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Response to letter to the editor about Hookah smoking
Letter to the Editor DEAR EDITOR: I would like to comment on Ms. Serota’s interesting case study ‘‘A Pack in 30 Minutes’’ (Serota, 2007), and particularly on its Questions & Answers appendix. Concerning health effects, I am afraid the equivalence between a halfhour hookah session and 20 cigarettes (as originally cited in Loffredo [2006]) is a bit inflated, because the experimental studies these figures are generally extrapolated from were based on prototype smoking machines entailing obvious flaws (Chaouachi, 2007). Certainly our teenagers deserve clinicians’ and parents’ full attention regarding this new form of smoking in the United States and Europe (Chaouachi, 2006). Finally, to the question, ‘‘Why is hookah smoking so attractive?’’ I would like to point out that I have identified up to 15 reasons, but perhaps there are more (Chaouachi, 2007). Further research is needed in this field. Kamal Chaouachi, PhD University Paris X DIU Tabacologie Inter-University Paris XI-Paris XII doi:10.1016/j.pedhc.2008.03.003
REFERENCES Chaouachi, K. (2006). P3R (post-publication peer review): Shisha (narghile, hookah) tips for child health care clinicians. Retrieved January 4, 2008, from http://pediatrics.aappublications. org/cgi/eletters/118/3/e890. Chaouachi, K. (2007). The narghile (hookah, shisha, goza) epidemic and the need J Pediatr Health Care. (2008). 22, 270. 0891-5245/$34.00 Copyright Q 2008 by the National Association of Pediatric Nurse Practitioners.
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Volume 22
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for cleaning up confusion and solving problems related with model building of social situations. TheScientificWorldJOURNAL: TSW Holistic Health & Medicine, 207(7), 1691-1696. Loffredo, C. (2006). Hold the hookah: Researcher warns against trendy tobacco use. Retrieved January 10, 2006, from http://lombardi.georgetown.edu. Serota, J. (2007). A pack in 30 minutes. Journal of Pediatric Health Care, 21, 180-181, 209–210.
AUTHOR’S RESPONSE: Hookah smoking is a nationally growing trend in the United States, especially among college students. Students, parents and teachers need to be informed of the risks and hazards of hookah smoking. The American Lung Association (2007) published a Tobacco Policy Trend Alert about waterpipe tobacco use. This alert reviewed the existing evidence and found that the smoke from waterpipes contains significant amounts of nicotine, tar, and heavy metals and has the same adverse health effects of tobacco use including lung, oral, and bladder cancer as well as heart disease. In fact, the nicotine blood level increased up to 250% after one 40- to 45-minute session. ‘‘Waterpipe use may increase exposure to carcinogens because smokers use a water pipe over a much longer period of time, often 40 to 45 minutes, rather than the 5 to 10 minutes it takes to smoke a cigarette. Due to the longer, more sustained period of inhalation and exposure, a waterpipe smoker may inhale as much smoke as consuming 100 or more cigarettes during a single session’’ (American Lung Association, 2007, page 2).
www.jpedhc.org
The World Health Organization Study Group on Tobacco Product Regulation (2005) published an advisory on waterpipe tobacco smoking and suggested several public health initiatives for tobacco water pipes, which should be subjected to the same regulations as cigarettes. These initiatives include providing a strong health warning, educating health professionals, regulators, and the public about the risks of the tobacco waterpipes, and continuing research to develop prevention and cessation strategies. As health care professionals, we all are concerned about the risks of any type of tobacco use, and hookah smoking is another trend that is most concerning and unhealthy. Jo Ann Serota, MSN, RN, CPNP Ambler Pediatrics Ambler, Pennsylvania doi:10.1016/j.pedhc.2008.03.006
REFERENCES American Lung Association. (2007). Tobacco policy trend alert: An emerging deadly trend: Water pipe tobacco use. Retrieved March 21, 2008, from http:// www.lungusa.org/site/apps/s/content. asp?c=dvLUK9O0E&b=34706&ct= 3637143 World Health Organization Study Group on Tobacco Product Regulation. (2005). Water pipe tobacco smoking: Health effects, research needs and recommended actions by regulators. Retrieved March 21, 2008, from http://www. who.int/tobacco/global_interaction/ tobreg/waterpipe/en/index.html
Journal of Pediatric Health Care
REFERENCES Chaouachi, K. (2006). P3R (post-publication peer review): Shisha (narghile, hookah) tips for child health care clinicians. Retrieved January 4, 2008, from http://pediatrics.aappublications. org/cgi/eletters/118/3/e890. Chaouachi, K. (2007). The narghile (hookah, shisha, goza) epidemic and the need J Pediatr Health Care. (2008). 22, 270. 0891-5245/$34.00 Copyright Q 2008 by the National Association of Pediatric Nurse Practitioners.
270
Volume 22
Number 4
for cleaning up confusion and solving problems related with model building of social situations. TheScientificWorldJOURNAL: TSW Holistic Health & Medicine, 207(7), 1691-1696. Loffredo, C. (2006). Hold the hookah: Researcher warns against trendy tobacco use. Retrieved January 10, 2006, from http://lombardi.georgetown.edu. Serota, J. (2007). A pack in 30 minutes. Journal of Pediatric Health Care, 21, 180-181, 209–210.
AUTHOR’S RESPONSE: Hookah smoking is a nationally growing trend in the United States, especially among college students. Students, parents and teachers need to be informed of the risks and hazards of hookah smoking. The American Lung Association (2007) published a Tobacco Policy Trend Alert about waterpipe tobacco use. This alert reviewed the existing evidence and found that the smoke from waterpipes contains significant amounts of nicotine, tar, and heavy metals and has the same adverse health effects of tobacco use including lung, oral, and bladder cancer as well as heart disease. In fact, the nicotine blood level increased up to 250% after one 40- to 45-minute session. ‘‘Waterpipe use may increase exposure to carcinogens because smokers use a water pipe over a much longer period of time, often 40 to 45 minutes, rather than the 5 to 10 minutes it takes to smoke a cigarette. Due to the longer, more sustained period of inhalation and exposure, a waterpipe smoker may inhale as much smoke as consuming 100 or more cigarettes during a single session’’ (American Lung Association, 2007, page 2).
www.jpedhc.org
The World Health Organization Study Group on Tobacco Product Regulation (2005) published an advisory on waterpipe tobacco smoking and suggested several public health initiatives for tobacco water pipes, which should be subjected to the same regulations as cigarettes. These initiatives include providing a strong health warning, educating health professionals, regulators, and the public about the risks of the tobacco waterpipes, and continuing research to develop prevention and cessation strategies. As health care professionals, we all are concerned about the risks of any type of tobacco use, and hookah smoking is another trend that is most concerning and unhealthy. Jo Ann Serota, MSN, RN, CPNP Ambler Pediatrics Ambler, Pennsylvania doi:10.1016/j.pedhc.2008.03.006
REFERENCES American Lung Association. (2007). Tobacco policy trend alert: An emerging deadly trend: Water pipe tobacco use. Retrieved March 21, 2008, from http:// www.lungusa.org/site/apps/s/content. asp?c=dvLUK9O0E&b=34706&ct= 3637143 World Health Organization Study Group on Tobacco Product Regulation. (2005). Water pipe tobacco smoking: Health effects, research needs and recommended actions by regulators. Retrieved March 21, 2008, from http://www. who.int/tobacco/global_interaction/ tobreg/waterpipe/en/index.html
Journal of Pediatric Health Care