Health Effects of Adolescent Water Pipe Smoking with & without Cigarette Smoking

描述(申请人提供)：世界卫生组织和美国肺脏协会都报告了全球和美国青少年使用水烟斗吸烟的增长趋势。成年人吸水烟斗被证明与吸烟引起的许多相同的健康问题有关(例如，肺功能低下、恶性和非恶性肺部疾病)，但对青少年吸水烟斗对健康的影响知之甚少。如果能够在青春期发现吸食或不吸食水烟对健康的早期和潜在的严重影响，对公共健康信息的好处将是巨大的。肺功能的肺活量测定为确定青少年的肺损伤提供了客观和非侵入性的手段。有几项研究报告了青少年吸烟者的肺功能受损，但没有一项研究调查了吸烟对青少年健康的影响。人们不能假设吸水烟斗和吸烟对肺部和健康的影响是相同的，因为它们以不同的方式、不同的剂量和不同的烟草类型进行。此外，它们还会产生不同数量的烟雾、颗粒物和尼古丁。我们的假设是，吸烟可湿性粉会显著降低肺功能，并导致青少年的一般健康问题。我们的推论是，吸烟的青少年会表现出不同的产品使用模式、频率和强度，但表现出与吸烟者相似或更严重的健康问题。这项拟议的为期三年的研究将在密歇根州东南部的三所公立高中进行。之所以选择这些学校，是因为我们之前的研究发现，中东和非中东血统的学生中吸烟水烟的比例很高。将从3000名高中生那里获得详细的烟斗和香烟吸烟史和烟草使用史。300名有最长和最严重的水烟和/或吸烟史的学生将被要求参加唾液可替宁测试(以验证他们的吸烟状况)和肺功能测试。这些学生将与在关键肺功能变量(年龄、性别、身高和种族)方面匹配的非吸烟者(n=300)进行比较。这些分析将评估吸烟状况对每个肺活量测定结果(FEV1、FVC、FEV1/FVC、FEV25-75)的影响。我们将确定吸烟烟斗和香烟的共同影响以及各自的独立影响。每种吸烟类型的相对影响将在剂量反应分析中进行检验，并通过对四个吸烟状态组的每个肺活量参数进行排名来检验。将确定可湿性粉尘和香烟吸烟开始和发展的模式和预测因素。 与公共健康相关：在中东、北非和亚洲，水烟斗吸烟(WPS)是一个非常古老的传统，现在全世界和美国都在使用。对于肺部仍在发育的青少年来说，这尤其危险。这项研究将考察青少年WPS对肺功能和一般健康的影响。此外，我们将确定这种形式的烟草使用的模式和预测因素。

DESCRIPTION (provided by applicant): The World Health Organization and the American Lung Association both report a growing trend in the use of water pipes for tobacco smoking by youth around the world and in the U.S.A. Water pipe smoking by adults has been shown to be associated with many of the same health problems that result from cigarette smoking, (e.g., poor lung function,malignant and non-malignant lung disease) but little is known about the health effects of water pipe smoking in adolescents. If early and potentially serious health effects can be identified in adolescence from water pipe smoking with or without cigarette smoking, the benefit to the public health message would be enormous. Spirometric measures of lung function provide an objective and noninvasive means to identify lung damage in adolescents. A few studies have reported impaired lung function in adolescent cigarette smokers but none have examined the health effects of water pipe smoking in adolescents. One cannot assume the lung and health consequences of water pipe and cigarette smoking are the same as they are performed in different ways with different doses and with different tobacco types. In addition, they produce different volumes of smoke, particulates, and nicotine. Our hypothesis is that WP smoking significantly diminishes lung function and contributes to general health problems in adolescents. Our corollary hypothesis is that adolescents who smoke the water pipe will show differing patterns, frequency, and intensity of product use, yet manifest similar or worse health problems than those found in cigarette smokers. The proposed three-year study will be conducted in three public high schools in southeastern Michigan. These schools were selected because our prior research found a high prevalence of water pipe smoking among students with Middle Eastern and non-Middle Eastern heritage. A detailed water pipe and cigarette smoking "life time" history of tobacco use will be obtained from 3000 high school seniors. The 300 students with the longest and most severe water pipe and/or cigarette smoking histories will be asked to participate in saliva cotinine testing (to verify their smoking status) and pulmonary function testing. These students will be compared with nonsmokers (n = 300) matched on key pulmonary function variables (age, gender, height, and ethnicity). The analyses will estimate the effects of smoking status on each of the spirometry outcomes (FEV1, FVC, FEV1/FVC, FEV25-75). We will determine the joint effect of smoking both water pipes and cigarettes and the independent effects of each. The relative effects of each type of smoking will be examined in a dose response analysis and by ranking the four smoking status groups on each of the spirometric parameters. Patterns and predictors of WP and cigarette smoking initiation and progression will be identified. PUBLIC HEALTH RELEVANCE: Water pipe smoking (WPS) is a very old tradition in the Middle East, North Africa, and Asia, which is now growing in use around the world and in the United States. It is especially dangerous for adolescents whose lungs are still developing. This study will examine the effects of adolescent WPS on lung function and general health. In addition, we will determine the patterns and predictors of this form of tobacco use.