title: Acute vascular effects of waterpipe smoking: Importance of physical activity and fitness status.
abstract: OBJECTIVE
  While new forms of tobacco, including waterpipe (WP) smoking, continue to gain popularity, limited literature has examined the vascular health consequences. The purpose of the current study was to examine: (i) the acute WP-induced changes in vascular function; (ii) whether acute changes in vascular function are modified by lifestyle behaviors (habitual physical activity, physical fitness).
  
  
  METHODS
  Fifty three (22.7 y, 36% F, 23.4 kg/m(2)) otherwise healthy WP smokers were recruited. Strain-gauge plethysmography was used to measure forearm blood flow, vascular resistance, venous capacitance, and venous outflow at rest and following occlusion. Habitual physical activity was determined using the Arabic version of short-form international physical activity questionnaire, while physical fitness was assessed using the 6 min walk test and handgrip strength. Partial correlations were used to examine the relationships between post-smoking vascular function and lifestyle behaviors, controlling for pre-smoking vascular measures.
  
  
  RESULTS
  (i) WP had a small effect on forearm post-occlusion blood flow (d = -0.19), a moderate effect on venous outflow (d = 0.30), and a moderate effect on post-occlusion vascular resistance (d = 0.32). (ii) Total habitual physical activity strongly correlated with resting blood flow (r = 0.50) and moderately with vascular resistance (r = -0.40). Handgrip strength moderately correlated with venous capacitance (r = 0.30) and post-occlusion blood flow (r = 0.30), while 6 min walked distance moderately correlated with resting venous capacitance (r = 0.30).
  
  
  CONCLUSIONS
  Waterpipe smoking is associated with immediate changes in vascular function, which are exacerbated in individuals with low habitual physical activity and physical fitness levels in young otherwise healthy individuals.
authors.affiliation: Division of Physical Therapy, Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan. Electronic address: Alomari@just.edu.jo.
authors.forename: Mahmoud A
authors.initials: MA
authors.lastname: Alomari
authors.affiliation: Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid, Jordan; Department of Biology, Faculty of Science, Taibah University, Madinah Munawara, Saudi Arabia. Electronic address: Khabour@just.edu.jo.
authors.forename: Omar F
authors.initials: OF
authors.lastname: Khabour
authors.affiliation: Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan. Electronic address: KHAlzoubi@just.edu.jo.
authors.forename: Karem H
authors.initials: KH
authors.lastname: Alzoubi
authors.affiliation: Department of Nutrition, Jordan University of Science and Technology, Irbid, Jordan. Electronic address: Dana3_7@yahoo.com.
authors.forename: Dana M
authors.initials: DM
authors.lastname: Shqair
authors.affiliation: School of Sport and Exercise, Massey University, Wellington, New Zealand. Electronic address: l.stoner@massey.ac.nz.
authors.forename: Lee
authors.initials: L
authors.lastname: Stoner
mesh_terms: D005080:Exercise Test; D005260:Female; D005542:Forearm / Q000098:blood supply*; D018737:Hand Strength; D006304:Health Status; D006439:Hemodynamics; D006801:Humans; D008019:Life Style; D008297:Male; D009043:Motor Activity; D010809:Physical Fitness; D012039:Regional Blood Flow; D012307:Risk Factors; D057185:Sedentary Behavior; D012907:Smoking / Q000009:adverse effects*; D011795:Surveys and Questionnaires; D062789:Tobacco Products / Q000009:adverse effects*; D014655:Vascular Resistance; D014867:Water; D055815:Young Adult
chemical_list: D014867:Water
keywords: Blood flow; Cardiovascular disease; Lifestyle behavior; Pleythsmography; Tobacco; Vascular function; Vascular resistance; Waterpipe