Dataset Information

E-cigarette and hookah adoption patterns: Is the harm reduction theory just so much smoke?

ABSTRACT:

Aims

This paper explores inter-generational changes in consumers smoking product uptake and use patterns after the introduction of e-cigarettes and hookahs.

Design

Item Response Theory (IRT) is used to analyze the Health Information National Trends Survey sponsored by the Food and Drug Administration (HINTS-FDA). The survey was fielded in 2015. IRT allows the pattern of product use to be described and help assess whether the new tobacco products (i.e., e-cigarettes, hookahs) serve as gateway to other products or act in harm reduction modality.

Findings

The results indicate that the new product alternatives have changed the how tobacco products are adopted in the U.S. In particular, younger respondents were more likely to have engaged in cigar, e-cigarette and water-pipe use than the older cohort.

Conclusions

The introduction of nicotine products previously unavailable in the U.S is creating new modes for smoking initiation in the age groups most likely to begin a new habit. There is little evidence that smokers in the older HINTS cohorts are using the e-cigarette as a smoking cessation tool. The rise of cigar use in the younger cohort may indicate that legal products are being mixed with illicit substances (i.e., 'blunting').

SUBMITTER: Ford EW

PROVIDER: S-EPMC7244911 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

E-cigarette and hookah adoption patterns: Is the harm reduction theory just so much smoke?

Ford Eric W EW Chan Kitty S KS Parikh Megha M Lowe Kevin B KB Huerta Timothy R TR

Addictive behaviors reports 20200120

<h4>Aims</h4>This paper explores inter-generational changes in consumers smoking product uptake and use patterns after the introduction of e-cigarettes and hookahs.<h4>Design</h4>Item Response Theory (IRT) is used to analyze the Health Information National Trends Survey sponsored by the Food and Drug Administration (HINTS-FDA). The survey was fielded in 2015. IRT allows the pattern of product use to be described and help assess whether the new tobacco products (i.e., e-cigarettes, hookahs) serve ...[more]

PMID: 32467835

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Project description:Rationale: The effects of hookah smoke on respiratory epithelia have not been well characterized. Objectives: To characterize and compare the effects of hookah tobacco smoke and conventional cigarette smoke on the epigenome and transcriptome of human respiratory epithelia. Methods: Normal human small airway epithelial cells and cyclin-dependent kinase 4/human telomerase reverse transcriptase–immortalized human bronchial epithelial cells were cultured for 5 days in normal media in the presence or absence of water pipe condensates or cigarette smoke condensates under relevant exposure conditions. CyQUANT assay (Thermo Fisher Scientific), RNA sequencing, quantitative reverse transcriptase–polymerase chain reaction, and Western blotting techniques were used to examine/compare the effects of hookah and cigarette smoke on cell proliferation, messenger RNA/microRNA expression, and global histone marks. Results: Water pipe condensates– and cigarette smoke condensates–mediated, dose-dependent growth-inhibitory effects in cultured respiratory epithelial cells were measured. Under conditions mediating equipotent mild to moderate growth-inhibitory effects, water pipe condensates as well as cigarette smoke condensates decreased histone H4 lysine 15 acetylation (H4K16ac) and histone H4 lysine 20 trimethylation (H4K20me3) levels in small airway epithelial cells and human bronchial epithelial cells; these histone alterations are putative “hallmarks of cancer.” RNA sequencing analysis demonstrated that cigarette smoke condensates and water pipe condensates mediated dose-dependent alterations in gene expression in small airway epithelial cells and human bronchial epithelial cells. A total of 873 genes were commonly regulated (fold change >2) by water pipe condensates (1.0 mg/ml) and cigarette smoke condensates (0.05 mg/ml) in small airway epithelial cells, whereas a total of 1,577 genes were commonly regulated by water pipe condensates (1.0 mg/ml) and cigarette smoke condensates (0.05 mg/ml) in human bronchial epithelial cells. Ingenuity Pathway Analysis (QIAGEN Bioinformatics) of the 100 genes commonly regulated by water pipe condensates and cigarette smoke condensates in small airway epithelial cells and human bronchial epithelial cells demonstrated that the top three activated upstream regulators are cigarette smoke (z-score = 2.577), benzo[a]pyrene (z-score = 2.905), and nuclear factor (erythroid-derived 2)-like 2 (NFE2L2, Nrf2) (z-score = 2.531). Analysis of downstream effects indicated that growth of epithelial tissue was predicted to be increased (z-score = 2.813; P < 0.001). The top three canonical pathways included xenobiotic metabolism signaling, aryl hydrocarbon receptor signaling, and nicotine degradation III. Conclusions: These preliminary findings strongly suggest that hookah tobacco is not a safe alternative to cigarettes, and warrant further evaluation of the epigenomic effects of hookah smoke in human respiratory epithelia using our established laboratory models and correlative analyses in hookah smokers.

Project description:IntroductionAcrolein is a highly ciliatoxic agent, a toxic respiratory irritant, a cardiotoxicant, and a possible carcinogen present in tobacco smoke including hookah tobacco.Methods105 hookah smokers and 103 non-smokers attended exclusively hookah smoking social events at either a hookah lounge or private home, and provided urine samples the morning of and the morning after the event. Samples were analyzed for 3-hydroxypropylmercapturic acid (3-HPMA), a metabolite of acrolein.ResultsGeometric mean (GM) urinary 3-HPMA levels in hookah smokers and non-smokers exposed to secondhand smoke (SHS) increased significantly, 1.41 times, 95% CI = 1.15 to 1.74 and 1.39 times, 95% CI = 1.16 to 1.67, respectively, following a hookah social event. The highest increase (1.68 times, 95% CI = 1.15 to 2.45; p = 0.007) in 3-HPMA post a hookah social event was among daily hookah smokers (GM, from 1991 pmol/mg to 3348 pmol/mg). Pre-to-post event change in urinary 3-HPMA was significantly positively correlated with pre-to-post event change in urinary cotinine among hookah smokers at either location of hookah event, (ρ = 0.359, p = 0.001), and among non-smokers in hookah lounges (ρ = 0.369, p = 0.012).ConclusionsHookah tobacco smoke is a source of acrolein exposure. Findings support regulating hookah tobacco products including reducing humectants and sugar additives, which are precursors of acrolein under certain pyrolysis conditions. We suggest posting health warning signs for indoor smoking in hookah lounges, and encouraging voluntary bans of smoking hookah tobacco in private homes.ImplicationsOur study is the first to quantify the increase in acrolein exposure in hookah smokers and non-smokers exposed to exclusively hookah tobacco SHS at hookah social events in homes or hookah lounges. Our findings provide additional support for regulating hookah tobacco product content, protecting non-smokers' health by posting health warning signs for indoor smoking in hookah lounges, and encouraging home bans on hookah tobacco smoking to safeguard vulnerable residents.

Project description:INTRODUCTION:Use of tobacco products among adolescents is a major global public health concern. Given the changing landscape of tobacco product use and the lack of epidemiologic data to inform tobacco prevention and control strategies in Kuwait, this study sought to estimate the prevalence and patterns of electronic cigarette (e-cigarette), conventional cigarette, and hookah use among adolescents in Kuwait. Moreover, exposure to secondhand smoke (SHS) and secondhand aerosol (SHA) from e-cigarettes was assessed. METHODS:This cross-sectional study enrolled high school students (n=1565; 16-19 years) across Kuwait. Current (past 30-day) use of e-cigarettes, conventional cigarettes, and hookah were assessed through self-reported data. Additionally, current (past 7-day) exposure to SHS and SHA in households and public places were ascertained. Associations were evaluated using Poisson regression, and adjusted prevalence ratios (APRs) and 95% confidence intervals (CIs) were estimated. RESULTS:Overall, 26.4% (402/1525), 25.1% (383/1525), and 20.9% (318/1525) of the study participants were current e-cigarette users, conventional cigarette smokers, and hookah smokers, respectively. Current use of any tobacco product was reported by 35.1% (535/1525) of the total study participants. The prevalence of concurrent triple use of 'e-cigarettes, conventional cigarettes, and hookah' was estimated to be 12.8% (195/1525). Also, among the study participants, 41.9% (619/1479) were exposed to household SHS, 32.0% (469/1465) were exposed to household SHA, and 62.2% (916/1472) were exposed to SHS and/or SHA in public places. Male adolescents were more likely than females to be current e-cigarette users (APR=5.19; 95% CI: 4.09-6.57), conventional cigarette smokers (APR=5.42; 95% CI: 4.26-6.90), and hookah smokers (APR=3.43; 95% CI: 2.72- 4.32). CONCLUSIONS:A substantial proportion of adolescents in Kuwait are currently using tobacco products and being exposed to SHS/SHA. The findings emphasize the need to continue monitoring all forms of tobacco product use among adolescents and to strengthen tobacco prevention and control programs.

Dataset Information

E-cigarette and hookah adoption patterns: Is the harm reduction theory just so much smoke?

Aims

Design

Findings

Conclusions

Publications

E-cigarette and hookah adoption patterns: Is the harm reduction theory just so much smoke?

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