Determinants of progression of nicotine dependence symptoms in adolescent waterpipe smokers

Bahelah, Raed; Ward, Kenneth D.; Taleb, Ziyad Ben; DiFranza, Joseph R.; Eissenberg, Thomas; Jaber, Rana; Maziak, Wasim

doi:10.1136/tobaccocontrol-2018-054244

Cited by 21 publications

(17 citation statements)

References 42 publications

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“…Epidemiological studies have shown that WP smoking is associated with increased risks of cardiovascular diseases,6 cancer (lung, oesophageal, head and neck, and gastric),7–10 metabolic syndrome11 and chronic obstructive pulmonary disease (COPD) 12. An additional health risk that is of particular concern for young adults is nicotine dependence, and similar to any other tobacco product is represented in WP smokers by substance addiction behaviours 13–19. In agreement with the health risks identified to date, analytical examination of the components in WP smoke include a mixture of chemicals with known or suspected disease-causative agents that closely resemble those found in cigarette smoke (CS), and in many cases at higher concentrations 20 21.…”

Section: Introductionmentioning

confidence: 83%

Immune modulation by chronic exposure to waterpipe smoke and immediate-early gene regulation in murine lungs

et al. 2019

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ObjectiveWe investigated the effects of chronic waterpipe (WP) smoke on pulmonary function and immune response in a murine model using a research-grade WP and the effects of acute exposure on the regulation of immediate-early genes (IEGs).MethodsWP smoke was generated using three WP smoke puffing regimens based on the Beirut regimen. WP smoke samples generated under these puffing regimens were quantified for nicotine concentration. Mice were chronically exposed for 6 months followed by assessment of pulmonary function and airway inflammation. Transcriptomic analysis using RNAseq was conducted after acute exposure to characterise the IEG response. These biomarkers were then compared with those generated after exposure to dry smoke (without water added to the WP bowl).ResultsWe determined that nicotine composition in WP smoke ranged from 0.4 to 2.5 mg per puffing session. The lung immune response was sensitive to the incremental severity of chronic exposure, with modest decreases in airway inflammatory cells and chemokine levels compared with air-exposed controls. Pulmonary function was unmodified by chronic WP exposure. Acute WP exposure was found to activate the immune response and identified known and novel IEG as potential biomarkers of WP exposure.ConclusionChronic exposure to WP smoke leads to immune suppression without significant changes to pulmonary function. Transcriptomic analysis of the lung after acute exposure to WP smoke showed activation of the immune response and revealed IEGs that are common to WP and dry smoke, as well as pools of IEGs unique to each exposure, identifying potential biomarkers specific to WP exposure.

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Section: Introductionmentioning

confidence: 83%

Immune modulation by chronic exposure to waterpipe smoke and immediate-early gene regulation in murine lungs

et al. 2019

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“…Different cultural and socioeconomic backgrounds as well as use of other tobacco products can be determinants regarding the consumption of WP by adolescents [ 15 , 16 , 17 ]. The aromatic taste of WP tobacco (e.g., apple, cherry, melon) appeals to young people and can be associated with a more pleasant, longer smoking experience which leads to increased nicotine exposure and dependence potential [ 18 , 19 , 20 ]. Furthermore, the consumption of WP is associated with other harmful health effects similar to those associated with cigarette smoking [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

Waterpipe Use among Adolescents in Germany: Prevalence, Associated Consumer Characteristics, and Trends (German Health Interview and Examination Survey for Children and Adolescents, KiGGS)

Klosterhalfen

Kotz

Kuntz

et al. 2020

IJERPH

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Waterpipe (WP) use is popular among youth worldwide, but epidemiological data from Germany are scarce. We aimed to describe prevalence rates of WP use (current, last 12 months, ever) and analysed correlates and trends among 11- to 17-year-olds in Germany. Analyses were based on data from the “German Health Interview and Examination Survey for Children and Adolescents” study during 2014–2017 (n = 6599). Changes in WP use prevalence compared with 2009–2012 were used to describe trends. Associations with sociodemographic characteristics and cigarette smoking were assessed with multivariable logistic regression models. Prevalence of current WP use among adolescents was 8.5% (95% confidence interval (CI) = 7.5–9.6), use in the last 12 months was 19.7% (95% CI = 18.3–21.2), and ever use was 25.8% (95% CI = 24.2–27.5). High prevalence rates were particularly found among 16–17-year-olds. During 2009–2012, these prevalence rates were 9.0%, 18.5%, and 26.1%, respectively. WP use was associated with older age, male sex, migration background, lower educational level, and current smoking status. Among current WP users, 66.2% (95% CI = 60.0–71.9) identified themselves as non-smokers, and 38.1% (95% CI = 32.5–44.0) had used WP ≥ three times in the last month. WP consumption is popular among German youth, and prevalence rates have not changed over time. Specific prevention strategies to reduce harmful WP consumption among youth should be implemented.

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“…E-cigarette use and waterpipe tobacco smoking are of growing concern due to the adolescents’ exposure to nicotine. There is often a misconception that nicotine/tobacco dependence cannot be developed by waterpipe tobacco smoking 5 . Furthermore, nicotine exposure and nicotine dependence specific to e-cigarettes among adolescents are severe public health issues 6 .…”

Section: Introductionmentioning

confidence: 99%

Prevalence and correlates of concurrent use of cigarettes, electronic cigarettes, and waterpipes among Serbian youth

Kilibarda

Vukovic

Krstev³

2019

Tob. Induc. Dis.

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INTRODUCTIONConcurrent use of tobacco products is associated with an increased risk of nicotine dependence and smoking-related health complications. Growing popularity of concurrent use of cigarettes and electronic cigarettes and/or waterpipe tobacco is of concern, especially due to the adolescents’ exposure to nicotine and call for the better understanding of patterns and predictors of multiple product use.METHODSThis is a secondary analysis of cross-sectional data obtained through the 2017 Global Youth Tobacco Survey conducted in Serbia on a nationally representative sample of 3362 students aged 13–15 years. Students were categorized into eight groups based on their experience with cigarette, e-cigarette and waterpipe use. To explore differences in sociodemographic and psychosocial characteristics, students were further placed in four groups: non-users; exclusive cigarette users; users of e-cigarette and/or waterpipe who do not smoke cigarettes; cigarette and other product users.RESULTSWe show that among the 13–15 years old students, the most common pattern of tobacco/nicotine use is waterpipe and/or e-cigarette use with no cigarette smoking (7.5%, 95% CI: 6.6–8.4) followed by exclusive cigarette use (5.8 %, 95% CI: 5.0–6.6). Among cigarette smokers, 52.8% were exclusive cigarette smokers. Having the majority of their friends smoking is a mutual predictor for exclusive cigarette (AOR=33.2, 95% CI: 14.52–75.90) waterpipe and/or e-cigarette (AOR=2.57, 95% CI: 1.56–4.25) and cigarette and other products use (AOR=52.3, 95% CI:12.28–223.22) compared to no use of any product, and the same in the case of exposure at the point-of-sale marketing: exclusive cigarette vs not any product users (AOR=1.82, 95% CI: 1.22–2.73); waterpipe and or/e-cigarette vs not any product users (AOR=1.64, 95% CI:1.18–2.28); and cigarette and other products vs not any product users (AOR=3.40, 95% CI: 1.99–5.80).CONCLUSIONSTobacco control interventions should address dual- and poly-tobacco use with special focus on inter-personal factors and protection from exposure to advertising of e-cigarettes and waterpipes.

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Determinants of progression of nicotine dependence symptoms in adolescent waterpipe smokers

Abstract: A significant proportion of adolescent waterpipe smokers progressed on ND. Venue-based policies such as limiting youth access to waterpipe cafés are warranted.

Cited by 21 publications

References 42 publications

Immune modulation by chronic exposure to waterpipe smoke and immediate-early gene regulation in murine lungs

Immune modulation by chronic exposure to waterpipe smoke and immediate-early gene regulation in murine lungs

Waterpipe Use among Adolescents in Germany: Prevalence, Associated Consumer Characteristics, and Trends (German Health Interview and Examination Survey for Children and Adolescents, KiGGS)

Prevalence and correlates of concurrent use of cigarettes, electronic cigarettes, and waterpipes among Serbian youth

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