Hookah tobacco smoking is increasing among US college students, including those who would not otherwise use tobacco. Part of hookah's appeal is attributed to the perception that hookah is less harmful than cigarettes. The aims of this study were to assess knowledge of harmful exposures associated with hookah smoking relative to cigarette smoking and to determine associations between this knowledge and hookah smoking outcomes. Students (N = 852) at the University of Florida were randomly sampled via e-mail to obtain information on demographics, hookah smoking behavior and knowledge of five exposures (e.g. tar and nicotine). Multivariable logistic regression models assessed independent associations between knowledge and hookah smoking outcomes. Of the five factual knowledge items asked, 475 (55.8%) of the respondents answered none correctly. In multivariable models, correct responses to any knowledge items were not associated with lower odds of hookah smoking or susceptibility to hookah smoking in the future. Although college students are largely unaware of the toxicant exposures associated with hookah smoking, there is little association between knowledge and hookah smoking behavior.

Aims The average US adolescent is exposed to 34 references to alcohol in popular music daily. Although brand recognition is an independent, potent risk factor for alcohol outcomes among adolescents, alcohol brand appearances in popular music have not been systematically assessed. We aimed to determine the prevalence of and contextual elements associated with alcohol brand appearances in U.S. popular music. Design Qualitative content analysis. Setting We used Billboard Magazine to identify songs to which US adolescents were most exposed in 2005-2007. For each of the 793 songs, two trained coders independently analyzed the lyrics of each song for references to alcohol and alcohol brand appearances. Subsequent in-depth assessments utilised Atlas.ti to determine contextual factors associated with each of the alcohol brand appearances. Measurements Our final code book contained 27 relevant codes representing 6 categories: alcohol types, consequences, emotional states, activities, status, and objects. Findings Average inter-rater reliability was high (κ=0.80), and all differences were easily adjudicated. Of the 793 songs in our sample, 169 (21.3%) explicitly referred to alcohol, and of those, 41 (24.3%) contained an alcohol brand appearance. Consequences associated with alcohol were more often positive than negative (41.5% vs. 17.1%, P<.001). Alcohol brand appearances were commonly associated with wealth (63.4%), sex (58.5%), luxury objects (51.2%), partying (48.8%), other drugs (43.9%), and vehicles (39.0%). Conclusions One-in-five songs sampled from U.S. popular music had explicit references to alcohol, and one quarter of these mentioned a specific alcohol brand. These alcohol brand appearances are commonly associated with a luxury lifestyle characterised by wealth, sex, partying, and other drugs.

Objective To determine associations between positive and negative attitudes and hookah tobacco smoking (HTS) outcomes among college students. Methods Among a random sample of University of Florida students (N=852), multivariable logistic regression models assessed independent associations between positive and negative attitudes toward HTS. Results Positive attitudes were associated with adjusted odds of 4.32 (95% CI=3.20, 5.82) for current HTS, while negative attitudes were associated with lower adjusted odds for current smoking HTS (AOR=0.64, 95% CI=0.53, 0.76). Positive attitudes were also associated with adjusted odds of 9.31 (95% CI=6.77, 12.80) for intention for future hookah use. Conclusion Positive attitudes toward HTS were more strongly associated with HTS outcomes compared to negative attitudes. It may be particularly valuable for future research and interventions to focus on decreasing positive attitudes towards HTS.

Rationale: Rodent studies have shown that pyruvate dehydrogenase (PDH) levels are low in sepsis. This may cause cells to shift to anaerobic metabolism, resulting in increased lactate production. Alterations in PDH during sepsis have never been studied in humans.Objectives: The objective of this pilot study was to measure PDH activity and quantity in patients with severe sepsis. Methods:We conducted a pilot case-control study at a single urban tertiary care center. We compared PDH activity and quantity between patients with severe sepsis admitted to the intensive care unit and healthy control subjects. PDH activity and quantity were measured in isolated peripheral blood mononuclear cells. We measured PDH activity and quantity in control subjects at baseline and in patients with sepsis at 0 (baseline), 24, 48, and 72 hours. Measurements and Main Results:We enrolled 56 patients with sepsis and 20 control subjects with at least one blood sample being drawn from each patient. PDH activity and quantity in the sepsis group were significantly lower than the control group (P , 0.001). In multivariable linear regression adjusting for age, race, sex, and assay plate, the difference remained significant. Patients with sepsis who died had significantly lower PDH activity compared with those who survived (P = 0.03).Conclusions: PDH activity and quantity is decreased in peripheral blood mononuclear cells of humans with severe sepsis when compared with healthy control subjects, and may be associated with mortality. Whether decreased PDH activity plays a role in lactate metabolism or whether pharmacologic modification of PDH activity may improve outcomes remains unknown.