found that peer pressure and curiosity were reported as the most common triggers behind the commencement of waterpipe smoking by Egyptian females. Apart from the health risks and addiction, many young waterpipe users are attracted to its aromatic smell and the chance it provides for social interface. In qualitative studies among Arab American adolescents, waterpipe use has been seen as being “cool” and a means to hang out with friends  . Smith reported that socializing is a general thought in the few studies conducted in the United States making an allowance for shisha smoking a fine approach to hang out with friends . Likewise the findings of our study revealed that curiosity was the prime reason of burning up shisha (23%), followed by hanging out with friends (21%) and pleasure- seeking (18%). Shisha smoking was found relaxing by more than 50% persons; 21.37% felt drowsy and 21.37% suffered from headache/nausea/vomiting after its consumption (Fig 2).
Our study population consisted of 578 medical students from both public and private sectors. Out of them 544 (94.1%) said that they were familiar with the term shisha smoking and 208(36%) confessed that they had smoked water pipe at least once. In our study out of 208 smokers ,40(19.23%)experienced shisha for 1st time between 10-15 years of age, 110(52.88%)between 15-20 years of age and 57(27.40%)above 20years of age which is similar to a study done by Qudsia Anjum that shows that the mean age of students initiating shisha smoking was 14 years 13 . Results of study by Moham-
The dangers of smoking shisha have been established and the next phase of action is to identify individuals who are at a higher risk of developing serious consequences. The severity of cigarette smoking can be catego- rized by number of cigarettes smoked, but categorizing the severity of shisha addiction has not yet been standar- dized. Several options were given by various groups, including the Lebanon Water pipe Dependence Scale which uses an 11 scale questionnaire to discriminate between mild, moderate and heavy shisha smoking .
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The smoking of Shisha is a tobacco smoking, occasionally combined with molasses sugar or fruit through a tube or hose and a bowl. The claim has been made that over 100 million people across the world are using Shisha smoking on daily basis. Using of Shisha is a normal practice in Bangladesh, India, Middle East, Pakistan, Turkey and some parts of China. It has been revealed in the estimation that the deaths caused by the tobacco are expected to increase from 5.4 million in 2005 to 6.4 million in 2015 and by 2030 it will be 8.3 million. There are different forms of using tobacco, but Shisha smoking is getting more popular only due to the reason it appeals to the youths.
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This study was done to investigate the knowledge, attitude and practices of shisha smoking among doctors in our society. A previous study was done in Karachi to investigate shisha use among doctors , but this is the first of its kind which has been done across five major metropolitan cities. Moreover, this is the first time that the attitude of physicians and surgeons towards shisha smoking has been compared in Pakistan. In the Karachi study , 5.2% of doctors admitted to using shisha daily, whereas our study showed that 15.7% of all doctors smoke shisha daily, with the number being higher amongst surgeons (p <0.001). In a study conducted on Iranian physicians, 4.3% used shisha regularly , whilst a Bahrain study showed it to be 4% . Amongst the study participants, there was a higher number of female doctors (70%), which may reflect their willingness to participate in the study, and may also be due to social norms due to which females choose shisha smoking over cigarette smoking . Of those who smoke shisha, 54.6% of surgeons and 46.9% of physicians said that they were not ready to quit in the next six months (p=0.002). This was a better result than a study conducted on Americans with Middle Eastern ethnicity, where 73% of shisha smokers reported no intention to quit smoking . In a similar study conducted India, it was seen that 66.7% of participants had no intention to quit . About 75% of those surveyed were age 40 or under, which may reflect the willingness of younger doctors to participate in the survey.
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Sultan Ayoub Meo, a senior physiology professor at King Saud University, recently suggested a shisha-MERS linkage. Specifi- cally, he argued that shisha café culture, which is common in Saudi Arabia and is predominantly practiced by men in public, may further exacerbate the spread of the MERS vi- rus in Saudi Arabia. Other studies suggest shisha smoking, also known as “hookah” smoking, may be a mechanism that increases the risk of MERS virus among family and friends. Notably, shisha uses tobacco that is sweetened with fruit or molasses sugar, which makes the smoke more aromatic than a cigarette. 23 Wood, coal, or even charcoal is used to burn the
In this study, overall student knowledge and belief about the detrimental effects of smoking such as cardiac problem, hypertension, shisha contains more nicotine and is more addictive than cigarettes was higher among students who had the intention to quit compared to the students who did not have intention to quit shisha smoking. This finding is consistent with previous studies that students intend to quit shisha as they experience various health problems such as dry throat, headache and nausea [6,27]. Students were willing to quit when they believe water pipe smoking was harmful . This study could not find significant difference between, students who had intention to quit and non-intention to quit shisha on the detrimental effect of smoking leads to cancer, sexual dysfunction, gum infection, stroke and shisha pipe filters the toxic substance. This indicates both group students did not have adequate knowledge and belief about the detrimental effect of shisha smoking. This could be one of the reasons for the students to continue their smoking habit. Though the university warns the consequences of smoking, students tend to smoke shisha as they have insufficient knowledge about shisha and strongly believe that shisha is not harmful to them. So there is a need to educate and promote awareness by conducting workshop and incorporating health awareness programs in the curriculum.
Abstract Background: Acute sepsis in the region of the anus is common and important clinical and surgical problem. The objective of the study was to study the risk factors and complications of anorectal abscess in Khartoum state. Patients and methods: This was hospital based, retro-prospective, case control and multicenter study was done in Khartoum state public teaching hospitals. All patients underwent perianal abscess drainage in the selected hospitals during the study period were included and matched with control group who never diagnosed with anorectal abscess. 108 patients were included as cases and 108 as control group. Results: Gender distribution was the same in both groups. Considering risk factors, the study showed that Shisha smoking (P value = .001), cigarette smoking (P value = .005), diabetes (P value = .015), past history of anorectal abscess (P value = .03) all statistically significant as risk factors for developing anorectal abscess. We observed that, in the case group 94% of patients presented by anal pain, 62% by indurated mass and 43% by fever. Regarding abscess type, perianal abscess form 58% of types, while other types like isciorectal, submicosal and intersphiteric form the remaining 42%. Regarding Complications, 20.4% develop Fistula and 15.7% of cases complicated by recurrence of the abscess. Sixteen percent of cigarettes smokers suffered from abscess recurrence (7/45) and a high rate (8/39) 21% was seen in Shisha smokers group, while a much higher rate (9/20) 45% was observed in diabetic patients. In this study only cigarettes smoking is statistically significant for abscess recurrence (p value 0.04). Conclusion: The main risk factors for developing anorectal abscess is smoking either cigarette or shisha, cigarette smoking is the main cause of complications, and the most common presenting symptom is anal pain.
“TURBO Dokha Premium-1” was found to contain the highest level of cadmium (58.460 µg/g), whereas the cadmium level did not exceed 5 µg/g in all the other tobacco samples. Apart from its high level of cadmium, “TURBO Dokha Premium-1” also contained high levels of Al (231.575 µg/g), B (162.455 µg/g), Fe (654.700 µg/g), and Pb (438.170 µg/g). It is worth noting that “Al Fakher Double Apple Shisha” contained small concentrations of the heavy metals compared to the other studied tobaccos. This was also noticed with the Marlboro Cigarette Tobacco with the exception of its high contents of Fe, Mn, and Pb. “Dokha” tobacco has been very much spread among youngsters and a wide variety of this product is available in the market. Smoking “dokha” is very damaging since 100% of the smoke is directly inhaled to the lungs and no pauses exist between one inhale and the other as it is common with cigarettes, cigars, and shisha smoking.
As far as can be ascertained a study To determine the prevalence of cigarette and Shisha Smoking and the prevalence of tuberculosis among age and sex groups has not been conducted yet in the Sudan*, therefore, such study was justifiable and highly needed, Putting in mind the increasing incidence rate of T.B in the Sudan generally and specially in the White Nile area.
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This study aims to examine the risk of bacterial and fungal transmission through frequent or repeated usage of the same water pipe by different smokers in public café shops. A total of 110 samples were extracted from different parts of used shisha apparatuses. These samples were collected from different cafes in seven cities in the UAE in the time period between Nov. 2016 and Feb. 2017. In all 110 samples, the bacterial and fungal strains were examined at Canadian university Dubai laboratories using standard protocols for culturing, isolating and identifying microorganisms. Later on, the samples were sent to Iranian hospital Dubai to examine the resistance of isolated bacteria to common antibiotics. Statistical analysis was conducted using quantitative data analysis and figures were expressed in percentage for clearer conclusion. Five bacterial strains were detected which are; Pseudomonas putida; Staphylococcus saprophyticus; Micrococcus luteus; Bacillus cereus and Providencia alcalifaciens (See table 2). One of the most important findings of the current study is the isolated bacteria Staphylococcus saprophyticus which showed methicillin resistance. Shisha smoking is a public health issue and could be a carrier of pathogens for smokers. There is a need for further assessments to address the impact of the sharp increase of Shisha smoking among specific populations especially in the Gulf countries (GCC) and among the female segment of society.
2013). In order to come up with an intervention strategy for stopping the use of shisha in Saudi Arabia, several factors need to be considered. First of all, the aforementioned limitations should be addressed and strategies to overcome them should be developed. This would ensure that whatever strategies are employed hereafter are not impeded by any current limitations. The first step to creating a suitable management plan would be to address the issues that have arisen from the steps taken so far (Maziak, Ward and Eissenberg, 2007). Consideration needs to be given to the suppliers of tobacco and how to deal with them. Tobacco in Saudi Arabia is not grown at all. It is imported from abroad in crude form and then refined in the country to make the tobacco that is consumed by smokers. The government authorities would begin the intervention process by looking for ways to stop the entry of tobacco in whatever form into the country. These measures could take the form of import bans or very high import taxes on imported tobacco. Consumers could also be banned from using tobacco. These bans once enforced would make it very hard for the suppliers to acquire the product and consequently the consumers would also find it difficult to possess tobacco (Ministry of Finance and National Economy, 1996). Moreover, the intervention plan should take into consideration the involvement of researchers. These researchers would be in a position to provide insights into the situation as it is and as it would be after the implementation of the intervention strategies. Aside from the researchers, the non-governmental organizations in Saudi Arabia could be involved in implementing a ban and eventually in tobacco control. This would ensure that there is enough information to work with in relation to the issue of shisha smoking (Maziak, Ward and Eissenberg, 2007).
A second argument against smoking reduction is that encouraging smoking reduction might increase the risk of undermining smoking cessation efforts. Reduction may have given smokers an easy way out and a false sense of dealing with their smoking (Hughes et al., 1999). However, some have made the converse argument (Hill et al., 1988; Hughes et al. 1999; Fagerström, Tejding, Westin & Lunell, 1997) . Reduction could increase self-efficacy about gaining control over one’s smoking and thus promote cessation attempts . One study showed that the chance of smoking cessation in participants who had cut down to 1-9 cigarettes per day at the end of a smoking cessation treatment, is equal to those who did not reduce (Hill et al., 1988). This study contained a smoking cessation course among 1326 participants. This result shows that reduction does not undermine cessation, while reduction has no negative influence on future quit attempts. Hughes et al. (1999) also showed no significant differences in future quit attempts between quitters and reducers. Also, in a study of four weeks where subjects took nicotine replacement medications on smoking reduction, 93% of the subjects reported they were even more likely to give up smoking as a consequence of reduction in the intervention. The attitude towards reduction as a good method to quit smoking, was positive in 92% of the subjects (Fagerström et al., 1997).
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Our finding that current smokers had lower prostate cancer incidence than never smokers is consistent with reports from previous studies [13, 34]. However, this apparent protective effect seems to be confined only to low-grade/localized prostate tumors, whereas higher- grade/advanced prostate tumors were directly associated with smoking . We observed higher prostate cancer mortality among current smokers and an advancement of nearly 2 years of the risk of prostate cancer death among current smokers. We also observed a delay in the risk of prostate cancer mortality by nearly 2 years after 20 years since smoking cessation. Furthermore, both higher smoking intensity and duration were associated with increased prostate cancer mortality. A plausible ex- planation for the apparent differences between prostate cancer incidence and mortality may be that current smokers might be less likely to seek medical attention and undergo prostate cancer screening than never smokers, therefore being less often diagnosed with low-grade/local- ized tumors. Alternatively, mechanisms have been proposed
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Buechley et al. studied the relationship of amount of cigarette smoking to coronary heart disease mortality rates in men . Robinson et al. conducted a comparative study of the amount of smoke absorbed from low yield cigarettes with both non-invasive and invasive measures [25,26]. Weijenberg et al. discussed the cigarette smoking and KRAS oncogene mutations in sporadic colorectal cancer based on the results from the Netherlands Cohort Study . Mulder et al. studied the effect of smoking and time since quitting on the smoking cessation and quality of life . Glasgow et al. studied the self-help books and amount of therapist contact in smoking cessation programs . Jonh et al. studied the relationship between nicotine dependence and lifetime amount of smoking in a population sample . Hammond revealed the inhalation in relation to type and amount of smoking . Gao et al. proposed a new form of independent variable educed from the number of cigarettes smoked per day .
Children ’ s exposure to passive smoking is associated with a range of adverse health outcomes for children . Parental smoking is the most common source of children’s exposure to passive smoking. In our study about one third of the participants revealed having at least one (up to maximum of four) smokers in their homes; these smokers are exposing 269 children to pas- sive smoking, most of the smokers being fathers of these children. Bloch et al has also reported 51.4% of children being exposed to passive smoking in a large sample of pregnant women in Pakistan . Knowledge of harmful effects is the key determinant in reducing the passive smoking exposure of children/women as the leg- islations cannot reach the home, which is the primary place of passive smoking for women and young children . A large number of women in our study recognized passive smoking to be harmful for children ’ s health, though knowledge of specific effects was limited. It has been shown that educating parents about health risks of SHS would significantly reduce exposure to passive Table 3 Perceptions towards smoking and its associated factors among women attending primary care clinics in Karachi, Pakistan
SSB of CS in Japan is estimated at more than US$ 1,052 million, which is not acceptable by all means from tax payers’ point of view. Banning smoking during office hours is a good motivation for smokers to eventually quit smoking, thereby improving their work productivity and improving their health condition. No smoking colleagues can be free from the extra work during the absence of smokers for smoking break and avoid the risk of exposure to third-hand smoke. This is a ”win, win” proposal, which is beneficial for not only tax-payers, but also CS regardless of their smoking status. In addition, ban on smoking of CS during office hours should have the good influence to private work places and promote tobacco de-normalization as the social norm in Japan.
Study strengths include the large sam- ple size and heterogeneous population in terms of duration of tobacco use and frequency and quantity of use. Ad- ditional strengths include the carefully designed intervention on the basis of current recommendations and tai- lored for adolescents; a rigorous, ran- domized controlled design with a con- dition controlling for contact with the school nurse and access to informa- tion on smoking and cessation; bio- chemical validation of self-reported abstinence; long-term follow-up; use of an intent-to-treat analysis; use of real- world providers to deliver the inter- vention; and strong retention rates of 96.4% at 3-month and 88.4% at 12- month follow-up. Limitations of the study include potential variability be- tween school nurses in ﬁdelity to deliv- ering the intervention protocol given this was an effectiveness trial, that we did not address forms of tobacco use other than cigarette smoking, and the study was limited to 1 geographical area.
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single popular movie with smoking can deliver tens of millions of smoking depictions to adolescents on the first run at the box office. Once that film also appears on DVD, video, and movie channels, the movie extends its reach and may ultimately deliver hundreds of millions of gross smoking impressions to youth. These findings rep- resent a conservative estimate of the impact of movies, because we did not assess exposure to all of the films, did not determine how many times adolescents had seen each film, and restricted our survey to a both a narrow age range and date range for the movie sample. Indeed, children begin watching animated movies with smoking as preschoolers, and, with the penetration of VCRs and DVD players, are able to view their favorite films over and over throughout childhood and adolescence. Older movies are also readily available, resulting in the deliv- ery of many more smoking depictions from these films than we were able to document in this study.
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Coronary artery disease (CAD)  is the end result of the accumulation of atheromatous plaques within the walls of the coronary arteries .Atherosclerosis is a disease in which fatty substances such as cholesterol, cellular waste, calcium and other substances are deposited along the lining of the artery walls. These sticky, yellowish deposits, known as plaques, may progress to the narrowing of the arteries and is the most coronary arteries are the major sites of atherosclerotic disease. A spectrum of symptoms result, the severity ofwhich depends on the extent of the involvement and the available collateral circulation. Thus, the symptoms may range from pain at rest to exertion. The pain is due to insufficient blood flow in the risk factors for atherosclerosis are gender, age , heredity, cigarette smoking, diabetes, high blood pressure, high triglyceride levels, low density lipoprotein levels, chronic kidney disease, abdominal aortic aneurysm, alcohol abuse, overweight, not getting enough exercise, excessive amounts of stress and excess C-reactive the single most important, independent and effective risk factor of that the risk of smokers developing coronary heart disease is at least 2–4 times of that seen in nonsmokers. Although all types of tobacco smoking are known to increase the risk of developing CAD, smoking cigarettes particularly increases this risk more than pipe smoking or cigar smoking. Environmental tobacco smoke which is also called passive smoke is known to cause chronic respiratory conditions, cancer, and heart disease. Active and passive tobacco smoke is associated with the dysfunction of the endothelial physiology and vascular impairment.