Waterpipe Tobacco Research Articles

Decoding Waterpipe Tobacco Smoking: A Comprehensive Narrative Review Exploring Mechanics, Health Risks, Regulatory Challenges, and Public Health Imperatives.

Waterpipe tobacco smoking, commonly known as hookah or shisha, has witnessed a surge in popularity globally, particularly among young adults. However, this activity is associated with several issues related to health. This comprehensive narrative review aims to provide a valuable resource for researchers, policymakers, and public health professionals seeking to deepen their understanding of waterpipe tobacco smoking and implement evidence-based strategies to address its challenges. The present article focuses on an in-depth analysis of the health risks associated with waterpipe tobacco smoking. Basedon evidence from the current scientific literature, the review explores the impact of waterpipe smoking on respiratory health, cardiovascular outcomes, and the potential links to infectious diseases. Additionally, the review discusses the emerging evidence on the long-term health consequences, highlighting the need for continued research in this area. Also, it touches on the regulatory challenges surrounding waterpipe tobacco smoking, which were critically examined, emphasizing the gaps and inconsistencies in existing policies. Finally, the review underscores the public health imperatives necessitated by the rise of waterpipe tobacco smoking. The narrative concludes by proposing a holistic approach that integrates scientific evidence, regulatory frameworks, and public health initiatives to mitigate the growing impact of waterpipe tobacco smoking on population health.

Trends and Disparities in Waterpipe Tobacco Smoking Among US Adolescents and Adults: PATH Study 2013-2021.

Waterpipe tobacco smoking (WTS) is a popular mode of nicotine delivery among young people. We examined the trends and disparities in WTS from 2013 to 2021 among US adolescents and adults. Data were from Wave 1 (initially conducted among 32320 adults and 13651 adolescents) to Wave 6 (2013-2021) of the Population Assessment of Tobacco and Health Study. We assessed the weighted prevalence of ever and current (past 30-day) WTS for adults and adolescents across waves stratified by demographics. From 2013-2021 among adolescents, the prevalence of ever and current WTS decreased by 86.5% (7.4% to 1.00%; p = 0.0364) and 97.1% (1.65% to 0.05%; p = 0.0012), respectively. Despite the decreasing trends among adolescents across all waves, females had a higher prevalence of ever and current WTS compared to males (p 's < 0.001 for all trends). Hispanics had the highest prevalence of ever WTS compared to other races/ethnicities (p 's < 0.001). Adolescents aged 15-17 had a higher (except Wave 6) prevalence of ever and current WTS than 12-14 years old (p 's < 0.001). For adults, the prevalence of ever WTS increased by 27.4% (16.39% to 20.92%; p = 0.0006), and current WTS decreased by 45.5% (2.19% to 1.24%; p = 0.0012). Young adults aged 18-24 experienced increasing trends in WTS and had the highest prevalence of ever and current WTS compared to other age groups (p 's < 0.001) across all waves. Our study indicates a notable decrease in adolescent WTS prevalence from 2013 to 2021 but an increase of ever WTS among adults. Demographic differences underscore disparities in WTS, calling for tailored interventions.

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.

Biomarkers of Waterpipe Tobacco Smoke Exposure: A Systematic Review and Meta-Analysis.

The prevalence of waterpipe tobacco smoking is increasing globally. Biomarkers of waterpipe tobacco smoke (WTS) exposure are less studied. To identify the types of biomarkers of WTS exposure and estimate changes in biomarker concentrations pre- to post-WTS exposure. PubMed, Embase, Web of Science, CINAHL Plus, PsycINFO, and Cochrane Library were searched for studies up to April 24, 2023. The types of biomarkers were identified. Random-effects models were used to estimate changes in biomarker concentrations pre- to post-WTS exposure. Seventy-three studies involving 3755 participants exposed to WTS (49% male, mean age: 24.8 years) and 11 types of biomarkers of WTS exposure were identified. The biomarkers included tobacco alkaloids, expired carbon monoxide (eCO), carboxyhemoglobin (COHb), tobacco-specific nitrosamines, volatile organic compounds (VOCs), polycyclic aromatic hydrocarbons (PAHs), heavy metals, unmetabolized VOCs, unmetabolized PAHs, furan metabolites, and heterocyclic aromatic amines. Compared with pre-WTS exposure, eCO (breath; mean difference [MD] 27.00 ppm; 95% confidence interval [CI]: 20.91 to 33.08), COHb (blood; MD 4.30%; 95%CI: 2.57 to 6.03), COHb (breath; MD 7.14%; 95%CI: 4.96 to 9.31), nicotine (blood; MD 8.23 ng/mL; 95%CI: 6.27 to 10.19), and cotinine (urine; MD 110.40 ng/mL; 95%CI: 46.26 to 174.54) significantly increased post-WTS exposure. Biomarkers of WTS exposure were systematically identified. The similarity between the biomarkers of WTS exposure and those of cigarette smoke and higher concentrations of some biomarkers post-WTS exposure underscore the need for further research on applying biomarkers in surveillance, interventions, and regulations to mitigate the harms of waterpipe tobacco smoking. This study provides the first comprehensive overview of biomarkers investigated and available for assessing WTS exposure and their concentration changes in the human body. Researchers can use biomarkers such as eCO, COHb, nicotine, and cotinine to measure the health risks associated with WTS exposure and objectively evaluate the effectiveness of public health interventions aimed at reducing waterpipe tobacco smoking. Public health policymaking can also be informed through increased biomarker concentrations following WTS exposure, to implement regulations and public health education campaigns on limiting or preventing waterpipe tobacco smoking.

Factors associated with intentions to quit tobacco use in Lebanon: A cross-sectional survey

IntroductionThe prevalence of tobacco smoking in Lebanon is among the highest globally. This study aims to determine past attempts to quit smoking among adults and identify factors associated with intentions to quit. MethodsA nationally representative telephone survey was conducted between June and August 2022. Eligibility criteria included people aged >=18 years residing in Lebanon. The questionnaire was divided into three components: socio-demographic characteristics, cigarette and waterpipe tobacco use behaviours. Binary logistic regression was used to examine factors associated with intention to quit cigarette and waterpipe tobacco use. ResultsA total of 2003 respondents were included in the study. The prevalence of any tobacco product use was 41%, the prevalence of current cigarette smoking was 41% and the prevalence of current waterpipe tobacco use was 20%. Approximately 24% of adults who smoke cigarettes and 26% of those who use waterpipe tobacco had previous quit attempts mainly due to health concerns. Intentions to quit smoking within the next 6 months were reported among 12% of survey respondents. Among adults who smoke, past quit attempts increased the likelihood of intentions to quit cigarette smoking by 5-fold (OR: 5.11; 95% CI: 1.80–14.47, p = 0.002) and waterpipe tobacco use by 7-fold (OR: 6.98, 95% CI: 2.63–18.51, p = <0.001). Age and income were associated with intentions to quit cigarette but not waterpipe tobacco use. ConclusionIntention to quit smoking was strongly associated with past quitting attempts. Understanding factors associated with intentions to quit can help inform the development of context specific smoking cessation interventions.

Effects of Pictorial Health Warning Labels on Intention to Quit Waterpipe in Lebanon: A Mediation Analysis.

Pictorial health warning labels (HWLs) on waterpipe (WP) tobacco packages represent a better strategy for communicating the health risks associated with WP use and promoting quit intention than text-only. However, the mechanism by which these warnings lead to higher intentions to quit remains unknown. This study explores how pictorial warnings versus text-only induces higher quit intention among a sample of young adult WP smokers in Lebanon. An online randomized cross-over experimental study was conducted in August 2021 among 276 young adult WP smokers who were exposed to two conditions: pictorial HWLs and text-only warnings on WP tobacco packages in random order. After each image, participants completed post-exposure assessments of health communication outcomes (eg, attention and negative affect). Using serial and parallel mediation analysis, we examined the role of attention, negative affect, cognitive elaboration, and perceived harm in mediating the relationship between exposure to HWLs and intention to quit. Using serial mediation, exposure to pictorial warnings versus text-only was found to affect intention to quit through the following pathways: attention and negative affect, which accounted for 17.28% of the total effect, and through negative affect and cognitive elaboration, which accounted for 21.53% of the total effect. Results of parallel mediation showed that the indirect effect pathways via negative affect (β = 0.063; [95% bootstrap CI = 0.004 to 0.149]) and cognitive elaboration (0.047; [0.001 to 0.114]) were statistically significant. The findings call on designing and implementing attention-grabbing, emotionally evocative, and cognitively persuasive pictorial warnings in Lebanon and other countries to curb WP tobacco smoking. This is among the first experimental studies looking at multiple mediators underlying the effect of exposure to pictorial HWLs on intention to quit in a sample of current WP smokers in Lebanon. The findings showed that using attention-grabbing, emotionally evocative, and persuasive pictures with a clear textual warning is crucial to maximizing the impact of implementing WP-HWLs regulations in Lebanon and other countries to curb WP tobacco smoking.

First report on BTEX leaching from waterpipe tobacco wastes (WTWs) into aquatic environment

Waterpipe tobacco wastes (WTWs) may contain considerable levels of hazardous contaminants such as BTEX (benzene, toluene, ethylbenzene, o-xylene, and m/p-xylene). However, no research has been carried out on BTEX levels in WTWs and the release of these pollutants into the water environment. This research examined the levels of BTEX in WTWs of flavored/local tobacco and also the release rate of these toxins into three kinds of water, including seawater (SW), tap water (TW), and distilled water (DW) with different leaching times (15, 30 min, 1.2, 4, 8 h, and 1, 2, and 4 days). The mean contents of BTEX in WTW samples of Al-Mahmoud, Al-Fakher, Mazaya, Al-Ayan brands, and local tobacco samples were 17.0 ± 4.14, 19.1 ± 4.65, 19.6 ± 4.19, 18.8 ± 4.14, and 3.16 ± 0.63 μg/kg, respectively. The mean BTEX levels in flavored tobacco samples were considerably greater than that of local tobacco (p < 0.05). The WTWs leaching experiments showed that the levels of BTEX ranged from 5.26 to 6.12, 5.02–5.60, and 3.83–5.46 μg/L in DW, TW, and SW, respectively. All target compounds were found for all exposure times in DW, TW, and SW samples. After adding sodium azide as an antibacterial agent to water samples (simulating biodegradation processes), higher levels of BTEX compounds were detected in SW. Further research is needed to address the potential environmental hazards due to WTWs leaching into aquatic environments.

The Burden and Correlates of Waterpipe (Hookah) Smoking among Adolescents and Youth: A Systematic Review

Background This systematic review evaluated the available medical literature on the prevalence and trends of waterpipe tobacco smoking among adolescents and youth in jurisdictionally representative populations. Methods PubMed, Embase, and Scopus were searched for relevant studies from inception until 31 December 2022 that reported the burden of waterpipe smoking among adolescents and youth (10–24 years of age). We extracted qualitative data on the demographic characteristics, burden, and correlates of waterpipe smoking (PROSPERO ID: CRD42022310982). Results A total of 2,197 articles were screened and 62 were included in the analysis. The majority (29) of the studies was from the United States of America and there were no studies from the south-east Asian region. The prevalence of ever waterpipe smoking among the 10–24 years age group was noted to be 18.16% (95% CI, 18.03–18.29). The prevalence of current (30-day) waterpipe smoking was 6.43% (95% CI, 6.34–6.50). The age of initiation of waterpipe smoking was variable. The prevalence of waterpipe smoking was higher among males, among those who belong to the high- and middle-income groups, and among university students. The common risk factors of waterpipe smoking included cigarette smoking, alcohol, and substance use. Waterpipe smoking resulted in increased susceptibility to the use of conventional forms of tobacco (e.g. smoking) among those who were never smokers. Conclusion Waterpipe smoking usage was significantly high among adolescents and young adults. Developing regulatory guidelines for water-pipe smoking, surveillance of its use, intervention, and specific policy frameworks may be considered a public health priority.

Waterpipe tobacco smoking and risk of all-cause mortality: a prospective cohort study.

Despite an increasing proportion of smokers who use non-cigarette products, the harmfulness of these is inconsistent. This study aimed to evaluate the impact of waterpipe tobacco (WTP) smoking on all-cause mortality. A prospective cohort study followed up on 35 646 participants from 2007 to 2019 in Northern Viet Nam. Data for each type of cigarette and WTP smoking were collected based on demographic lifestyle and semi-quantitative food frequency questionnaires. Smokers were categorized as current smokers and former smokers who were lifetime ever smokers but stopped smoking >6months before the interview. Data on all-cause mortality (2449 deaths) were obtained from medical records at the state health facilities. The hazard ratios (HRs) and 95% CIs for mortality were estimated using a Cox proportional-hazards model. Compared with non-smokers, ever smokers had a higher all-cause mortality risk (HR = 1.29, 95%CI = 1.16-1.43). Current WTP (HR = 1.37, 95%CI = 1.19-1.57), current cigarette (HR = 1.40, 95%CI = 1.22-1.60) and former WTP smokers (HR = 1.39, 95%CI = 1.10-1.76) showed an elevated risk of dying. The mortality risk was significantly elevated in dual smokers using WTP and cigarettes (HR = 1.55, 95%CI = 1.35-1.79) and exclusive WTP smokers (HR = 1.38, 95%CI = 1.21-1.57). Elevated risk was observed for the main targeted attractions of cancer, diabetes and heart diseases. Smoking cessation of >10 years decreased the risk of all-cause mortality (HR = 0.61, 95%CI = 0.44-0.85) and cancer (HR = 0.24, 95%CI = 0.11-0.52). WTP smoking increases the risk of all-cause mortality. A unique programme to control exposure to WTP should be a high priority in Viet Nam and other countries.

Health and economic impacts of introducing specific excise tax to waterpipe tobacco in Egypt: a simulation model of simple and mixed tax policy approaches

IntroductionWaterpipe tobacco is taxed at half the rate of cigarettes in Egypt and, unlike cigarettes, does not have a specific excise component. We aimed to simulate the introduction of a...

Effect of glycerol concentration on levels of toxicants emissions from water-pipe tobacco smoking (WTS)

Glycerol, flavorings and sweeteners constitute approximately 70% of water-pipe tobacco smoking (WTS) mixtures. Tobacco mixture combustion produces smoke toxins (e.g. carbonyl compounds), of which the type and amount are highly dependable on tobacco mixture formula. While glycerol in tobacco mixture contribute to enhanced smoking experience, its’ combustion produces toxicants such as acrolein. According to WHO, there are no approved international upper limits regulations on WTS ingredients. This study aims to assess toxicant emission levels corresponding to increasing glycerol concentration in WTS mixtures, which may aid in developing tobacco regulations towards harm reduction.MethodsLaboratory experimental study. Using laboratory water-pipe smoking machine, levels of toxicant emissions in the smoke from WTS mixture samples containing varying glycerol concentrations were measured using High-performance Liquid Chromatography (HPLC). Smoke from 5 consecutive smoking cycles with 35 puffs each (ISO 22486 standard) was led through a trapping system as described in the Cooperation Centre for Scientific Research Relative to Tobacco (CORESTA) recommended method No. 74 (Determination of selected carbonyls in mainstream cigarette smoke by HPLC). Trapped carbonyls were then analysed by HPLC with a DAD detector.ResultsAcrolein emission is associated with glycerol addition in WTS mixture indicated by lab-made samples throughout all glycerol concentrations (10%, 20%, 40% and 60%), and brand samples with glycerol concentrations 10% to 20%. However, brand samples showed no increase in acrolein emission corresponding to the increase in glycerol concentrations from 20% to 60%.ConclusionThe effect of glycerol addition in waterpipe tobacco on acrolein emission varies between products. Tobacco fillers, additives and contents quality and other factors may affect toxicant emission levels. Therefore, regulatory recommendations towards defining upper limits of content concentrations require further investigations regarding potential confounders in acrolein emissions and health effects of market-available glycerol concentrations in waterpipe tobacco smoking.

Pathophysiologic effects of waterpipe (shisha) smoke inhalation on liver morphology and function in mice

AimsThe global prevalence of waterpipe tobacco smoking is increasing. Although the cardiorespiratory, renal, and reproductive effects of waterpipe smoking (WPS) are well-documented, there is limited knowledge regarding its adverse impact on the liver. Therefore, our study aimed to assess the effects and potential mechanisms of WPS inhalation for one or four weeks on the liver. Main methodsMice were exposed to WPS for 30 min per day, five days per week, while control mice were exposed to clean air. Key findingsAnalysis using light microscopy revealed the infiltration of immune cells (neutrophils and lymphocytes) accompanied by vacuolar hepatic degeneration upon WPS inhalation. At the four-week timepoint, electron microscopy analysis demonstrated an increased number of mitochondria with a concomitant pinching-off of hepatocyte plasma membranes. WPS exposure led to a significant rise in the activities of liver enzymes alanine aminotransferase and aspartate aminotransferase in the bloodstream. Additionally, WPS inhalation elevated lipid peroxidation and reactive oxygen species levels and disrupted the levels of the antioxidant glutathione in liver tissue homogenates. The concentration of proinflammatory cytokines, including tumor necrosis factor α, interleukin (IL)-6, and IL-1β, was significantly increased in the WPS-exposed group. Furthermore, WPS inhalation induced DNA damage and a significant increase in the levels of cleaved caspase-3, cytochrome C and hypoxia-inducible factor 1α along with alterations in the activity of mitochondrial complexes I, II, III and IV. SignificanceOur findings provide evidence that WPS inhalation triggers changes in liver morphology, oxidative stress, inflammation, DNA damage, apoptosis, and alterations in mitochondrial activity.

Central and Peripheral Hemodynamics in Young Adults Who Use Water Pipes and the Acute Effects of Water-Pipe Use

Tobacco use via water pipe (commonly referred to as water-pipe smoking [WPS]) is popular among young adults globally and exposes those who smoke to toxicants. Is WPS associated with impaired measures of arterial function and does WPS acutely impair these measures in young adults? We assessed heart rate (HR), brachial and aortic BP, HR-adjusted augmentation index (AI), and carotid-femoral pulse wave velocity (CFPWV) in 62 individuals who use water pipes and 34 individuals who have never used a water pipe recruited from the community (mean age, 22.5 ± 3.0 years; 48%female). Measurements were obtained before and after an outdoor session of WPS among participants who use water pipes and among the control group of participants who have never used a water pipe. Measurements were compared after vsbefore exposure and between those who use and those who do not use water pipes, adjusting for possible confounders using linear regression. Participants who use water pipes and control participants had similar demographic characteristics. BP and HR increased acutely after WPS (brachial systolic BP by 4.13mmHg [95%CI, 1.91-6.36mmHg]; aortic systolic BP by 2.31mmHg [95%CI, 0.28-4.33mmHg]; brachial diastolic BP by 3.69mmHg [95%CI, 1.62-5.77mmHg]; aortic diastolic BP by 3.03mmHg [95%CI, 0.74-5.33mmHg]; and HR by 7.75 beats/min [95%CI, 5.46-10.04 beats/min]), but not in the control group. AI was significantly higher in participants who use water pipes compared with those who do not (9.02%vs3.06%; P= .03), including after adjusting for BMI and family history of cardiovascular disease (β= 6.12; 95%CI, 0.55-11.69; P= .03) and when assessing habitual tobacco use via water-pipe extent (water pipes used/day× water-pipe use duration) in water-pipe-years (β= 2.51/water-pipe-year; 95%CI, 0.10-4.92/water-pipe-year; P= .04). However, CFPWV was similar in those who use water pipes and those who do not, and AI and CFPWV did not change acutely after WPS. In apparently healthy young individuals from the community, habitual WPS was associated with increased AI, a predictor of cardiovascular risk, and one WPS session acutely increased HR and brachial and aortic BP.

Geometric framework for statistical analysis of eye tracking heat maps, with application to a tobacco waterpipe study

Health warning labels have been found to increase awareness of the harmful effects of tobacco products. An eye tracking study was conducted to determine the optimal placement and type of a health warning label on tobacco waterpipes. Participants viewed images that contained one of (1) four waterpipes, (2) three different types of warning labels, (3) placed in three locations. Typically, statistical analysis of eye tracking data is conducted based on summary statistics such as total dwell time, duration score, and number of visits to an area of interest. However, these summary statistics fail to capture the complete variability in a participant's eye movement. Instead, we propose to estimate heat maps defined on the entire image domain using the raw two-dimensional coordinates of eye movement via kernel density estimation. For statistical analysis of heat maps, we adopt the Fisher–Rao Riemannian geometric framework, which enables computationally efficient comparisons of heat maps, statistical summarization and exploration of variability in a sample of heat maps, and metric-based hierarchical clustering. We apply this framework to eye tracking data from the tobacco waterpipe study and comment on the results in the context of the optimal placement and type of health warning labels on tobacco waterpipes.

Socioeconomic and environmental factors associated with waterpipe tobacco smoking among Iranian adults: a PERSIAN cohort-based cross-sectional study

BackgroundWaterpipe tobacco smoking (WTS) is associated with several deleterious health outcomes. We sought to estimate the prevalence of WTS and explore socioeconomic inequalities associated with this culturally-rooted tobacco smoking practice among Iranian adults.MethodsA cross-sectional analysis was conducted among 20,460 adults (ages 18 and older) enrolled in the PERSIAN cohort study during 2020. Data were collected on socioeconomic status (SES), lifestyle, alcohol consumption, cigarette smoking, and several risk factors related to non-communicable diseases. The concentration curve and relative concentration index (RCI) were administered to assess and quantify the SES-based inequality in WTS.ResultsOverall age-adjusted prevalence of past-month WTS was 5.1% (95%CI:4.6–5.8), with about 1% for women and 10.6 for men. Age-adjusted prevalence of WTS was higher among younger adults, men, cigarette smokers, obese adults, and those with higher SES. The RCI estimation showed that WTS is more popular among adults with high income and education. WTS was higher among younger adults, cigarette smokers, obese adults, and those with higher SES.ConclusionThere is a clear socioeconomic inequality in WTS, with a higher prevalence among adults with higher income and education. The findings suggest the need for targeted interventions to address this inequality and reduce the prevalence of WTS among high-income communities.

Waterpipe smoke inhalation induces lung injury and aortic endothelial dysfunction in mice.

Waterpipe tobacco smoking (WPS) inhalation has been shown to trigger endothelial dysfunction and atherosclerosis. However, the mechanisms underlying these effects are still unknown. Here, we assessed the impact and underlying mechanism of WPS exposure for one month on endothelial dysfunction using aortic tissue of mice. The duration of the session was 30 min/day and 5 days/week. Control mice were exposed to air. Inhalation of WPS induced an increase in the number of macrophages and neutrophils and the concentrations of protein, tumor necrosis factor alpha (TNF alpha), interleukin (IL)-1beta, and glutathione in bronchoalveolar lavage fluid. Moreover, the concentrations of proinflammatory cytokines (TNF alpha, IL-6 and IL-1beta), adhesion molecules (intercellular adhesion molecule-1, vascular cell adhesion molecule-1, E-selectin and P-selectin) and markers of oxidative stress (lipid peroxidation, glutathione, superoxide dismutase and nitric oxide) in aortic homogenates of mice exposed to WPS were significantly augmented compared with air exposed mice. Likewise, the concentration of galectin-3 was significantly increased in the aortic homogenates of mice exposed to WPS compared with control group. WPS inhalation induced vascular DNA damage assessed by comet assay and apoptosis characterized by a significant increase in cleaved caspase-3. While the aortic expression of phosphorylated nuclear factor kappaB (NF-kappaB) was significantly increased following WPS inhalation, the concentration of sirtuin 1 (SIRT1) was significantly decreased in WPS group compared with air-exposed group. In conclusion, our study provided evidence that WPS inhalation triggers lung injury and endothelial inflammation, oxidative stress and apoptosis which were associated with nuclear factor-kappaB activation and SIRT1 down-regulation.

Endurance Exercise Training Attenuates the Waterpipe Smoke Inhaling-Induced Learning and Memory Impairment in Rats: Role of Neurotrophic Factors and Apoptotic System.

The increasing prevalence of waterpipe tobacco smoking (WTS) and its detrimental effects on memory function have been reported. This study was conducted to investigate the effect of moderate-intensity endurance exercise on the detrimental effects of WTS on learning and spatial memory in rats. Animals were divided into the Control group (CTL), the exercise group (Ex) which trained for 8 weeks, the WTS group (Wp) exposed to smoke inhalation (30 minutes per day, 5 days each week, and for 8 weeks), and the group that did exercise training and received waterpipe smoke together (Ex + Wp). Thereafter, learning and spatial memory were assessed by the Morris water maze test and hippocampal molecular measurements were done. Waterpipe smoke significantly impaired learning and spatial memory, decreased expression of neurotrophic factors IGF-1 and BDNF (p < .01 and p < .05 vs. CTL group, respectively), increased BAX to BCL-2 ratio (p < .001 vs. CTL group) in hippocampal tissue, and increased the percent of damaged neurons in the hippocampal CA1 area (p < .05 vs. CTL group). Combination of exercise training with WTS prevented learning and spatial memory disturbances and recovered expression of neurotrophic factors IGF-1 (p < .05 vs. Wp group), decreased BAX to BCL-2 ratio (p < .001 vs. Wp group), and reduced percentage of damaged neurons (p < .05 vs. Wp group). Findings suggest that moderate-intensity endurance exercise training can ameliorate learning and memory impairment caused by waterpipe smoke in rats. This effect partly results from increasing the expression of neurotrophic factors BDNF and IGF-1 and correcting pro/anti-apoptotic proteins balance in the hippocampal tissue. The popularity of WTS especially among youth is increasing. We assessed the effect of hookah smoke with/without exercise on learning and memory. Hookah smoke leads to CA1-neural injury and impairs learning and memory in rats. A combination of exercise training with hookah smoke attenuates these complications. This positive effect of exercise is partially mediated by the balancing of brain-derived neurotrophic factor (BDNF) and Insulin-like growth factor-1 (IGF-1) and also the BAX to BCL-2 ratio, a significant predictor of cell susceptibility to apoptosis. Extrapolation of these positive findings to humans needs complementary studies.

Novel hazards of waterpipe tobacco and the benefits of stop smoking in men, a prospective cohort study

Waterpipe smoking is an emerging epidemic and a severe public health problem worldwide. Observational studies on the hazards of a specific new waterpipe tobacco product are timely needed. The objectives were to analyze how dangerous waterpipe tobacco smoking is on the causes of all mortality, including cancer, and how effective smoking cessation is for improving health. We analyzed the hazards of exclusive waterpipe smoking through a prospective cohort study in Northern Vietnam. We obtained exposure data on the smoking status of specific cigarette and waterpipe and smoking cessation histories from each study participant. The outcome includes deaths due to all causes. The cause of death for each case is determined based on medical records. HR (95%CI) was estimated using a Cox proportional-hazards–regression analysis for overall mortality and all cancers. The ever-cigarette smoking group as the reference group, the exclusive waterpipe smoking group had a statistical increase in the risk for overall mortality HR (95% CI): 1.63 (1.32, 2.00), and all cancers HR (95%CI): 1.67 (1.18, 2.38). The risk of death increased statistically in the group of waterpipe smoking over 20 years for overall mortality HR (95%CI): 1.82 (1.45, 2.29), and all cancers HR (95%CI): 1.91 (1.27, 2.88). After stopping smoking, the risk of death decreased steadily. The risk of death was reduced by 41% for overall mortality HR (95%CI): 0.59 (0.39, 0.89), and 74% for death from cancers HR (95%CI): 0.26 (0.08, 0.83) after ten years or longer of cessation. Life expectancy was shortened by more than six years for the group of exclusive waterpipe smokers compared to non-smokers. This study found new novel hazards of exclusive waterpipe tobacco smoking. The findings are scientific evidence for developing strategies, policies, and budget allocations to control this novel tobacco product and promote cessation to improve life expectancy.

Sociodemographic inequalities in cigarette, smokeless tobacco, waterpipe tobacco, and electronic cigarette use among adolescents in 114 countries: a cross-sectional analysis

Sociodemographic inequalities in cigarette, smokeless tobacco, waterpipe tobacco, and electronic cigarette use among adolescents in 114 countries: a cross-sectional analysis

Effect of glycerin concentration on levels of toxicants emissions from water-pipe tobacco smoking (WTS)

Effect of glycerin concentration on levels of toxicants emissions from water-pipe tobacco smoking (WTS)