Mary Rezk-Hanna

• University of California, Los Angeles

Sugars are naturally present in tobacco plants and are introduced as additives during the manufacturing of various tobacco- and nicotine-containing products. Product palatability and appeal are the primary reasons for manufacturers’ attention to the sugar content in tobacco and nicotine products. However, because of the complex chemistry of sugars...

BACKGROUND The American Heart Association (AHA), in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, nutrition, sleep, and obesity) and health factors (cholesterol, blood...

Background Hookah tobacco smoking is prevalent among youth and young adults. While health warning labels play a critical role in communicating the health risks of tobacco product use to consumers, compliance with US Federal Regulation’s nicotine warning requirements on hookah tobacco packaging is low. Some labelling suggests that consumers are expo...

Smokeless oral nicotine products are addictive, and their use has potential adverse effects on some but not all biomarkers of cardiovascular risk. The use of some types of these products, for instance, is associated with an increased mortality risk in those with ischemic heart or cerebrovascular disease. Similarly, smokeless tobacco has the potenti...

Background Risk factors for cardiovascular disease (CVD) among young and middle-aged women have increased, whereas CVD knowledge and awareness remain low. Aims The objective of this study was to describe the relationship between the stage of behavior change and awareness, knowledge, and perceptions of CVD among women 25–55 years and identify predi...

Introduction: Flavored hookah tobacco smoking among young adults continues to be a public health concern. While short-term exposure to flavored hookah tobacco smoking impairs vascular function, data on the long-term impact of habitual use are not clearly delineated. Research Question: Is habitual flavored hookah tobacco smoking associated with vasc...

Heavily advertised as a harmless tobacco alternative, hookah (i.e., waterpipe)-flavored tobacco smoking has contributed to the wider epidemic of smoking, especially amongst marginalized sexual minority (SM) populations. Evidence regarding the concurrent use of substances and other drugs, among SM current hookah smokers, is scarce. We utilized natio...

BACKGROUND The American Heart Association (AHA), in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, nutrition, sleep, and obesity) and health factors (cholesterol, blood...

Vaping has risen substantially in recent years, particularly among young adults. While e-hookah vaping acutely reduces endothelial function, the role of nicotine and the mechanisms by which it may impairs endothelial function remain understudied. In a randomized cross-over study, we investigated the acute effects of vaping e-hookah, with and withou...

Background: Risk factors for cardiovascular disease (CVD) among young and middle-aged women have increased while knowledge and awareness of CVD remain low. To reverse these trends, it is important to assess whether knowledge and awareness of CVD are associated with intent to change behavior. Aims: Describe the relationship between stage of behavior...

Hookah smoking has grown to become a global tobacco epidemic. While cigarette smoking is a well-established cardiovascular disease (CVD) risk factor, the CVD risks of hookah smoking are unknown, particularly among regular U.S. adult hookah users who are predominantly non-daily users. Herein, we examined the association between hookah smoking and bi...

Vaping and electronic cigarette (e-cigarette) use have grown exponentially in the past decade, particularly among youth and young adults. Cigarette smoking is a risk factor for both cardiovascular and pulmonary disease. Because of their more limited ingredients and the absence of combustion, e-cigarettes and vaping products are often touted as safe...

Introduction The vaping epidemic in the US has been largely attributed to the emergence of pod-based e-cigarette devices. While these devices continue to be promoted as alternatives to cigarettes, their impact on cardiovascular and behavioral outcomes remains incompletely understood. This study assessed the impact of pod-based e-cigarettes on perip...

Background: The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glu...

Despite higher rates of hookah (i.e., waterpipe) tobacco smoking among sexual minority (SM) adults, little is known on concurrent substance use, including alcohol or other drugs, among SM hookah smokers as compared to their heterosexual counterparts. Utilizing data from the Population Assessment of Tobacco and Health Study (2013–2015), weighted ana...

Hypertension is a key driver of cardiovascular diseases. However, how stressors contribute to the development of hypertension remains unclear. The objective of this study was to examine prospective associations of adverse childhood experiences (ACEs) and adulthood psychosocial disadvantages (APDs) with incident hypertension. Data were from the Mid-...

For the 5th National Institute of Health Tobacco Regulatory Science meeting, we participated in a plenary session focused on sugars and sweeteners profiles in tobacco and nicotine products and their related toxicity and abuse liability implications. The meeting was organized by the Tobacco Regulatory Science Program, a partnership between the Natio...

Background: During the 2019 coronavirus disease (COVID-19), individuals' compliance with protective behaviors remains the most effective strategy to break the infection chain and prevent disease, even with vaccines' availability and usage. Understanding protective behaviors within the Jordanian context will shape health promotion campaigns and gui...

Background: The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glu...

Introduction Cigarette smoking is strongly associated with the development of cardiovascular disease (CVD). However, evidence is limited as to whether smokeless tobacco (ST) use is associated with CVD. Aims and Methods Using data from 4347 adults in the Population Assessment of Tobacco and Health Study (2013–2014), we compared geometric mean conce...

Introduction: Electronic nicotine delivery systems (ENDS) are growing quickly in the United States, particularly among youth. Electronic (e-) hookahs are a new category of vaping devices in which the e-bowl is combined with and placed on a traditional waterpipe, allowing the flavored aerosol to pass through a water-filled base before being carried...

Introduction: Combustible tobacco smoking is strongly associated with the development of cardiovascular disease (CVD). However, evidence is limited as to whether smokeless tobacco (ST) use is associated with CVD. Methods: Using data from 4347 adults in the Population Assessment of Tobacco and Health Study (2013-2014), we compared geometric mean con...

Background Traditional hookah smoking has quickly grown to become a global tobacco epidemic. More recently, electronic (e-) hookahs—vaped through traditional waterpipes—were introduced as healthier alternatives to combustible hookah. With combustible tobacco smoking, oxidative stress, inflammation and vascular stiffness are key components in the de...

Abstract Background Tobacco smoking using a hookah (i.e., waterpipe) is a global epidemic. While evidence suggests that sexual minorities (SM) have higher odds of hookah use compared to heterosexuals, little is known about their hookah use patterns and transitions. We sought to examine transitions between hookah smoking and use of other tobacco and...

Background Electronic hookah (e‐hookah) vaping has increased in popularity among youth, who endorse unsubstantiated claims that flavored aerosol is detoxified as it passes through water. However, e‐hookahs deliver nicotine by creating an aerosol of fine and ultrafine particles and other oxidants that may reduce the bioavailability of nitric oxide a...

Introduction There is a tendency of waterpipe smokers to advance their practice toward concurrent use (poly-tobacco use) of other tobacco products and nicotine delivery systems. This study investigated poly-tobacco use among waterpipe smokers, and its effect on their quit intention. Methods Descriptive cross-sectional design was utilized to recrui...

Electronic (e‐) hookah vaping has increased in popularity, especially among youth and young adults. Contributing to e‐hookah’s popularity is the unsubstantiated belief that smoke is detoxified as it passes through the water‐filled basin, rendering e‐hookah as a safer alternative to combustible tobacco smoking. With combustible tobacco smoking, vasc...

Hookah (waterpipe) smoking is a growing tobacco epidemic. Though perceived as a safer tobacco alternative, hookah smoke contains, in addition to tobacco combustion products, large amounts of charcoal combustion products—implicated in cardiovascular disease—from the burning charcoal used to heat the flavored tobacco. To date, little is known on the...

Introduction: ENDS are evolving quickly with increasing use in the U.S. More recently, e-hookahs have been introduced as healthier alternatives to the traditional hookah-flavored tobacco smoking. To date, virtually all studies of ENDS have focused on e-cigarettes; consequently, little is known about e-hookah use. Methods: Data were drawn from th...

Smoking is a major cause of cardiovascular morbidity and mortality worldwide. Over recent years, alternative forms of traditional tobacco smoking have emerged, including electronic (e‐) cigarettes and e‐hookah bowls, with claims that they are safer tobacco alternatives. Unlike e‐cigarettes, e‐hookah bowls are used through traditional water‐pipes, a...

Tobacco smoking with a water pipe or hookah is increasing globally. There are millions of water pipe tobacco smokers worldwide, and in the United States, water pipe use is more common among youth and young adults than among adults. The spread of water pipe tobacco smoking has been abetted by the marketing of flavored tobacco, a social media environ...

Background: Hookah smoking is marketed to youth as a harmless alternative to cigarettes. Although cigarette smoking acutely impairs endothelial function, the effect of smoking fruit-flavored hookah tobacco is unknown. Because charcoal traditionally is used to heat the hookah tobacco in the waterpipe, hookah smoke delivers tobacco toxicants and nic...

Background Europe continues to have among the highest worldwide prevalence of adult smoking (28%) and the highest among females (19%). Nurses’ rates of smoking in the region are comparable or higher than the general female population. Nurses who smoke are less likely to intervene with patients who smoke; therefore, supporting nurses’ efforts to qui...

Purpose: Smoking among nurses is a barrier to providing smoking cessation interventions to patients. In Central and Eastern Europe-where tobacco use is the leading cause of preventable death and disease-there is limited knowledge about nurses' attitudes toward cessation interventions. Our aim was to describe the attitudes of nurses who are former...

Hookah (waterpipe) smoking is rapidly increasing in popularity worldwide. Despite being heavily advertised in the media as a healthier alternative to cigarettes, the toxicology of hookah smoke suggest otherwise. Cigarette smoking unequivocally causes an acute increase in arterial stiffness, but whether hookah does the same is unknown. In 48 young h...

Implications: This review provides an overview on the potential impact of hookah smoking on cardiovascular health. Readers will gain an insight into evidence on its toxicological constituents, human health effects, and pathophysiological mechanisms by which hookah smoking might cause cardiovascular disease. The review also highlights current resea...

Hookah (waterpipe) smoking is a centuries‐old, revived yet understudied epidemic of tobacco use. Despite being heavily advertised and glamorized in the media as a healthier alternative to cigarettes, the toxicology of hookah smoke suggest otherwise. Cigarette smoking unequivocally causes an acute increase in arterial stiffness, but whether hookah d...

Hookah (water pipe) smoking has reached epidemic proportions due to unregulated social media marketing to young adults as a safer avant‐garde alternative to cigarettes. In contrast, much is suspected by tobacco researchers—yet little is proven—about hookah's putative health risks. What distinguishes hookah from all other tobacco products is that bu...

Hookah (water pipe) smoking is a major new understudied epidemic of tobacco abuse particularly affecting youth. Hookah's rapidly growing popularity is due to unregulated expansion of hookah cafes near college campuses and social media marketing to young adults as a safer avant‐garde alternative to cigarettes. Whereas multiple studies have shown tha...

Hookah (water pipe) smoking is a major new understudied epidemic affecting youth. Because burning charcoal is used to heat the tobacco product, hookah smoke delivers not only nicotine but also large amounts of charcoal combustion products, including carbon-rich nanoparticles that constitute putative coronary vasoconstrictor stimuli and carbon monox...

Background: Hookah (water pipe) smoking is a form of tobacco use, historically from the Middle East and India that is fueling a contemporary epidemic of tobacco abuse and a nationwide public health crisis, particularly among young adults. There is little information on factors influencing hookah smoking and health beliefs of hookah smokers. Objec...

Purpose: The purpose of this study is to assess hookah smokers’ attitudes, beliefs, perceptions, and preferences towards hookah smoking. Information gained from this study will provide preliminary data for future intervention studies targeting the community health needs of adolescents and young adults. Background: Hookah smoking (also known as wa...