Narghile (water pipe) smoking influences platelet function and (iso-)eicosanoids
Introduction
The water pipe is familiar to about 1 billion people throughout the world and is daily used by more than 100 million men and women in Africa, Asia and several Mediterranean countries. The Hooka, Shisha, or Narghile, which are names of water pipes known in different parts of the world, has been smoked for at least 400 years. Despite the fact that civilization has progressed into the third millennium, its popularity has not decreased, and in fact it is experiencing a great revival. Different progenitors and types of the water pipe have been described, varying in material, size and shape. What remains unaltered are the consisting parts, which include the body, bowl, and tube. The body is usually made of glass or steel and shaped like a decanter and is filled with water. Second, the heart of the water pipe is the bowl (Fig. 1), which is positioned in the body. Tobacco is placed into the bowl, pierced and covered with a conical cap to protect the flame from extinction when smoked in the open space. Finally there is the tube. A water pipe may have one or several tubes mainly made of amber, and smoke generated in the body is sucked from the tube, usually shared among several smokers. There are several opinions as to the origin of the water pipe; they point in various directions from South Africa over Iran to India; thus its origin remains a mystery.
Smoking the water pipe is based on the principle that the smoke before being inhaled passes through a sophisticated cooling and purification system in a water container (body), resulting, via the serpent like tube, in the inhalation of tobacco smoke with a lower tar and nicotine content. The sweet flavoured tobacco and a multitude of social and other factors, and/or the elevated cigarette prizes in these areas, have recently resulted in the phenomenal revival of the Narghile, called Shishamania.
In contrast to active and passive cigarette smoking, the biological influence of smoking water pipe on haemostasis and the eicosanoid system is unknown. Considering the large number of people actually smoking water pipes daily, we investigated the potential effect of the latter upon oxidation injury by monitoring parameters of the (iso)eicosanoid system.
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Volunteers
Seven healthy adult non-cigarette smoking male volunteers were monitored. Some of them (3) had occasionally smoked a water pipe previously, but not during the 3 months prior to the study. All subjects were drug-free for at least 2 weeks. After fasting since breakfast, the volunteers initiated water pipe smoking in the late afternoon for a period ranging from 45 to 70 minutes (mean: 55 minutes). Smoking was performed once daily for two weeks. The Narghile contained 15 g of tobacco (nicotine
8-Epi-PGF2α
After a single exposure to the smoke only a minor (p = 0.03) response (from 19.4 ± 2.4 to 20.6 ± 2.6 pg/ml) was observed. There was, however, a further increase after 1 (p = 0.00003) and even more after 2 weeks. Post-smoking values were higher after 1 (p = 0.0003) and even higher after 2 weeks (p = 0.003) (Table 1).
11-DH-TXB2
Immediately after water pipe smoking 11-DH-TXB2 (Table 1) showed a significant (p = 0.00003) increase by about 20% (from 24.9 ± 1.9 to 29.9 ± 2.7 pg/ml) with a significant (p =
Discussion
Cigarette smoking is the second most important risk factor for the development of atherosclerosis Gotto, 1986, Krupski, 1991. It is associated with an oxidative injury leading to a modification of lipoproteins, in particular LDLs and in parallel to a formation of isoprostanes (IP), especially 8-epi-PGF2α. The precise constituents of cigarette smoke responsible for elevated levels of 8-epi-PGF2α in smokers remain unknown. It is unlikely to be nicotine, as patients who stopped the smoking habit
Conclusion
Single water pipe smoking induces oxidation injury as evidenced by various markers. Repeated daily smoking induces a persistent longer-lasting oxidation injury.
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Cited by (0)
- 1
Fahdi Chehne, MD, was on leave from the University of Aleppo, Syrian Arabic Republic (SAR).
- 2
Anthony Oguogho, MD, PhD, was on sabbatical leave from the Department of Physiology, Edo State University Faculty of Basic Medical Sciences, Ekpoma, Nigeria, and supported by a stipendium of the ÖAAD (Austrian Academic Exchange Division).