Do you really understand Hookah?

Hookahs

• Overview
• Compared with Cigarettes
• Health Effects
• References
• For Further Information

Overview

• Hookahs are water pipes that are used to smoke specially made tobacco that comes in different flavors, such as apple, mint, cherry, chocolate, coconut, licorice, cappuccino, and watermelon.1,2

• Although many users think it is less harmful, hookah smoking has many of the same health risks as cigarette smoking.1,2
• Hookah is also called narghile, argileh, shisha, hubble-bubble, and goza.1,2
• Hookahs vary in size, shape, and style.2
• A typical modern hookah has a head (with holes in the bottom), a metal body, a water bowl, and a flexible hose with a mouthpiece.3,4
• Hookah smoking is typically done in groups, with the same mouthpiece passed from person to person.1,2,3,4

Tobacco users should quit all tobacco products to reduce health risks.

Hookah smoking is NOT a safe alternative to smoking cigarettes.1

Hookah Use

• Hookah use began centuries ago in ancient Persia and India.1,2,3,4
• Today, hookah cafés are gaining in popularity around the world, including Britain, France, Russia, the Middle East, and the United States.1
• Hookah use by youth1,2,3 and college students is increasing.5
• In 2010, the Monitoring the Future survey found that among high school seniors in the United States, about 1 in 5 boys (17%) and 1 in 6 girls (15%) had used a hookah in the past year.5
• Other small studies of young adults have found high prevalence of hookah use among college students in the United States. These studies show past-year use ranging from 22% to 40%.5
• New forms of electronic hookah smoking, including steam stones and hookah pens, have been introduced.
  • These products are battery powered and turn liquid containing nicotine, flavorings, and other chemicals into a vapor, which is inhaled.6
  • Very little information is currently available on the health risks of electronic tobacco products.6

Health Effects

Using a hookah to smoke tobacco poses serious health risks to smokers and others exposed to the smoke from the hookah.

Hookah Smoke and Cancer

• The charcoal used to heat the tobacco can raise health risks by producing high levels of carbon monoxide, metals, and cancer-causing chemicals.1,4
• Even after it has passed through water, the smoke from a hookah has high levels of these toxic agents.4
• Hookah tobacco and smoke contain several toxic agents known to cause lung, bladder, and oral cancers.1,4
• Tobacco juices from hookahs irritate the mouth and increase the risk of developing oral cancers.4,7

Other Health Effects of Hookah Smoke

• Hookah tobacco and smoke contain many toxic agents that can cause clogged arteries and heart disease.1,4
• Infections may be passed to other smokers by sharing a hookah.2
• Babies born to women who smoked water pipes every day while pregnant weigh less at birth (at least 3½ ounces less) than babies born to nonsmokers.5,8
• Babies born to hookah smokers are also at increased risk for respiratory diseases.8

Hookah Smoking Compared With Cigarette Smoking

• While many hookah smokers may think this practice is less harmful than smoking cigarettes, hookah smoking has many of the same health risks as cigarette smoking.1,2
  • Water pipe smoking delivers nicotine—the same highly addictive drug found in other tobacco products.2
  • The tobacco in hookahs is burned (exposed to high heat) and the smoke is at least as toxic as cigarette smoke.1,2
• Because of the way a hookah is used, smokers may absorb more of the toxic substances also found in cigarette smoke than cigarette smokers do.1,2
  • An hour-long hookah smoking session involves 200 puffs, while smoking an average cigarette involves 20 puffs.1,2
  • The amount of smoke inhaled during a typical hookah session is about 90,000 milliliters (ml), compared with 500–600 ml inhaled when smoking a cigarette.4
• Hookah smokers may be at risk for some of the same diseases as cigarette smokers. These include:3,4
  • Oral cancer
  • Lung cancer
  • Stomach cancer
  • Cancer of the esophagus
  • Reduced lung function
  • Decreased fertility

• Hookahs and Secondhand Smoke

  • Secondhand smoke from hookahs can be a health risk for nonsmokers. It contains smoke from the tobacco as well as smoke from the heat source (e.g., charcoal) used in the hookah.1,5,9

  Nontobacco Hookah Products

  • Some sweetened and flavored nontobacco products are sold for use in a hookah.10
  • Labels and ads for these products often claim that users can enjoy the same taste without the harmful effects of tobacco.10
  • Studies of tobacco-based shisha and “herbal” shisha show that smoke from both preparations contain carbon monoxide and other toxic agents known to increase the risks for smoking-related cancers, heart disease, and lung disease.10,11

  References

  1. American Lung Association. An Emerging Deadly Trend: Waterpipe Tobacco Use . [PDF–222 KB] Washington: American Lung Association, 2007 [accessed 2013 Dec 17].
  2. American Lung Association. Hookah Smoking: A Growing Threat to Public Health Issue Brief. . [PDF–1.34 MB] Smokefree Communities Project, 2011 [accessed 2013 Dec 17].
  3. Akl EA, Gaddam S, Gunukula SK, Honeine R, Jaoude PA, Irani J. The Effects of Waterpipe Tobacco Smoking on Health Outcomes: A Systematic Review. International Journal of Epidemiology 2010;39:834–57 [accessed 2013 Dec 17].
  4. Cobb CO, Ward KD, Maziak W, Shihadeh AL, Eissenberg T. Waterpipe Tobacco Smoking: An Emerging Health Crisis in the United States. American Journal of Health Behavior 2010;34(3):275–85 [accessed 2013 Dec 17].
  5. U.S. Department of Health and Human Services. Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Office on Smoking and Health, 2012 [accessed 2013 Dec 17].
  6. U.S. Food and Drug Administration. Electronic Cigarettes (e-Cigarettes) [last updated 2013 April 25; accessed 2013 Dec 17].
  7. El-Hakim Ibrahim E, Uthman Mirghani AE. Squamous Cell Carcinoma and Keratoacanthoma of the Lower Lips Associated with "Goza" and "Shisha" Smoking. International Journal of Dermatology 1999;38:108–10 [cited 2013 Dec 17].
  8. Nuwayhid, I, Yamout, B., Ghassan, and Kambria, M. Narghile (Hubble-Bubble) Smoking, Low Birth Weight and Other Pregnancy Outcomes . American Journal of Epidemiology 1998;148:375–83 [accessed 2013 Dec 17].
  9. Cobb CO, Vansickel AR, Blank MD, Jentink K, Travers MJ, Eissenberg T. Indoor Air Quality in Virginia Waterpipe Cafés. Tobacco Control 2012 Mar 24 doi:10.1136/tobaccocontrol-2011-050350 [cited 2013 Dec 17].
  10. Shihadeh A, Salman R, Eissenberg T. Does Switching to a Tobacco-Free Waterpipe Product Reduce Toxicant Intake? A Crossover Study Comparing CO, NO, PAH, Volatile Aldehydes, Tar and Nicotine Yields. Food and Chemical Toxicology 2012;50(5):1494–8 [accessed 2013 Dec 17].
  11. Blank MD, Cobb CO, Kilgalen B, Austin J, Weaver MF, Shihadeh A, Eissenberg T. Acute Effects of Waterpipe Tobacco Smoking: A Double-Blind, Placebo-Control Study. Drug and Alcohol Dependence 2011;116(1–3):102–9 [cited 2013 Dec 17].

  For Further Information

  Centers for Disease Control and Prevention
  National Center for Chronic Disease Prevention and Health Promotion
  Office on Smoking and Health
  E-mail: tobaccoinfo@cdc.gov
  Phone: 1-800-CDC-INFO
  Media Inquiries: Contact CDC's Office on Smoking and Health press line at 770-488-5493.

The 5 Healthiest Winter Fruits and Vegetables

by Keri Gans, R.D.N.

It seems every year when winter approaches, many of my patients complain, "There just aren't as many fruits and veggies available." I, of course, beg to differ. Yes, the farmers markets and supermarkets aren't booming with an assortment of colorful berries (at least tasty and inexpensive ones), tomatoes, or corn, but they still have plenty of healthy options. These five are delicious and provide the greatest nutrition bang for your caloric buck. You just might miss them come summer.




1. Beets: The problem with beets is that many people avoid them because they think they are high in sugar. However, that really isn't so: One raw beet has 5.5 grams for 35 calories. Plus they are a good source of magnesium and calcium (both important for bone health), iron (which you need for energy and to prevent and hair loss), fiber (to help to fill you up), and folic acid (necessary for the production and maintenance of new cells in our bodies, and especially important for pregnant woman). Beets are especially important during the winter because they have a unique source of phytonutrients, called betalains, which provide antioxidant and anti-inflammatory support to help keep your immune system strong.



2. Brussels sprouts: A member of the cabbage family, Brussels sprouts have seen a recent rise in popularity, and that's a good thing. (I wonder what took everyone so long-I love them!) They are an excellent source of bone-strengthening vitamin K and may give you a glow thanks to the vitamin C, which supports collagen production and products against free radicals. A cup also provides 15 percent of your daily iron and 13 percent of your recommended fiber.






3. Cauliflower: Ever since we were told to load our plates with color, white foods have been getting a bad rap. Cauliflower doesn't deserve it. It is an excellent source of folic acid and vitamins C and K, and also contains lots of iron, fiber, potassium for efficient muscle function, and B vitamins, which play a role in everything from hair growth to red blood cell creation to carrying oxygen and nutrients to cells of our body.



4. Clementines: I know the winter season is upon us when I see the boxes of clementines, a cross between a mandarin and an orange, in the supermarket. So easy to peel, they make the easiest grab-and-go citrus fruit this time of year. Besides being a excellent source of vitamin C, they also contain calcium and potassium, and are a great low calorie fruit: a serving of two clementines is only 80 calories.



5. Pears: I think pears are an overlooked fruit, with so many more people grabbing apples at this time of year. One of the highest-fiber fruits, a medium pear offers about 6 grams, which can help with blood sugar control and promote weight loss. An excellent source of vitamins C and K, pears are also packed with B vitamins, calcium, magnesium, potassium, and manganese.

Happy Holidays! BeHealthConscious Organization Inc.

The 8 Biggest Fitness Myths You Still Believe

 by Jay Cardiello for SHAPE.com

There is no shortage of opinions on the best ways to lose weight and get into shape. Over my career I have heard some fitness myths over and over again, and still hear them today! To help decipher fact from fiction, here is some more information about eight persistent assumptions that might be holding you back. 1. It's better to use a machine. Machine-only based programs train your body in a single, linear motion. These one-dimensional forms of exercise make you more susceptible to injury. Think about it: We live in a multi-dimensional world. Completing multi-joint exercises such as weighted squats, lunges, and deadlifts will prepare your body better for real life. 2. Losing weight only happens in the gym. It takes 250,000 crunches to burn one pound of fat. I believe that 80 percent of all fitness success happens in the kitchen, not the gym. If you spend one hour (or just four percent) of your day working out, you have the rest of you day to nullify your hard work. Nothing you do in the gym is going to combat the rest of the equation when it comes to weight loss. That equation of course includes fitness, as well as diet, sleep, hydration, and stress management. RELATED: 10 Unbelievable Diet Rules Backed By Science 3. You can spot reduce. This is a myth that has withstood the test of time, even after it's been reported time and again as being completely false. So I repeat, you cannot select certain places on your body to reduce fat. Crunches are not going to target the fat in your core region. Fat is burned through a combination of cardiovascular and strength training that decreases your body's overall fat content when coupled with a healthy diet. 4. Running is the best form of exercise for weight loss. A lot of people think steady-state cardio is best form of exercise to lose weight, but strength training combined with short spurts of high intensity cardio creates more damage on your muscles and thus a better after-burn effect due to more required repair. Read: More calories burned at a faster rate, even after the workout is over. 5. Staying fit takes up a lot of time. Speaking of which, science has shown that high-intensity interval training really works when it comes to building muscle and burning calories in less time. Also, there are simple exercises, like jumping rope, that burn major calories in not a lot of time. (One minute of jumping rope burns 11 calories!) The long drawn-out days in the gym are over. Try one of my JCORE workout DVDs and you'll see what I'm talking about. They're just 20 minutes long-you have time for that! RELATED: 8 Benefits of High Intensity Interval Training (HIIT) 6. Women will get "bulky" if they lift heavy weights. This is another misconception that I've heard many times over the years and still hear over and over again. Enough! Heavier weights will not make you bulk up and they are not just for men. Reason: Women and men are not created equal. It's cliché, but it's especially true when it comes to our biology. Testosterone is a key component to muscle building, and women have up to 20 times less testosterone than men. Because of their low levels, it's almost impossible for women to get that bulky effect. 7. You need a gym membership to stay in shape. Bodyweight exercises and workouts are all the rage lately, and for great reason. You can get a better workout more safely when you use just your body to challenge yourself than when you use a machine or equipment you may not know how to use correctly. Also, this style of exercise allows your body to work on all different planes and challenge muscles from all angles. So forget the idea that you can't get a workout if you don't go to the gym. Pull out a mat in your living room and get to work! 8. If it works for her, it's going to work for me. Everybody's body is different. I hear many people talk about a certain celebrity's favorite workout or quote someone else's trainer about a new training plan or workout they should try. However, the main reason anyone finds success in their fitness routine comes down to more than just what type of workout they're doing. It's because they've adapted it into their lifestyle, it keeps them committed, and they're comfortable with it. Find a workout that does the same for you and you will reach your goals.