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Hookah Smoking: The Past and Future of Tobacco?

Hookah Smoking: The Past and Future of Tobacco?. Brian Primack, MD, EdM, MS Assistant Professor of Medicine and Pediatrics April 2009. Terminology. Hookah Waterpipe Shisha-Pipe Narghile Bong Hubble-bubble. www.hookah-bars.com. Hours. Sunday – Thursday: 4 PM – 12:30 AM

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Hookah Smoking: The Past and Future of Tobacco?

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  1. Hookah Smoking:The Past and Future of Tobacco? Brian Primack, MD, EdM, MS Assistant Professor of Medicine and Pediatrics April 2009

  2. Terminology • Hookah • Waterpipe • Shisha-Pipe • Narghile • Bong • Hubble-bubble

  3. www.hookah-bars.com

  4. Hours • Sunday – Thursday: 4 PM – 12:30 AM • Friday – Saturday: 4 PM – 2 AM

  5. Fruit Apple Banana Cherry Melon Candy Bubble gum Chocolate mint Alcohol Margarita Piña colada Flavors

  6. Good Quality Regular $7.00Large $10.00 Arabic Coffee, Apple, Apple Alex, Double Apple, Apricot, Banana, Candy, Cappuccino, Cherry, Carmel, Coconut, Cola, Grape, Jasmine, Lemon, Mint, Mango, Mandarin, Mixed Fruit, Orange, Pistachio, Peach Rose, Salloum, Strawberry, Vanilla, Zaghoul Light, Zaghoul, Licorice

  7. Excellent QualityRegular $8.00Large $11.00 Double apple, Apricot, Banana, Cantaloupe, Cappuccino, Cherry, Coconut, Mint, Melon, Orange, Peach, Pineapple, Rose, Raspberry, Strawberry, Tutti-Frutti, Vanilla Cognac, Margarita, Pina Colada, Strawberry Daiquiri

  8. Premiume Quality Regular $8.50Large $11.50 Apple, Special Apple, Bahrany Apple, Apple Eskandarani, Banana, Cola, Cappuccino, Fruit Cocktail, Honey Melon, Mango, Orange, Peach, Pipe, Rose, Strawberry

  9. Superior Quality Regular $9Large $12 Apple, Strawberry, Grape, Rose

  10. * Make your Hookah Cool with adding ice for $1 * Mix & Match Flavors Add $2 * Flavor Your Hookah Water Add $3 * Add 0.25 Per Each Person** Minimum 1 Order Per Person ** ** Bring your own bottle $2 cork charge ** You Must Be 21 to bring your own alcohol bottle

  11. Also Have • Fruit Smoothies (e.g. Strawberry, Banana, Mango, Guava) • Ice Cream • Coffee and Tea • Milk Shakes • Desserts • Games (Mancala, Dominoes)

  12. Apple Shaped, $35

  13. Silver Crane$120

  14. $200(It rotates!)

  15. $600

  16. $13 for 250 gm

  17. $20 Sampler

  18. 16 Coals for $4

  19. Smoke Exposure • 30-60 minute sessions • Each session ~100 inhalations • Each inhalation ~500 mL in volume • Total volume • Waterpipe session: 50,000 mL • Cigarette: 500-600 mL

  20. Smoking Topography 1Shihadeh 2003; Shihadeh 2004 2Breland 2005; Djordjevic 2000

  21. 1Shihadeh, 2005; 2Djordjevic, 2000

  22. 1Shihadeh, 2003; 2Hoffman, 2000

  23. Blood Nicotine Level = Shafagoj, 2002

  24. Known Harm • Waterpipe smoke contains ... • Carcinogens • Carbon monoxide • Nicotine • Tar • Metals • Waterpipe smoking associated with ... • Cancer • Cardiovascular disease • Decreased pulmonary function • Nicotine dependence

  25. History • India, ~1600? • EMR = Eastern Mediterranean Region • Syria • Lebanon • Israel • Egypt • Jordan

  26. Travel Guide to Syria/Lebanon

  27. Prevalence Globally • EMR • Syria: 45% report ever use • Lebanon: 30% report weekly use • Europe • Germany • Sweden • Other • Brazil • Korea • Canada • Ukraine

  28. What about the US? • 200-300 new waterpipe cafés opened in the U.S. between 1999 and 2004 • Particularly in college towns • Convenience sample surveys suggest high current use (past 30 days) • 411 first-year college students: 15.3% • 744 introductory psychology students: 20%

  29. Holes in Literature • Random sample • Associations between waterpipe smoking and • Demographics • Beliefs (e.g., harm, addiction, popularity) • Populations outside college

  30. STUDY 1: COLLEGE

  31. Purpose • Determine the 30-day, annual, and lifetime prevalence of waterpipe smoking in a random sample of college students • Associations between smoking and predictors?

  32. Design • Cross-sectional survey • Random sample of students at the University of Pittsburgh • Collect data via web-based version of the American College Health Association’s (ACHA) National College Health Assessment (NCHA) • Added items related to waterpipe use

  33. Approvals • University of Pittsburgh Institutional Review Board • University Vice Provost

  34. Procedure • April 2007 during a three-week period • Avoided the 30-day period following Spring Break • Email invitation sent to 3600 randomly selected Pitt students • Incentive: lottery to win cash prizes ranging from $25 to $100 • Three reminder e-mails sent to students during the three-week period

  35. Demographic Measures • Age • Gender • Race • Residence (on-vs. off-campus) • Undergraduate vs. graduate • Membership in a fraternity or sorority • Self-reported academic achievement

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