Carboxyhemoglobin concentrations in smokers of sheesha and cigarettes in Saudi Arabia.

Zahran, F M; Ardawi, M. S. M.; Al-Fayez, Saud F.

doi:10.1136/bmj.291.6511.1768-a

Cited by 75 publications

(65 citation statements)

References 3 publications

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“…Another explanation of the difference in levels of ECO might be previous findings showing that waterpipe use is associated with greater CO exposure than cigarette use [29]. Other studies also had results similar to ours, showing that a waterpipe smoker was found to likely emit as much CO as 7, 8 or even 10 cigarette smokers [19,30,31]. On another hand, although CO has been shown to vary with age [32][33][34][35] and exposure to combustion of petroleum (β = 6.03) exhaled higher levels of carbon monoxide.…”

Section: Ijomeh 2014;27(4)supporting

confidence: 62%

Carbon monoxide and respiratory symptoms in young adult passive smokers: A pilot study comparing waterpipe to cigarette

Zeidan¹,

Rachidi²,

Awada³

et al. 2014

International Journal of Occupational Medicine and Environmental Health

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Objectives: Studies have correlated second hand smoke (SHS) with many diseases, especially respiratory effects. The goal of this study was to measure the impact of SHS on the respiratory symptoms and exhaled carbon monoxide. Material and Methods: The study population consisted of 50 young workers in restaurants serving waterpipes, 48 university students who sit frequently in the university cafeteria where cigarette smoking is allowed and 49 university students spending time in places where smoking is not allowed. Subjects completed questionnaires on socio-demographic characteristics, respiratory symptoms and exposure to SHS. Exhaled carbon monoxide levels were measured. ANOVA and Chi-square tests were used when applicable as well as linear and logistic regression analysis. Results: Exposure to cigarette smoke in university (adjusted odds ratio (ORa) = 6.06) and occupational exposure to waterpipe smoke (ORa = 7.08) were predictors of chronic cough. Being married (ORa = 6.40), living near a heavy traffic road (ORa = 9.49) or near a local power generator (ORa = 7.54) appeared responsible for chronic sputum production. Moreover, predictors of chronic allergies were: being male (ORa = 7.81), living near a local power generator (ORa = 5.52) and having a family history of chronic respiratory diseases (ORa = 17.01). Carbon monoxide levels were augmented by the number of weekly hours of occupational exposure to waterpipe smoke (β = 1.46) and the number of daily hours of exposure to cigarette smoke (β = 1.14). Conclusions: In summary, young non-smoker subjects demonstrated more chronic cough and elevated carbon monoxide levels when exposed to SHS while the effect of waterpipe was even more evident.

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Section: Ijomeh 2014;27(4)supporting

confidence: 62%

Carbon monoxide and respiratory symptoms in young adult passive smokers: A pilot study comparing waterpipe to cigarette

Zeidan¹,

Rachidi²,

Awada³

et al. 2014

International Journal of Occupational Medicine and Environmental Health

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“…A study of habitual water-pipe smokers in Saudi Arabia found them to have a mean COHb level of 10.06% (SD 2.50%) compared with 1.60% (SD 0.20%) for nonsmokers and 6.47% (SD 2.73%) for cigarette smokers. 9 In contrast, our study demonstrated an acute rise in COHb levels in a single smoking session under controlled conditions.…”

Section: Discussioncontrasting

confidence: 48%

Carboxyhaemoglobin levels in water-pipe and cigarette smokers

Theron¹,

Schultz²,

Ker

et al. 2010

S Afr Med J

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Water-pipes (hookah, narghile, shisha, goza, hubble bubble and in South Africa hubbly-bubbly) have been used to smoke tobacco for more than 400 years. Traditionally in the Middle East water-pipe smoking has been the habit of older men, but it is increasing in popularity worldwide, especially among students, other young people and children. 1 The popularity of water-pipe smoking appears to be based on its social nature and the assumption that its effects are less harmful than those of cigarette smoking.2 The increase in water-pipe smoking can partly be attributed to the popularity of the sweetened and variously flavoured tobaccos that are used in the water-pipe.A water-pipe is essentially a glass bottle with hoses and a mouthpiece through which to smoke. 3 The head contains the tobacco, and since the tobacco is too moist to burn on its own, charcoal is placed on top of the tobacco-filled head. The body is fixed to the neck of the bottle, and its central conduit is submerged in the bottle. The bottle is half-filled with water and placed on the ground. The hose is attached to an aperture in the side of the pipe (Fig. 1). When the charcoal is lit, the smoker inhales through the hose. This creates a vacuum above the water, drawing air through the body and over the tobacco and charcoal. The smoke bubbles through the water, where it is diluted and cooled, and then inhaled by the smoker.Carbon monoxide (CO) is produced by the incomplete combustion of carbon-containing material, notably tobacco, biomass fuel and fossil fuel. The carboxyhaemoglobin (COHb) level in the blood (half-life 2 -6 hours) after inhalation of CO will depend on concentrations of inspired CO, duration of exposure, pulmonary ventilation and the COHb level before the inhalation. 4 COHb is a sensitive specific physiological marker of atmospheric CO exposure from both indoor and outdoor sources.In water-pipe smokers expired CO was reported to increase by 300% after an hour of smoking, while in cigarette smokers it only increased by 60%. 5During a single water-pipe smoking session a smoker may produce a 24-hour urinary cotinine level that is equivalent to smoking 10 cigarettes a day (95% confidence interval (CI) 7 -13 cigarettes a day).6 Contrary to popular belief, noxious substances such as nicotine, tar and heavy metals (chromium, arsenic, lead) are found in the smoke of water-pipes.7 Although water-pipe smoking is so widespread, its adverse health effects are not well documented. Data on CO levels in the blood after a controlled smoking session comparing water-pipe smoking with cigarette smoking are limited.We aimed to measure COHb levels in the blood before and after water-pipe smoking and cigarette smoking under controlled conditions. Materials and methodsOnly self-confessed smokers of cigarettes and water-pipes aged 18 years and older were recruited from students and hospital workers. There were no regular pipe smokers among Water-pipe smoking is growing in popularity, especially among young people, because of the social nature of the smoking sessio...

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“…It has also been found that, of 14.7 mg of metals contained in 1 gm of jurak paste, only 3.1 μg was transferred to the inhalant smoke. This indicates that the water in the sheesha reservoir does retain some of the organic and metallic inhalants by acting as a solvent and a condensation medium, and thus the carcinogenic effect of the metallic compounds in jurak smoke is reduced.In an assessment of the risk factors prevalent among Saudi citizens for smoking-related diseases, serum levels of carboxyhemoglobin among jurak smokers were found to be significantly higher than those in cigarette smokers and nonsmokers [4,5]. Zahran et al [4,5,] attributed this finding to the carbon monoxide produced from jurak and charcoal.…”

mentioning

confidence: 91%

Effects of Jurak Smoke Condensate on Enzyme Activity of the Mouse

1991

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The effect of jurak smoke condensate on the activities of alkaline phosphatase, glucose 6-phosphatase, 5'-nucleotidase, and cholinesterase of mouse liver and small intestine was investigated. Jurak smoke condensate was administered orally by stomach tube five times weekly over a three-month period. Fifteen animals were used at 1, 2, and 3 months after the start of the administration, with 5 animals killed on days 1,5, and 9, and the liver and small intestine removed for enzyme assays. The activities of all four enzymes, which are known to be sensitive to toxic agents, were significantly affected. These results indicate that the low content of tobacco leaves in jurak paste and the filtration of the smoke by water in the sheesha reservoir are not sufficient to make the smoke inhaled by smokers risk free. Cigarette smoking is common among both males and females throughout the world, and has been implicated in a variety of diseases. Smoking increases the risk of lung cancer, heart disease, and respiratory diseases of all kinds [1].Jurak (a mixture of tobacco and fruits cooked to produce a dark paste) is popular as the ingredient for hubblebubbles (sheesha). Although many Saudi subjects of both sexes and various ages are regular sheesha smokers, little experimental and clinical research has been done on the effects of sheesha smoking. It is generally believed by sheesha smokers, however, that jurak smoking is not as dangerous as cigarette smoking because there is no tobacco in the mixture.The chemical composition of jurak smoke condensate has been analyzed [2], and of 142 chemical compounds detected, only 88 were found in the smoke condensate. These include alkenes and alkynes; alkaloids and other bases; and alcohols, aldehydes, and ketones. The polynuclear aromatic hydrocarbons-the major carcinogenic agents in cigarette smoke-were not detected in jurak smoke condensate. However, El-Aaser et al [3] discovered 16 metals in jurak paste and jurak smoke condensate. It has also been found that, of 14.7 mg of metals contained in 1 gm of jurak paste, only 3.1 μg was transferred to the inhalant smoke. This indicates that the water in the sheesha reservoir does retain some of the organic and metallic inhalants by acting as a solvent and a condensation medium, and thus the carcinogenic effect of the metallic compounds in jurak smoke is reduced.In an assessment of the risk factors prevalent among Saudi citizens for smoking-related diseases, serum levels of carboxyhemoglobin among jurak smokers were found to be significantly higher than those in cigarette smokers and nonsmokers [4,5]. Zahran et al [4,5,] attributed this finding to the carbon monoxide produced from jurak and charcoal. In another study of the effect of sheesha smoke on animal models, the carboxyhemoglobin levels of sheesha-exposed rats were found to be significantly higher than those in normal control rats [6].We evaluated the long-term oral administration of jurak smoke condensate and its effect on mouse liver and

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Carboxyhemoglobin concentrations in smokers of sheesha and cigarettes in Saudi Arabia.

Cited by 75 publications

References 3 publications

Carbon monoxide and respiratory symptoms in young adult passive smokers: A pilot study comparing waterpipe to cigarette

Carbon monoxide and respiratory symptoms in young adult passive smokers: A pilot study comparing waterpipe to cigarette

Carboxyhaemoglobin levels in water-pipe and cigarette smokers

Effects of Jurak Smoke Condensate on Enzyme Activity of the Mouse

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