New York University study: 18% of higher income kids smoke Hookah

7 Jul

Douglas Quenqua reported in the New York Times article, Putting A Crimp In the Hookah about hookah.

Kevin Shapiro, a 20-year-old math and physics major at the University of Pennsylvania, first tried a hookah at a campus party. He liked the exotic water pipe so much that he chipped in to buy one for his fraternity house, where he says it makes a useful social lubricant at parties.
Like many other students who are embracing hookahs on campuses nationwide, Mr. Shapiro believes that hookah smoke is less dangerous than cigarette smoke because it “is filtered through water, so you get fewer solid particles….”
Many young adults are misled by the sweet, aromatic and fruity quality of hookah smoke, which causes them to believe it is less harmful than hot, acrid cigarette smoke. In fact, because a typical hookah session can last up to an hour, with smokers typically taking long, deep breaths, the smoke inhaled can equal 100 cigarettes or more, according to a 2005 study by the World Health Organization.
That study also found that the water in hookahs filters out less than 5 percent of the nicotine. Moreover, hookah smoke contains tar, heavy metals and other cancer-causing chemicals. An additional hazard: the tobacco in hookahs is heated with charcoal, leading to dangerously high levels of carbon monoxide, even for people who spend time in hookah bars without actually smoking, according to a recent University of Florida study. No surprise, then, that several studies have linked hookah use to many of the same diseases associated with cigarette smoking, like lung, oral and bladder cancer, as well as clogged arteries, heart disease and adverse effects during pregnancy. And because hookahs are meant to be smoked communally — hoses attached to the pipe are passed from one smoker to the next — they have been linked with the spread of tuberculosis, herpes and other infections…
http://www.nytimes.com/2011/05/31/health/31hookah.html?emc=eta1&_r=0

Kids mistakenly think hookah is safe.

Anthony Rivas reported in the Medical Daily article, 1 In 5 High School Seniors Smoke Hookah;

Educating Them About Its Harms Is Crucial:
There’s no questioning the stigma cigarette smoking has developed over the past couple of decades. The health risks associated with smoking has led to large declines in the amount of smokers in the U.S. since the 1970s, dropping from around 40 percent to about 18 percent of adults. But as always, as one popular vice fades away, another one gains steam — or in this case, smoke. Now, a new study from New York University has determined how popular hookah smoking has become among high school seniors.
Traditionally from the Middle East, hookah involves smoking flavored tobacco from a large water pipe. It’s become increasingly popular in North America and other parts of the world, in part, because it’s believed to be less harmful to the body — the tobacco is considered to be milder. However, that’s not entirely the case because hookah smokers tend to take more puffs in one session, resulting in similar, if not worse effects than smoking.
The NYU researchers’ study involved data from the Monitoring the Future nationwide study, which follows teens’ behaviors, values, and attitudes. Of the almost 15,000 kids aged 18 involved in the study, 5,540 were questioned about their hookah use between 2010 and 2012. They discovered that 18 percent, or almost one in five high school seniors, had smoked hookah within the 12 months prior to being surveyed.
Interestingly, they also found that “students of higher socioeconomic status appear to be more likely to use hookah,” said Dr. Joseph Palamar, assistant professor of population health at NYU Langone Medical Center, in a press release. “Surprisingly, students with more educated parents or higher personal income are at high risk for use. We also found that hookah use is more common in cities, especially big cities. So hookah use is much different from cigarette use, which is more common in non-urban areas….” http://www.medicaldaily.com/1-5-high-school-seniors-smoke-hookah-educating-them-about-its-harms-crucial-291584

Citation:

Hookah Use Among US High School Seniors
1. Joseph J. Palamar, PhD, MPHa,
2. Sherry Zhou, BAb,
3. Scott Sherman, MD, MPHa, and
4. Michael Weitzman, MDb
+ Author Affiliations
1. Departments of aPopulation Health, and
2. bPediatrics and Environmental Medicine, New York University Langone Medical Center, New York, New York
Abstract
OBJECTIVES: Prevalence of hookah use is increasing significantly among adolescents. This study aimed to delineate demographic and socioeconomic correlates of hookah use among high school seniors in the United States. We hypothesized that more impoverished adolescents and those who smoked cigarettes would be more likely to use hookahs.
METHODS: Data were examined for 5540 high school seniors in Monitoring the Future (years 2010–2012), an annual nationally representative survey of high school students in the United States. Using data weights provided by Monitoring the Future, we used multivariable binary logistic regression to delineate correlates of hookah use in the last 12 months.
RESULTS: Eighteen percent of students reported hookah use in the past year. Compared with white students, black students were at lower odds for use (adjusted odds ratio [AOR] = 0.27, P < .0001). High parent education increased the odds for use (AOR = 1.58, P $50/week (AOR = 1.26, P < .05) or $11 to $50 per week from other sources (AOR = 1.35, P < .01) also increased odds for use. Males and urban students were also at higher odds for use, as were users of alcohol, marijuana, and other illicit substances. Former cigarette smokers were at higher risk, and current smokers were at highest risk for use.
CONCLUSIONS: Adolescents of higher socioeconomic status appear to be at particularly high risk for hookah use in the United States. Prevention efforts must target this group as prevalence continues to increase. http://pediatrics.aappublications.org/content/early/2014/07/01/peds.2014-0538.full.pdf+html

Here is the press release from New York University:

Jul 6 at 10:26 PM
PUBLIC RELEASE DATE:
7-Jul-2014
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Contact: Lorinda Klein
lorindaann.klein@nyumc.org
212-404-3533
NYU Langone Medical Center / New York University School of Medicine
NYU researchers find 18 percent of high school seniors smoke hookah
Higher socioeconomic status associated with higher rates of hookah use
New York, NY – July 7, 2014 – While cigarette use is declining precipitously among youth, evidence indicates that American adolescents are turning to ethnically-linked alternative tobacco products, such as hookahs, cigars, and various smokeless tobacco products, according to a recent report from the Centers for Disease Control and Prevention (CDC).
Now a new study by researchers affiliated with New York University’s Center for Drug Use and HIV Research (CDUHR), in the August 2014 edition of Pediatrics identifies how prevalent Hookah use is and which teens are most likely to be using it.
The study, “Hookah Use Among U.S. High School Seniors,” published online July 7, used data from Monitoring the Future (MTF), a nation-wide ongoing annual study of the behaviors, attitudes, and values of American secondary school students. The MTF survey is administered in approximately 130 public and private schools throughout 48 states in the US. Roughly 15,000 high school seniors are assessed annually. This study examined data from the 5,540 students (modal age = 18) who were asked about Hookah use from 2010-2012. The researchers found the annual prevalence (use in the last 12 months) of hookah use was nearly 1 in 5 high school seniors.
“What we find most interesting is that students of higher socioeconomic status appear to be more likely to use hookah,” said Joseph J. Palamar, PhD, MPH, a CDUHR affiliated researcher and an assistant professor of Population Health at NYU Langone Medical Center (NYULMC). “Surprisingly, students with more educated parents or higher personal income are at high risk for use. We also found that hookah use is more common in cities, especially big cities. So hookah use is much different from cigarette use, which is more common in non-urban areas.”
Hookah, an ancient form of smoking, in which charcoal-heated tobacco or non-tobacco based shisha smoke is passed through water before inhalation, is rapidly gaining popularity among adolescents in the US. The researchers found those students who smoked cigarettes, and those who had ever used alcohol, marijuana or other illicit substances were more likely to use hookah.
“Tobacco use and exposure to secondhand smoke are the leading preventable causes of morbidity and mortality in the US,” said a study co-author Michael Weitzman, MD, a professor of Pediatrics and of Environmental Medicine at the NYULMC. “Cigarette use has decreased by 33% in the past decade in the US, while the use of alternative tobacco products such as hookahs has increased an alarming 123%. This is especially worrisome given the public misperception that hookahs are a safe alternative to cigarettes whereas evidence suggests that they are even more damaging to health than are cigarettes.”
While the US is experiencing an alarming increase in hookah use among adolescents, Dr. Palamar does point out that “Use tends to be much different from traditional cigarette smoking. Right now it appears that a lot of hookah use is more ritualistic, used occasionally–for example, in hookah bars, and not everyone inhales.”
“However, times are beginning to change,” notes Dr. Palamar. “Now something called hookah pens, which are similar to e-cigarettes, are gaining popularity. While not all hookah pens contain nicotine, this new delivery method might normalize hookah use in everyday settings and bring use to a whole new level.”
Researchers note that social stigma toward cigarette use appears to have played a large part in the recent decrease in rates of use, but they caution that it is doubtful these new hookah pens are frowned upon as much as cigarettes. Hookah pens also come in trendy designs and colors, which may be appealing to both adolescents and adults.
“These nifty little devices are likely to attract curious consumers, possibly even non-cigarette smokers,” said Dr. Palamar. “And unlike cigarettes, hookah comes in a variety of flavors and is less likely to leave users smelling like cigarette smoke after use. This may allow some users to better conceal their use from their parents or peers.”
Researchers conclude increased normalization might lead to increases in use, and possibly adverse consequences associated with repeated use. “This portends a potential epidemic of a lethal habit growing among upper and middle class adolescents,” said Dr. Weitzman. They stress that it is crucial for educators and public health officials to fill in the gaps in public understanding about the harm of hookah smoking.
###
Researcher Affiliations: Joseph J. Palamar, PhD–NYULMC, Department of Population Health; NYU CDUHR; Sherry Zhou, MD, MSc 2015, NYULMC, Departments of Pediatrics and Environmental Medicine; Scott Sherman, MD, MPH, NYULMC, Department of Population Health; Michael Weitzman, MD, NYULMC, Departments of Pediatrics and Environmental Medicine.
Declaration of Interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.
Acknowledgements: This project was not funded. The National Institute on Drug Abuse, Inter-university Consortium for Political and Social Research, and Monitoring the Future principal investigators, had no role in analysis, interpretation of results, or in the decision to submit the manuscript for publication. Monitoring the Future data were collected through a research grant (R01 DA-01411) from the National Institute on Drug Abuse (NIDA), National Institutes of Health (NIH). The content is solely the responsibility of the authors and does not necessarily represent the official views of the principal investigators, NIH or NIDA
About CDUHR
CDUHR, funded by the National Institute on Drug Abuse, is the first center for the socio-behavioral study of substance use and HIV in the United States. The Center is dedicated to increasing the understanding of the substance use-HIV/AIDS epidemic, particularly among individuals in high-risk contexts. The Center’s theme is “Discovery to Implementation & Back: Research Translation for the HIV/Substance Use Epidemic.” The Center facilitates the development of timely new research efforts, enhances implementation of funded projects and disseminates information to researchers, service providers and policy makers.
About NYU Langone Medical Center
NYU Langone Medical Center, a world-class, patient-centered, integrated academic medical center, is one of the nation’s premier centers for excellence in clinical care, biomedical research, and medical education. Located in the heart of Manhattan, NYU Langone is composed of four hospitals—Tisch Hospital, its flagship acute care facility; Rusk Rehabilitation; the Hospital for Joint Diseases, the Medical Center’s dedicated inpatient orthopaedic hospital; and Hassenfeld Children’s Hospital, a comprehensive pediatric hospital supporting a full array of children’s health services across the Medical Center—plus the NYU School of Medicine, which since 1841 has trained thousands of physicians and scientists who have helped to shape the course of medical history. The Medical Center’s tri-fold mission to serve, teach, and discover is achieved 365 days a year through the seamless integration of a culture devoted to excellence in patient care, education, and research. For more information, go to http://www.NYULMC.org, and interact with us on Facebook, Twitter, and YouTube.
About New York University College of Nursing
NYU College of Nursing is a global leader in nursing education, research, and practice. It offers a Bachelor of Science in Nursing, a Master of Science and Post-Master’s Certificate Programs, a Doctor of Philosophy in Research Theory and Development, and a Doctor of Nursing Practice degree. For more information, visit https://nursing.nyu.edu/
Contact: Lorinda Klein, NYULMC | 212.404.3533 |917.693.4846 LorindaAnn.Klein@nyumc.org
Christopher James, CDUHR | 212.998.6876 | christopher.james@nyu.edu

As with a many issues adolescents face, it is important for parents and guardians to know what is going on in their children’s lives. You should know who your children’s friends are and how these friends feel about smoking, drugs, and issues like sex. You should also know how the parents of your children’s friends feel about these issues. Do they smoke, for example, or are they permissive in allowing their children to use alcohol and/or other drugs. Are these values in accord with your values?

Resources:

1. A History of Tobacco http://archive.tobacco.org/History/Tobacco_History.html

2. American Lung Association’s Smoking and Teens Fact Sheet Women and Tobacco Use
African Americans and Tobacco Use
American Indians/Alaska Natives and Tobacco Use
Hispanics and Tobacco Use
Asian Americans/Pacific Islanders and Tobacco Use
Military and Tobacco Use
Children/Teens and Tobacco Use
Older Adults and Tobacco Use http://www.lung.org/stop-smoking/about-smoking/facts-figures/specific-populations.html

3. Center for Young Women’s Health A Guide for Teens
http://www.youngwomenshealth.org/smokeinfo.html

4. Kroger Resources Teens and Smoking
http://kroger.staywellsolutionsonline.com/Wellness/Smoking/Teens/

5. Teens Health’s Smoking
http://kidshealth.org/teen/drug_alcohol/tobacco/smoking.html

6. Quit Smoking Support.com http://www.quitsmokingsupport.com/teens.htm

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