Perceptions of Hookah Smoking Harmfulness: Predictors and Characteristics Among Current Hookah Users (2009) Khaled Aljarrah, Zaid

Q Ababneh & Wael K Al-Delaimy Sara Boland Anatomy & Physiology II Professor Winters-Ricci Spring 2012

Introduction Lung cancer is a leading cause of cancer death around the world. Lung cancer is overwhelmingly caused by cigarette smoking. Up to 87% of lung cancer deaths worldwide can be attributed to cigarette smoking. In the United States, nearly 90% of lung cancers are the result of smoking. (Marieb & Hoehn, 2010) In addition to lung cancer, smoking causes cancers of the larynx, mouth, pharynx, esophagus and bladder. (Aljarrah etal, 2009) Once diagnosed the cure rate is notoriously low, with most victims dying with in one year of diagnosis. (Marieb & Hoehn, 2010) Continued cigarette smoking after diagnosis increases the resistance to treatment, specifically in lung cancer patients. (Aljarrah et al, 2009) Tobacco smoke contains over 60 carcinogens that can cause respiratory ailments in addition to cancer. Nicotine, which is contained in the tobacco smoke, depresses the immune systems response to malignant growth in tissue exposed to smoke. (Aljarrah et al, 2009) Hookah smoking is another way of ingesting tobacco smoke. The practice of hookah smoking began in India in the 15th century, migrated to the Ottoman Empire, Egypt, Mediterranean regions and the Middle East. (Aljarrah et al, 2009) More recently the popularity of hookah smoking has spread to Europe and the United States. There are many different flavors of tobacco available in for use in a hookah and this recent addition of flavors to hookah tobacco has helped to spike the popularity of hookah use. There seems to be some perception amongst hookah smokers about how safe the tobacco smoke from a hookah is. It is not any less harmful than smoke from a cigarette. It contains more nicotine

and more heavy metals than cigarette smoke. In addition, because the burning temperature of the hookah tobacco is so much higher than that of a cigarette, about 900 degrees to a cigarettes 450 degrees, it is possible that the hookah smoke actually contains more harmful ingredients released by the excessive heat. (Aljarrah et al, 2009) The Centers For Disease Control state that Due to the mode of smokingincluding frequency of puffing, depth of inhalation, and length of the smoking sessionhookah smokers may absorb higher concentrations of the toxins found in cigarette smoke. (www.cdc.gov) A hookah draws the tobacco smoke through the chamber of the hookah which contains water. Quite often a session of hookah smoking at a hookah bar can last approximately an hour and it is due to this length of time that the CDC also states that A typical 1-hourlong hookah smoking session involves inhaling 100200 times the volume of smoke inhaled from a single cigarette. (www.cdc.gov) Despite the fact that smoking tobacco from a hookah is decidedly harmful and certainly no less harmful than that of cigarette smoking, because of the water filtration process in a hookah many smokers perceive it to be safer than other forms of tobacco ingestion. This study is designed to assess the beliefs of hookah smokers about harmful hookah smoking is. ( Aljarrah et al, 2009)

Methods The participants in the survey are individuals who were actually inside said venues while data was being collected. A survey was handed out to willing participants over a four week period in August and September of 2008 mostly nights and weekends due to the popularity of those nights amongst patrons. (Aljarrah et al, 2009) There were 257 participants in this study and 57% of them were male. The participants were 32.9% white, 22.4% Latino, 21.5% Middle Eastern, 11% Asian and 6.6% African American. The average age of the participants was 21.8 years. Amongst the 257 participants, only 28.4% were cigarette smokers. A total of 35.2% of the hookah smokers surveyed smoked every week, with 27% smoking hookah only every six months, 24.4% smoking every month, and 13.5% smoking hookah every day. ( Aljarrah et al, 2009)

Results The vast majority of hookah smokers believe hookah to be less harmful than cigarettes at a whopping 58.3%. Only 30.4% of survey participants do not believe that smoking hookah is more harmful than cigarettes and these beliefs were split fairly evenly between males and females, nor was there any distinction in belief between smokers and non-smokers. ( Aljarrah et al, 2009) Ethnic groups and their beliefs about the safety of hookah smoking showed any statistical significance with Whites, African Americans and Middle Eastern individuals much more likely to believe that hookah smoking is less harmful than cigarettes. Asians and Latinos were more likely to believe that hookah smoking is more harmful than smoking cigarettes. ( Aljarrah et al, 2009)

Conclusion This study fulfilled the objectives of its authors by showing that there are a large number of individuals in the United States who believe that smoking from a hookah is less harmful to their health than smoking cigarettes. In fact, the authors were able to show that a very high percentage of hookah smokers are operating under the belief that they are engaging in less risky behavior than cigarette smoking by partaking in hookah. They found that these widespread misconceptions are more prevalent amongst certain ethnic groups. There are a higher percentage of cigarette smokers amongst the studys [participants versus the general public. This study shows how these misconceptions, which run demographically, might cause increased usage of hookah. It might serve the objective of the study to survey individuals who do not habitually partake of hookah smoking to see how their perceptions are different than those in this study who were interviewed inside a hookah bar.

Works Referenced Aljarrah, Khaleed & Ababneh, Zaid Q. & Al-Delaimy, Wael K. (18 December 2009). Perceptions of Hookah Smoking Harmfulness: Predictors and Characteristics Among Current Hookah Users. Tobacco Induces Diseases, Volume 5:16. doi: 10.1186/16179625-5-16. Marieb, Elaine N. & Hoehn, Katja. (2010). Human Anatomy & Physiology. San Francisco, CA: Pearson Benjamin Cummings Smoking & Tobacco Use. (n.d.) Centers For Disease Control and Prevention. Retrieved from http://www.cdc.gov/tobacco/ data_statistics/ fact_sheets/tobacco_industry/hookahs/#overview