sedative outcome. Males (73%) showed a higher frequency of drug mixing compared to females (27%). In addition, non-medical reported mixing drugs with the tobacco of water-pipe more than medical students. This study provides valuable insights into the complex phenomenon of drug mixing with tobacco in water-pipe smoking among university students in Jordan. The findings highlight the need for further research on clinical implications and interventions to address this emerging trend.

Predictors and health outcomes of cigarette and shisha smoking among men in Gaza: a cross-sectional study

Tobacco smoking, a significant public health concern globally, is associated with a rise in noncommunicable diseases (NCDs) and preventable deaths, with pronounced impacts in conflict zones like Gaza. A cross-sectional study, conducted in 2020, in Gaza focused on individuals over 40 years of age, aiming to identify predictors of tobacco use and its links to diseases like coronary artery disease (CAD), chronic lung disease (CLD), and stroke using regression analysis. The research, based on the Gaza NCD study data with 4576 participants and a 96.6% response rate, found an overall tobacco smoking prevalence of 19.4%, with higher rates among men. After adjusting for various factors, the study identified significant associations between cigarette smoking in men and adverse health outcomes, such as CAD and CLD, with adjusted odds ratios (OR) of 1.67, 95% CI (1.22–2.29) and 1.68, 95% CI (1.21–2.33) respectively. However, after adjusting for independent variables, shisha smoking in men showed no association with these health outcomes. The findings of this study could assist other researchers in designing interventions aimed at reducing smoking prevalence by utilizing the associated factors identified in our analysis, such as age, education level, physical activity, and body mass index among men in Gaza.

Prevalence and Management of Chronic Obstructive Pulmonary Disease in the Gulf Countries with a Focus on Inhaled Pharmacotherapy.

Background: Chronic obstructive pulmonary disease (COPD) is a preventable, progressive disease and the third leading cause of death worldwide. The epidemiological data of COPD from Gulf countries are very limited, as it remains underdiagnosed and underestimated. Risk factors for COPD include tobacco cigarette smoking, water pipe smoking (Shisha), exposure to air pollutants, occupational dusts, fumes, and chemicals. Inadequate treatment of COPD leads to worsening of disease. The 2024 GOLD guidelines recommend use of inhaled bronchodilators, corticosteroids, and adjunct therapies for treatment and management of COPD patients based on an individual assessment of the severity of symptoms and risk of exacerbations. This article reviews COPD pharmacotherapy in the Gulf countries and explores the role of nebulization in the management of COPD in this region. Methods: To review the COPD pharmacotherapy in the Gulf Countries, literature search was conducted using PubMed, Medline, Cochrane Systematic Reviews, and Google Scholar databases (before December 2022), using search terms such as COPD, nebulization, inhalers/inhalation, aerosols, and Gulf countries. Relevant articles from the reference list of identified studies were reviewed. Consensus statements, expert opinion, and other published review articles were included. Results: In the Gulf countries, pressurized metered-dose inhalers (pMDIs), dry powder inhalers (DPIs), soft mist inhalers, and nebulizers are used for drug delivery to COPD patients. pMDIs and DPIs are most prone to errors in technique and other common device handling errors. Nebulization is another mode of inhalation drug delivery, which is beneficial in certain patient populations such as the elderly and patients with cognitive impairment, motor or neuromuscular disorders, and other comorbidities. Conclusion: There is no major difference between Gulf countries and rest of the world in the approach to management of COPD. Nebulizers should be considered for patients who have difficulties in accessing or using MDIs and DPIs, irrespective of geographical location.

Second-Hand Tobacco Smoke Exposure: Results of Particulate Matter (PM2.5) Measurements at Hospitality Venues in Addis Ababa, Ethiopia.

In Ethiopia, a comprehensive smoke-free law that bans smoking in all public areas has been implemented since 2019. This study aimed to evaluate compliance with these laws by measuring the air quality and conducting covert observations at 154 hospitality venues (HVs) in Addis Ababa. Indoor air quality was measured using Dylos air quality monitors during the peak hours of the venues, with concentrations of particulate matter <2.5 microns in diameter (PM2.5) used as a marker of second-hand tobacco smoke. A standardized checklist was used to assess compliance with smoke-free laws during the same peak hours. The average PM2.5 concentrations were classified as good, moderate, unhealthy for sensitive groups, unhealthy for all, or hazardous using the World Health Organization's (WHO) standard air quality index breakpoints. Only 23.6% of the venues complied with all smoke-free laws indicators. Additionally, cigarette and shisha smoking were observed at the HVs. Overall, 63.9% (95% confidence interval: 56-72%) of the HVs had PM2.5 concentrations greater than 15 µg/m3. The presence of more than one cigarette smoker in the venue, observing shisha equipment in the indoor space, and the sale of tobacco products in the indoor space were significantly associated with higher median PM2.5 concentration levels (p < 0.005). Hazardous level of PM2.5 concentrations-100 times greater than the WHO standard-were recorded at HVs where several people were smoking shisha and cigarettes. Most HVs had PM2.5 concentrations that exceeded the WHO average air quality standard. Stricter enforcement of smoke-free laws is necessary, particularly for bars and nightclubs/lounges.

Polyglobulie secondaire chez un fumeur français de chicha

AbstractThe diagnosis of polycythemia, particularly to distinguish primary from secondary causes, can be challenging. Biological criteria associated with a detailed anamnesis are essential to explore secondary polycythemia. Several causes may be involved, tobacco being one of the most common.We describe the case of a 46-old French man from Cape Verde with suffer from polycythemia and a high level of carboxyhemoglobin. The JAK2 mutation (V617F) was absent and the EPO level was high. The patient had no clinical symptoms. The anamnesis ruled out a daily habit of smoking shisha. After one month without smoking, blood counts and carboxyhaemoglobin completely normalized, confirming the hypothesis of polycythemia secondary to carbon monoxide intoxication from shisha smoke.

Sleep disruptions and associated risk factors among Iranians during Ramadan amid COVID-19 pandemic: A nationwide cross-sectional study.

The global COVID-19 pandemic has disrupted daily routines and heightened stress levels worldwide, impacting various aspects of health, including sleep. This cross-sectional study conducted in Iran aimed to investigate the impact of Ramadan Intermittent Fasting (RIF) during the pandemic on sleep disturbances and associated risk factors in adults aged ≥ 18 years. Data was collected from Iranian participants observing RIF. A structured electronic questionnaire, translated into Persian, gathered information on sociodemographics, dietary habits, sleep parameters, physical activity, and more. The study assessed sleep quality, duration, and disturbances and conducted a thorough analysis to identify risk factors associated with sleep disruptions. The study revealed that 48% of the participants experienced sleep disturbances during RIF, with 21% reporting poor sleep quality and 46% having unusual sleep duration. Various factors were associated with an elevated risk of sleep disruptions, including body mass index, place of residence, income levels, cohabitation status, family history of obesity, hypertension, diabetes, heart disease, personal history of obesity, weight fluctuations, Shisha smoking, and unemployment. The results highlight the critical importance of health promotion strategies tailored to cultural contexts. This study advocates for enhanced health education initiatives focusing on sleep hygiene and stress management, especially during periods of significant lifestyle alterations like Ramadan amid a global pandemic. Such initiatives are vital in mitigating sleep disturbances and promoting overall well-being in populations facing unique health challenges.

THE EFFECT OF HOOKAH (SHISA) AND VAPING ON CARDIOVASCULAR DISEASE: A LITERATURE REVIEW

Background: The popularity of shisha (hookah) and vaping as alternatives to smoking has increased significantly in recent years. Shisha smoking, prevalent in Arab nations and other regions, exposes users to various harmful substances including nicotine, fine particles, carbon monoxide, polycyclic aromatic hydrocarbons, and heavy metals. Similarly, vaping involves inhaling aerosols produced by heating e-liquids containing nicotine and other chemicals. Purpose: This literature review aims to provide a comprehensive summary of recent studies examining the cardiovascular health effects of shisha and vaping. Methods: Epidemiological patterns and adverse consequences of these practices on cardiovascular health were explored through a systematic search of relevant articles from PubMed, ScienceDirect and Google Scholars. Results: The findings suggest that chronic use of shisha and vaping is associated with respiratory issues and adverse cardiovascular outcomes. Moreover, shisha smoking has been linked to infectious diseases, pulmonary complications, metabolic syndrome, and adverse effects on fetal development during pregnancy. Conclusion: The review highlights the need for further research to better understand the mechanisms and long-term cardiovascular consequences of shisha and vaping.

Patterns and associated factors of shisha usage among the undergraduate students of Jouf University, Saudi Arabia: A cross-sectional study.

Shisha tobacco use is gaining popularity around the world, especially among young people and college students. Shisha users are exposed to many of the same harmful substances as cigarette smokers but at much higher levels, which could have more serious adverse health impacts. The aims of this study were to: 1) determine the patterns of shisha smoking among university students in the Northern Province of Saudi Arabia; 2) identify the reasons for using shisha tobacco; and 3) ascertain whether usage of shisha smoking differs by their sociodemographic characteristics. A cross-sectional survey was conducted among students of seven different colleges at a public university between October and December 2022. A modified version of the Global Youth Tobacco Survey questionnaire was used to collect information specifically on shisha smoking. After adjusting for confounding variables, a logistic regression analysis was used to determine the related factors. A total of 418 participants were included in the study. Of the studied population, shisha smoking was seen in 73.7% (n=308). Out of 308 shisha smokers, 208 (67.5%) had their first session of shisha smoking within the past two years; 34.4% of participants had used it in the past 30 days (current users), of which 27.4% had smoked shisha from 1 to 7 days during the past 30 days. The majority of respondents (63.6%) reported having friends that smoke. The most popular flavor among respondents (24.6%) was apple. For quitting attempts, 46.4% reported a 24-hour quit attempt in the previous year. Stress (23.0%) was reported as the main reason for beginning shisha use. Shisha smoking was significantly associated with age (Ref. 18-20 years; 24-26 years, AOR=0.08; 95% CI: 0.02-0.33, p<0.001; ≥27 years, AOR=0.12; 95% CI: 0.02-0.62, p=0.01), living status (Ref. alone; with family, AOR=0.23; 95% CI: 0.11-0.47, p<0.001; with friends, AOR=0.36; 95% CI: 0.18-0.76, p<0.001), with parents having higher education level (Ref. primary school and lower; Bachelor's, AOR=0.33; 95% CI: 0.14-0.76, p<0.001; diploma, AOR=0.33; 95% CI: 0.15-0.73, p<0.001; PhD, AOR=5.15; 95% CI: 1.00-9.65, p=0.05). Shisha use was more frequent among Saudi Arabian college students, especially those who were aged 18-20 years, living alone, and having highly educated parents.

Effect of Ramadan fasting on changes in smoking and vaping behaviors and withdrawal symptoms severity: a cross-sectional study

Background Ramadan fasting, an obligatory duty for adult Muslims, entails refraining from eating, drinking, smoking, and vaping from dawn until sunset. Throughout Ramadan, people accept major changes to daily routines. Consequently, Ramadan is associated with abstinence symptoms and changes in smoking or vaping behavior. Aim The study aims to assess the presence of withdrawal symptoms and its severity, as well as smoking or vaping behavior change and its determinants during Ramadan fasting. Methods A cross-sectional study was conducted during Ramadan in 2023. Data were collected online using a Google form, including questionnaires assessing socio-demographic data, nicotine dependence using Fagerstrom Test for Nicotine Dependence, vaping and shisha smoking, presence and severity of physiological and psychological withdrawal symptoms and its coping strategies. Smoking and vaping behavioral change during Ramadan and its contributing factors were also evaluated. Results A total of 251 participants (96% males), mean age ± standard deviation (33 ± 12.1) were surveyed. Withdrawal symptoms were reported among 70.5%, however, their severity was generally low both physiologically and psychologically. Education, nationality, smoking duration, nicotine dependence, and the amount of consumed E-liquid per day were the independent predictors of withdrawal symptoms presence. Attempts to quit smoking and vaping were reported by 54.6% of the participants; young age and higher educational levels were the factors associated with more quitting attempts. Conclusions The withdrawal symptoms severity linked to Ramadan fasting is minimal. Many smokers and vapers made attempts to quit during Ramadan. Ramadan presents a chance for smoking and vaping cessation with some behavioral support.

The prevalence of premenstrual syndrome symptoms and associated factors among female medical students at Al-Andalus University: a cross-sectional study

Background: Premenstrual syndrome (PMS) is a menstrual disorder defined as a cluster of various physical, emotional, and behavioural symptoms that negatively affect women’s quality of life. This cross-sectional study aimed to assess the prevalence of common PMS symptoms and determine their association with body mass index (BMI), lifestyle, dietary habits, perceived stress, menstrual flow, family history and family income among medical students at Al-Andalus University in Syria. Methods: A sample of 205 female students were interviewed and filled out a questionnaire. All data were coded and entered into excel (Microsoft 2019). One-way analysis of variance (ANOVA) and Chi-square tests were used to evaluate the association between PMS symptoms and the studied factors. Results: The most frequently reported PMS symptoms were anxiety (80%), bloating (74.6%), and breast tenderness (62.9%). Our study found a significant association between weight gain pre-menstruation and BMI (p=0.02). A significant relationship was found between increased premenstrual consumption of sweets and both breast tenderness and bloating (p=0.01). Daily consumption of coffee was significantly correlated with weight gain and headaches (p&lt;0.001). This study found a significant relationship between smoking cigarettes and abdominal and back pain (p=0.04, p=0.02, respectively). Smoking shisha was significantly associated with fatigue and bloating (p=0.01, p&lt;0.001, respectively). A significant relationship was found between menstrual flow and both abdominal pain and headaches (p=0.01, p=0.02, respectively). Conclusions: A high prevalence of PMS symptoms was reported in Al-Andalus University female medical students. Additionally, this study found multiple significant associations between BMI, dietary habits, lifestyle, menstrual flow and the severity of symptoms.

Reasons for shisha smoking: Findings from a mixed methods study among adult shisha smokers in Nigeria.

Shisha smoking has increased significantly worldwide over the past decade including in developing countries such as Nigeria. We aimed to understand the reasons for shisha smoking in Nigeria in order to address the lack of context-specific evidence to inform the national response to the growing threat posed by shisha smoking. We adopted the Theory of Planned Behaviour to conduct in-depth interviews among 78 purposely sampled current shisha smokers in 13 states (six in each state), and a quantitative survey including a random sample of 611 current shisha smokers in 12 states, across the six geopolitical zones in Nigeria. The in-depth interview data was analysed using thematic analysis whilst the quantitative survey data was analysed descriptively. We triangulated the key findings from the two datasets using a triangulation matrix organised by the three meta-themes: attitude, subjective norms, perceived behavioural control. Positive attitudes towards shisha smoking stem from shisha flavours, perceived pleasure from shisha smoking, curiosity about product attributes, beliefs about health benefits, limited knowledge on the health effects, and weak regulation. Having friends and family members who smoke shisha and the need to belong, particularly during social events, also promote shisha smoking. Negative societal views towards shisha smoking are potentially a protective factor. The availability of and ability to smoke shisha in many places makes shisha more accessible, whilst the high costs of shisha are potentially prohibitive. The findings also indicate that quitting shisha smoking without support is difficult. Restrictions on flavours, strengthening compliance monitoring and enforcement of the tobacco control laws in relation to shisha (e.g., smoke-free environments in indoor and outdoor public places; health warnings in English on shisha products including the pots; and tax and price measures) have the potential to minimise initiation and use, and to protect the health and wellbeing of Nigeria's general public.

Gender differences in use of cigarette and non-cigarette tobacco products among adolescents aged 13-15 years in 20 African countries.

Examining gender differences in youth tobacco use is important as it aligns tobacco control within the context of broader human development goals seeking to eliminate gender inequalities. In this study, we examined gender differences in adolescent use of cigarettes, smokeless tobacco, shisha, and e-cigarettes in Africa. This was a cross-sectional study using data from the Global Youth Tobacco Survey. Our analytical sample comprised 56442 adolescents aged 13-15 years from 20 African countries. Weighted, country-specific prevalence estimates were computed overall and by gender. Adjusted prevalence ratios (APRs) were calculated in a multivariable Poisson regression model to examine whether correlates of tobacco use differed between boys and girls. Ever cigarette smoking prevalence was significantly higher among boys than girls in 16 of the 20 countries, but a significantly higher percentage of girls reported earlier age of cigarette smoking initiation than boys within pooled analysis. Some of the largest gender differences in current cigarette smoking were seen in Algeria (12.2% vs 0.8%, boys and girls, respectively), Mauritius (21.2% vs 6.6%), and Madagascar (15.0% vs 4.1%). Current use of e-cigarettes, shisha, and smokeless tobacco was generally comparable between boys and girls where data existed. Among girls, higher levels of reported exposure to tobacco advertisement were positively associated with shisha smoking whereas perceived tobacco harm was inversely associated with current cigarette and shisha smoking. Among boys, perceived social acceptability of smoking at parties was associated with an increased likelihood of cigarette smoking (APR=2.27; 95% Cl: 1.20-4.30). The prevalence of cigarette smoking among boys was higher than that of girls in many countries. However, girls who smoke tend to start at an earlier age than boys. Differential gender patterns of cigarette and non-cigarette tobacco product use among youth may have implications for future disease burden. As the tobacco control landscape evolves, tobacco prevention efforts should focus on all tobacco products, not just cigarettes.

Relationship between tobacco smoking and hematological indices among Sudanese smokers

BackgroundTobacco Smoking is one of the leading causes of preventable morbidity and mortality in the world. It is well documented that tobacco smoking is risk factor for many diseases like: cancers, chronic respiratory and cardiovascular diseases, and the effects of tobacco smoking on hematological indices gets a little attention: the data is mostly inconsistent regarding the differential of WBCs, a conflicting studies described the effect of smoking on hemoglobin descriptive parameters and a regular monitoring of platelets count in smokers was advised.ObjectivesThe study aimed to evaluate the relationship between tobacco smoking and hematological parameters among Sudanese healthy Smokers at Bahri Town.MethodsThis was a cross sectional study conducted during 2022 in Bahri town, Khartoum state. A total of 120 male subjects participated in this study. Of them, 60 healthy non-smokers participants (Control), and 60 age matched smokers who were smoking tobacco for a minimum of 1 year. Smokers group was divided into three major sub-groups with each group contains 20 subjects: Cigarettes smokers (CS), Water pipes (Shisha) smokers (WP) and both Cigarettes and water pipes (shisha) smokers (CSWP). Data was collected through questionnaire interviews and laboratory investigation. A sample of Five ml venous blood was taken for Complete blood count testing using Urite 3000 plus semi-automated hematology analyzer. Data were analyzed using SPSS version 25. Assocation between the variables were estimated and p value ≤ 0.05 was considered statistically significant.ResultsSmokers had significantly higher RBCs count (p = 0.017), Hb level (p < 0.001), WBCs count (p = .017), Neutrophils (p < 0.001), MCH (p = 0.029), MCHC (p < 0.001), RDW (p < 0.001), and PDW (p < 0.001) compared to the non-smokers. In contrast, non-smokers had higher MPV (p < 0.001) and MCV (p < 0.001) levels than smokers. Between the non-smokers and different subtypes of the smokers (CS, WP & CSWP), there were significant differences between the subgroups for all hematological parameters except for PLTs and lymphocytes count. CS had lower levels of MCV (p < 0.001), MCHC (p < 0.001), HCT (p = 0.036), and RDW (p < 0.001) compared to the non-smokers, while both cigarette and shisha smokers had the higher levels of neutrophils count (p < 0.001) and PDW (p < 0.001) compared to the non-smokers.ConclusionSmoking affects hematological parameters; smokers had significantly higher RBCs count, Hb level, WBCs count, Neutrophils, MCH, MCHC, RDW and PDW compared to the non-smoker group. WP smoking caused higher levels of RBCs, Hb, neutrophils, MCH and MCHC. PDW was high in smokers’ sub-groups compared to control group, while MPV was lower despite insignificant change In PLTs count.

Prevalence and associated factors of shisha smoking among students in Senegal: Global Youth Tobacco Survey 2020.

Although shisha smoking is banned in Senegal, it has become increasingly popular, especially among youth. Despite the health risks associated with shisha smoking, there are few studies on shisha smoking in West Africa and none in Senegal. Our study assessed the prevalence and factors associated with shisha smoking among students aged 13-15 years in Senegal. We used the 2020 Global Youth Tobacco Survey (GYTS) Senegal data from 2524 students aged 13-15 years. We calculated the weighted prevalence of ever and current (past 30 days) shisha smoking. Multivariable logistic regression analyses identified factors associated with ever and current shisha smoking among students. The prevalences of ever and current shisha smoking were 9.8% (95% CI: 7.7-12.3) and 2.2% (95% CI: 1.5-3.1), respectively. Ever shisha smoking was significantly associated with being male (AOR=1.97; 95% CI: 1.33-2.92), current cigarette smoking (AOR=7.54; 95% CI: 2.95-19.29), higher class grade (AOR=2.27; 95% CI:1.10-4.67), more weekly pocket money (AOR=3.29; 95% CI:1.36-7.95), current use of smokeless tobacco (AOR=11.53; 95% CI: 4.98- 26.72), and exposure to secondhand cigarette smoke in public (AOR=1.55; 95% CI: 1.00-2.41). Current shisha smoking was significantly associated with current cigarette smoking (AOR=21.75; 95% CI: 6.08-77.78), more weekly pocket money (AOR=8.91; 95% CI: 1.75-45.40), current use of smokeless tobacco (AOR=8.26; 95% CI: 2.07-33.04), and fathers' smoking (AOR=3.34; 95% CI: 1.24-8.96). One in 10 students aged 13-15 years have ever smoked shisha and 2.2% were currently smoking it, suggesting that shisha smoking is a public health concern in Senegal. Senegal might consider offering students more education on the harms of shisha, both in schools and through comprehensive media campaigns that address all tobacco products.

Knowledge and Attitudes of Students About Water Pipe Smoking at Technical Institute / Alsuwayra in Middle Technical University

Water pipe (WP) is also referred to as Narghile, Hubble-bubble, Ghoza, and Hookah, depending on the country. Water pipe tobacco smoking is a type of tobacco consumption that involves smoking flavored or unflavored tobacco via a single or multi-stemmed instrument. The objective of the study knowledge and attitudes about water pipe (shisha) smoking. A descriptive cross-sectional study design (mixed methods design) was carried out at the technical institute –Suwaira. Included (240) students. The sampling technique was a random sample, and data was collected using an interview with students, from December 2021 to March 2022. Results of the study show demographic characteristics of students' age groups (21-24) years (50.0%), type of smoking (21.2%) of smoking both (cigarettes and water pipes), the overall level of knowledge to study sample about waterpipe smoking was intermediate knowledge (67.1%). The conclusions of the study show a majority of participants were smoking (52.1%), and most of them were smoking both (Cigarettes, Water pipes). Knowledge of students about waterpipe smoking was more (Yes) responses are harmful to health, the overall level of knowledge about waterpipe smoking was intermediate and poor knowledge. The study recommends great interest to the Ministry of Health and the consideration of the adjustment of strategies to improve knowledge, change attitudes, and correct the misconceptions about the habit of WPS, especially among students in colleges and universities.

Assessment of prevalence, predictors, reasons and regulations of substance smoking among children in Ghana

BackgroundIn Ghana, it is against the law for children to smoke. Nevertheless, a portion of children in the country do smoke. However, there is a paucity of research on young smokers in Ghana and other sub-Saharan African nations. This study, therefore, investigated the prevalence of smoking, the kinds of substances children smoke, predictors of smoking, reasons for and factors that lead children to smoke, and regulation of smoking among children in Ghana.MethodsIn total, 5024 children aged 8–17 were studied using a cross-sectional convergent parallel mixed method. Descriptive statistics, Person’s Chi-square test, Fisher Exact test, and binary logistic regression were used to analyse the quantitative data. In contrast, thematic analysis was used to analyse the qualitative data.ResultsThe results showed that 3.2% of children had ever smoked. Male children smoked more often than female children. The prevalence of cigarette, marijuana, and shisha smoking was 78.3%, 18%, and 3.7%, respectively. While more male children than female children smoked cigarettes and marijuana, more female children than male children used shisha. Children mainly smoked for fun and due to group culture. In addition, children were influenced by friends; parents, family members, and neighbours who smoke; curiosity; and advertisements and videos to initiate smoking. Despite the availability of regulations and laws regulating tobacco products in public places, tobacco advertisement, promotion, and sale to persons under 18, children are still smoking.ConclusionsChildren who have ever engaged in smoking reported using cigarettes, marijuana, and shisha. Policymakers urgently need to strategise and strengthen their policies, programmes, and interventions to address smoking among children.

Impact of COVID-19 restrictions on health and well-being in the United Arab Emirates.

Restrictions during the COVID-19 pandemic are thought to have impacted both the physical health and well-being of individuals where lockdown was applied. The United Arab Emirates (UAE) was one of the leading countries in implementing the international guidelines to limit the intensely contagious nature of the outbreak. To identify the impact of COVID-19 on changes to exercise and general physical activity habits, changes to the consumption of various foods and potential weight gain, as well as any differences in smoking habits among individuals residing in the UAE during the COVID-19 quarantine. This is a cross-sectional analytical study that used a quantitative electronic questionnaire sent by the Ministry of Health and Prevention to individuals on its platform in order to collect data on the physical health and well-being of a UAE sample population. A total of 2,362 responses were received to specific questions on physical activity, eating habits, and tobacco use for the period before, during, and after the COVID-19 lockdown. Descriptive statistical analysis was used to display the sample's demographic data and the changes in physical health and well-being. Paired t-test was used to show the changes in dietary habits. This study reveals concerning changes in health risk behaviors during the COVID-19 lockdown in the UAE. Physical activity levels declined across mild, moderate and vigorous ranges in most participants. Alarmingly, sedentary behavior dramatically increased with 71% of participants spending an average of 4-8 h per day sitting and over 54% of participants spending more than 4 h watching TV on an average day during lockdown. Fast-food consumption and snacking rose, hence weight gain was observed in over 53% of participants. Smoking habits, especially among cigarette smokers, may have worsened, with 45.2% reporting an increase in cigarette smoking, 16.8% declaring an increase in shisha smoking and 35.3% reporting an increase in smoking other tobacco products. These unfavorable behaviors during confinement could have serious long-term health consequences. This study demonstrates that long periods of home quarantine may have led to unhealthy consequences that increase the risk of developing disease. This study therefore aims to highlight these health impacts, and recommend strategies and policies that can encourage healthy habits.

Knowledge about Shisha Smoking and its Health Effects among Selected Girls College students, Farasan

Knowledge about Shisha Smoking and its Health Effects among Selected Girls College students, Farasan