Exhaled Biomarkers of Oxidative Stress and Inflammation in Hookah Smokers: A Public Health Concern

Abstract

Current public policy does not reflect health risk awareness associated with hookah smoking. Although, cigarette smoking has gained considerable attention accompanied by public restrictions, hookah smoking continues to increase as an unrestricted, socially acceptable means of recreation. This study identified novel biomarkers altered by hookah smoking compared to cigarette smoking using exhaled breath condensate collected from nonsmokers, hookah smokers and cigarette smokers pre and post smoking. Both cigarette and hookah smokershad higher levels of inflammatory mediators suggestive of inflammasome activation as well as altered expression of miR-217 and miR-17, which are known to regulate inflammasome activation and promote oncogenesis. Toassess current public knowledge of risk factors and behaviors associated with hookah smoking, and if knowledge of hookah dangers would influence smoking behaviors, the experimental data were integrated into a survey emphasizing cancer risk associated with hookah smoking. Survey results indicated that 70% of study participants were encouraged to abstain from hookah smoking after gaining knowledge of cancer risk associated with hookah. The identification of behaviors associated with hookah smoking and novel biomarkers of health risk may influenceits public health regulation and facilitate community health education.