Hookah Facts that might surprise you! A hookah, also known as a waterpipe, narghile or shisha is a single or multi-stemmed instrument for smoking sweetened, flavored tobacco. The user inhales through a hose which pulls air over burning charcoal, heating the tobacco and creating smoke. Due to sustained inhalation over a prolonged period, a hookah smoker may consume as much smoke as 100 cigarettes in a single session!1 Proven Facts: • A single session of hookah use can produce between 1 and 50 • In addition to containing many of the same chemicals as cigarettes, cigarettes worth of toxic exposure.2 the charcoal used in heating the tobacco used for hookah releases 9 • Compared to smoking a single cigarette, which typically lasts 5 higher amounts of carbon monoxide. minutes in duration, a hookah session can last up to an hour.3 • Use of hookah is increasing worldwide and is viewed by health 10 • On average, one puff off the hookah is approximately equivalent to officials as a “global tobacco epidemic”. an entire cigarette in terms of total smoke volume inhaled.4 • Hookah use has spread rapidly in youth culture, with the majority of 11 • Hookah smoke contains many of the same carcinogens as cigarette hookah lounges popping up near college campuses. In 2011, 18.5% 12 smoke5 and has been associated with heart disease, cancer, nicotine of high school seniors reported hookah use during the past year. dependence and decreased pulmonary function.6 • Sharing a hookah mouthpiece or improper sterilization of the hose • Hookah use has also been associated with gum disease7, infertility may contribute to the spreading of diseases such as Hepatitis C, and low birth weight.8 Tuberculosis, Epstein-Barr Virus, Herpes Simplex and other respiratory viruses.13 For more information on how to quit call: 915-534-QUIT | www.setyourdate.org 1World Health Organization. (2005). 6Maziak, W., Ward, K. D., & Eissenberg, T. (2004). 11American Lung Association. (2007). Tobacco 2, 3, 4, 10Cobb, C., Ward, K. D., Maziak, W., Shihadeh, Drug and Alcohol Dependence. Policy Alerts. A. L., & Eissenberg, T. (2010). American Journal 6Ward, K. D., Eissenberg, T., Rastam, S., Asfar, 12Johnston, L. D., O’Malley, P. M., Bachman, J. of Health Behavior. T., Mzayek, F., Fouad, M. F., Maziak, W. (2006). G., & Schulenberg, J. E. (2012). Monitoring the 5Shihadeh, A. (2003). Food and Chemical Tobacco Control. Future national results on adolescent drug use: Toxciology. 7Natto, S.B. (2005). Swed.Dent. J. Suppl. Overview of key findings, 2011. 5, 9Shihadeh, A. & Saleh R. (2005). Food Chemical 8Nuwayhid, I.A., Yamout, B., Azar, G., & Kambris, 13El-Barrawy, M.A., Morad, M.I., & Gaber, M. Toxiocology. M.A. (1998). Journal of Epidemiology. (1997). East Mediterranean Health. 6Bedwani, R., Renganathan, E., El-Kwhsky (1997). 8Inhorn, M.C. & Buss, K.A. (1994). Soc. Sci. Med. 13Szyper-Kravitz, M., Lang, R., Monor, Y., & Lahav, International Journal of Cancer. 8Yadav, J.S. & Thakur, S. (2000). Cytobios. M. (2001). Leukemia Lymphoma. 13 6Jabbour, S., El-Roueiheb, Z., Sibai, A.M. (2003). 10Chaouachi, K. (2009). International Journal of Munckhof, W.J., Konstantinos, A., Wamsley, M., Annals of Epidemiology. Environmental Research and Public Health. Morlock, M., & Gilpin, C.A. (2003). International Journal of Tuberculosis and Lung Diseases. WHAT ARE ELECTRONIC CIGARETTES? Facts about Electronic cigarettes, commonly known as e-cigarettes, are battery-operated devices that generally contain cartridges with nicotine, flavor, and other chemicals. Food and Drug Administration (FDA) ELECTRONIC CIGARETTES An e-cigarette turns nicotine, which is highly addictive, and other chemicals into a vapor that is inhaled. FDA “Consumers have no way of knowing the doses they are inhaling, the types or concentrations of NICOTINE IS ADDICTIVE. potentially harmful chemicals, or if e-cigarettes are E-cigarettes may produce or maintain nicotine safe for their intended use.” dependence. AMA — 2009 Food and Drug Administration The FDA is concerned that e-cigarettes can increase nicotine addiction among young people and may lead kids to try other tobacco products, including conventional cigarettes. FDA Nicotine addiction is so powerful that every day about WH0’S AFFECTED? 1,000 teens become daily smokers. CDC About 1 in 5 adult cigarette smokers in the U.S. have tried an electronic Research has shown that nicotine influences the same cigarette. Centers for Disease Control and Prevention (CDC) brain regions as other drugs of abuse. Like cocaine and heroin, nicotine increases levels of dopamine, E-cigarettes come in fruit and candy flavors, which gives them the producing lasting changes in the cells of the brain. potential to entice new nicotine users, especially teens. American Medical These changes can eventually lead to addiction. Association (AMA) National Institutes of Health (NIH) “Use of e-cigarettes indoors could be a step backward for air quality as well as a negative for someone who may have otherwise quit nicotine FACTS ABOUT ELECTRONIC use.” 2013 Tim McAfee, MD, MPH, Director of CDC’s Office on Smoking and Health CIGARETTES The impact of e-cigarettes on long-term health has not yet been studied. CDC TAKE ACTION. Since e-cigarettes have not been submitted to the FDA Encourage those who are interested in quitting to take advantage of all the for evaluation, there is no way of knowing the levels of FREE local resources in our community, as listed on our website. nicotine or the amounts or kinds of other chemicals that Whether it’s a worksite, housing complex, or campus, encourage the the various brands of these products deliver to the user. owners to make it a 100% tobacco-free property, including e-cigarettes. FDA Use the fact sheets on our website to help make the case. There is no scientific evidence to support e-cigarettes as a healthier alternative to other tobacco or that they can Need help finding tools, resources, or information regarding e-cigarettes? help you quit. American Lung Association Visit us at LiveTobaccoFreeAustin.org or email us at An analysis of ingredients in a small sample of cartridges [email protected]. from 2 leading brands of e-cigarettes detected carcinogens, including nitrosamines, commonly found in pesticides. FDA Manufacturers have not proven that the chemicals in e-cigarettes are safe for inhalation when vaporized and delivered to the lung. World Health Organization (WHO) Made possible by funding from the Community Transformation Grant and Austin/Travis County Health and Human Services Department LiveTobaccoFreeAustin.org Proposed revisions to the El Paso Public and Workplace Smoking Restrictions Ordinance Summary of Changes El Paso’s Public and Workplace Smoking Restrictions Air Ordinance was approved in 2001. El Paso was one of the first cities to adopt a smoke free ordinance. • Since 2001, many cities have adopted similar smoke free ordinances. • Some best practices have been identified. The El Paso Clean Air Coalition reviewed these best practices and suggested updates to the El Paso Department of Public Health. Changes recommended include the following: An updated definition of “smoking” that includes e-cigarettes. • Electronic-cigarettes (e-cigarettes) are marketed as less harmful alternatives to smoking and possible cessation tools. However, claims of reduced harm have not been evaluated by the FDA.1 • Health concerns exist over the effect of e-cigarette vapor on non-smokers. E-cigarette aerosol is made up of a high concentration of ultrafine particles, and the particle concentration is higher than in conventional tobacco cigarette smoke. 2 • Americans for Nonsmokers’ Rights recommends that e-cigarettes not be used in areas where people will be exposed to the vapor. 3 Diagram of e-cigarette The addition of outdoor city-owned or leased facilities to the areas that are designated as non-smoking. These areas include city-owned parks, playgrounds, bus stops, sports arenas and stadiums. • Secondhand smoke affects nonsmokers outdoors and indoors. 4 • Cigarette butt litter is a leading source of litter and can remain in the environment for years. 5,6 The addition of smoking being prohibited 20 feet from the entrances of enclosed areas. A best practice definition of “private club.” • The current definition of “private club” is outdated and could allow for establishments to initiate “smoking clubs.” The proposed definition is included in a best practice model by Americans for Nonsmokers’ Rights.7 • “Private clubs” must have non-profit status in order to qualify for the exemption. Clarification of requirements for tobacco retail establishments to be isolated from neighboring businesses. • Protects establishments that share common walls with tobacco retail establishments from secondhand smoke. • Cigarette smoke seeps into adjoining units through lighting fixtures, cracks in walls, windows, doors, plumbing, and shared ventilation.8 Changes do not include: • Outdoor restaurant or bar patios. • Changes to the ratio of designated smoking rooms in hotels and motels. • Outdoor areas that are not owned or leased by the City. Please see attached documents for more information. References: 1 Henningfield, J.E., & Zaatari, G.S. (2010). Electronic nicotine delivery systems: emerging science foundation for policy. Tobacco Control, 19,(2), 89-90. 2 Fuoco, F.C.; Buonanno, G.; Stabile, L.; Vigo, P., "Influential parameters on particle concentration and size distribution in the mainstream of e-cigarettes," Environmental Pollution 184: 523-529, January 2014. 3 American Nonsmoker’s Rights Foundation. (2013). Electronic Cigarettes are NOT a Safe Alterative! Retrieved September 12, 2013, http://www.no-smoke.org/learnmore.php?id=645. 4 Klepeis, N.E., Ott. W.R., & Switzer, P. (2007). Real-time measurement of outdoor tobacco smoke particles. Journal of Air and Waste Management Association (Air & Waste Management Association), 57(5), 522-534. 5 Ariza, E. & Leatherman, S.P. (2012). No-smoking policies and their outcomes on U.S. beaches. Journal of Coastal Research, 28(1A), 143-147. 6 Texas Department of Transportation (2010). 2009 Visible Litter Study. Retrieved February 14, 2013, from http:dontmesswithtexas.org/research.