Assessment of tobacco dependence in waterpipe smokers in Egypt

Auf, Rehab; Radwan, Ghada Nasr; Loffredo, Christopher A.; Setouhy, Maged El; Israel, Ebenezer; Mostafa, Mohamed

doi:10.5588/ijtld.11.0457

Cited by 35 publications

(38 citation statements)

References 30 publications

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“…This is particularly concerning for adolescents and young adults, given that early exposure to nicotine increases the severity of future nicotine dependence (32) and the prevalence of water pipe use among these age groups. Further, tobacco dependence has been observed among regular water pipe users in Egypt (33), and is a concern in occasional users.…”

Section: Nicotine Intakementioning

confidence: 99%

Nicotine and Carcinogen Exposure after Water Pipe Smoking in Hookah Bars

Helen

Benowitz

Dains

et al. 2014

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background Water pipe tobacco smoking is spreading globally and is increasingly becoming popular in the United States, particularly among young people. While many perceive water pipe smoking to be relatively safe, clinical experimental studies indicate significant exposures to tobacco smoke carcinogens following water pipe use. We investigated biomarkers of nicotine intake and carcinogen exposure from water pipe smoking in the naturalistic setting of hookah bars. Methods Fifty-five experienced water pipe users were studied before and after smoking water pipe in their customary way in a hookah bar. Urine samples were analyzed for nicotine, cotinine, the tobacco-specific nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-1- butanol (NNAL), and mercapturic acid metabolites of volatile organic compounds (VOCs). Results We found an average 73-fold increase in nicotine, 4-fold increase in cotinine, 2-fold increase in NNAL, and 14-91% increase in VOC mercapturic acid metabolites immediately following water pipe smoking. We saw moderate to high correlations between changes in tobacco-specific biomarkers (nicotine, cotinine, and NNAL) and several mercapturic acid metabolites of VOC. Conclusion Water pipe smoking in a hookah bar is associated with significant nicotine intake and carcinogen exposure. Impact Given the significant intake of nicotine and carcinogens, chronic water pipe use could place users at increased risk of cancer and other chronic diseases.

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Section: Nicotine Intakementioning

confidence: 99%

Nicotine and Carcinogen Exposure after Water Pipe Smoking in Hookah Bars

Helen

Benowitz

Dains

et al. 2014

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…We previously conducted a baseline smoking prevalence survey in nine villages in the Qalyubia governorate in Delta Egypt ( Auf et al, 2012 ;Boulos et al, 2009 ;Radwan et al, 2007 ). In each village, 300 households were selected using a systematic random sample, and adults (aged ≥ 18 years) were interviewed for their demographics, smoking and quitting behaviors, exposure to ETS, and their knowledge, attitudes , and practices toward a variety of smoking-related variables.…”

Section: Study P Articipantsmentioning

confidence: 99%

Tobacco-Specific Nitrosamine Exposures in Smokers and Nonsmokers Exposed to Cigarette or Waterpipe Tobacco Smoke

Radwan

Hecht

Carmella

et al. 2012

Nicotine & Tobacco Research

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Introduction: The causal relationship between tobacco smoking and a variety of cancers is attributable to the carcinogens that smokers inhale, including tobacco-specifi c nitrosamines (TSNAs). We aimed to assess the exposure to TSNAs in waterpipe smokers (WPS), cigarette smokers (CS), and nonsmoking females exposed to tobacco smoke. Methods:We measured 2 metabolites , 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) and its glucuronides (NNAl-Gluc) in the urine of males who were either current CS or WPS, and their wives exposed to either cigarette or waterpipe smoke in a sample of 46 subjects from rural Egypt.Results: Of the 24 current male smokers, 54.2% were exclusive CS and 45.8% were exclusive WPS. Among wives, 59.1% reported exposure to cigarette smoke and 40.9% to waterpipe smoke. The geometric mean of urinary NNAL was 0.19 ± 0.60 pmol/ml urine (range 0.005 -2.58) in the total sample. Signifi cantly higher levels of NNAL were observed among male smokers of either cigarettes or waterpipe (0.89 ± 0.53 pmol/ml, range 0.78 -2.58 in CS and 0.21 -1.71 in WPS) compared with nonsmoking wives (0.04 ± 0.18 pmol/ml, range 0.01 -0.60 in CS wives, 0.05 -0.23 in WPS wives, p = .000). Among males, CS had signifi cantly higher levels of NNAL compared with WPS (1.22 vs. 0.62; p = .007). However, no signifi cant difference was detected in NNAL levels between wives exposed to cigarette smoke or waterpipe smoke. Conclusions:Cigarette smokers levels of NNAL were higher than WPS levels in males. Exposure to tobacco smoke was evident in wives of both CS and WPS. Among WPS, NNAL tended to increase with increasing numbers of hagars smoked/day.

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“…For example, Auf et al (2012) recently demonstrated that, according to a modified Fagerström Test for Nicotine Dependence (FTND) (Heatherton, Kozlowski, Frecker, & Fagerström, 1991), WTSonly men (mean age = 47 years) in Egypt exhibited many of the same features of nicotine dependence attributed to cigarette smokers. Researchers in Lebanon developed a scale specifically intended to measure addiction to WTS.…”

mentioning

confidence: 99%