The global epidemic of waterpipe smokingJournal: Addictive Behaviors, October 8, 2010
Author: Maziak W.
In the past decade waterpipe (WP) smoking (a.k.a. hookah, shisha, and narghile) has been steadily spreading among the youth around the world. The allure of this tobacco use method for the youth can stem from its pleasant smooth smoke, social ambience and the perception of reduced harm. The material in this review is based on detailed Medline search for articles appearing especially in the past two years that are of relevance to WP epidemiology, health and addictive effects, and WP-related tobacco control policies. It shows that WP smoking is continuing to spread among the youth worldwide, and perhaps represents the second global tobacco epidemic since the cigarette.
Available evidence suggests that the prevalence of current (past month) WP smoking range from 6 to 34% among Middle Eastern adolescents, 5%-17% among American adolescents, and that WP use is increasing globally.
Studies on the health effects of WP smoking are limited by methodological quality, as well as by the novelty of WP epidemic relative to the long latency of important smoking-related health outcomes. Still, research indicates substantial WP harmful effects similar to those of cigarettes, as well as to the potential of providing a bridge to cigarette smoking or relapse.
Developing effective interventions to curb WP use among the youth requires a detailed understanding of how dependence develops in WP users, and how it is shaped by WP's unique features such as the following; the predominantly intermittent use with prolonged sessions, preparation time, accessibility, potent sensory cues, and convivial experience of group use. It also requires assessing effective policy options such as factual and visible health warnings on all its parts, as well as youth access and indoor smoking restrictions.
WP smoking is currently showing all signs of a burgeoning global epidemic with serious implications for public health and tobacco control worldwide. Investment in research and policy initiatives to understand and curb WP use needs to become a public health priority.
PubMed Link: http://www.ncbi.nlm.nih.gov/pubmed/20888700
The acute effects of water pipe smokingJournal: Chest
on the cardio- respiratory system
on the cardio- respiratory system
Published online before print October 28, 2010.
Fahed Hakim, MD, Elias Hellou, Aviv Goldbart, MD, Rina Katz, Yedidia Bentur, MD and Lea Bentur, MD
Abstract Introduction: There are limited data on the acute effects of water pipe smoking (WPS) on cardio-pulmonary parameters.
Objectives To evaluate the acute effect of a single 30-minute session of WPS on carboxyhemoglobin, pulmonary functions tests, vital signs, fractional exhaled NO (FENO), and exhaled breath condensate (EBC) cytokines in volunteers.
Setting: Domestic open air group smoking.
Design: Prospective study evaluating the above outcome parameters before and after 30 minutes of WPS. Primary outcome parameter: change in carboxyhemoglobin (COHb).
Statistics: Paired Student's t-test for parametric values and Wilcoxon for non-parametric values. ANOVA followed by Neuman–Keuls for EBC analysis, general linear model was used to assess gender difference in the response of the outcome parameters. Bonferroni correction was applied.
Results: Forty-five volunteers (30 males), age 32.35±15.33 years, were recruited. Following one session of WPS, carboxyhemoglobin level rose significantly from 1.47%±0.57% (median 1.4) to 9.47%±5.52% (median 7.4), p<0.001. Systolic and diastolic blood pressure significantly increased after smoking (systolic 119.52±12.07 vs. 131.98±17.8 mmHg, diastolic 74.84±7.89 vs. 82.98±12.52 mmHg, respectively; p<0.001). Heart rate increased from 80.39±9.92 to 95.59±17.41, p<0.001, and respiratory rate increased from 14.36±1.63 to 16.68±2.24, p<0.001. In addition, there was a decrease in FEF25-75%, PEFR, FENO, % eosinophils in peripheral blood, and 8-isoprostane in exhaled breath condensate.
Conclusions: This study shows that one session of WPS causes acute biological changes that might result in marked health problems. This study adds to the limited evidence that WPS is harmful and supports interventions to control the continuing global spread of WPS, especially among youth.
http://chestjournal.chestpubs.org/conte ... 3.abstract