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exposed to the various toxins, thereby increasing the harmful risks for nonsmokers. References 1. Monzer B, Sepetdjian E, Saliba N, Shihadeh A. Charcoal emissions as a source of co and carcinogenic pah in mainstream narghile waterpipe smoke. Food and Chemical Toxicity. 2008; 46(9): 2991-5. Available at: www.scien-cedirect.com. 2. Ray CS. The hookah-the Indian waterpipe. Current Science. 2009; 96(10): 1319-23. Available at: docs.google.com/viewer. 3. Harvard Medical School. The hazards of hookah. Harvard Mental Health Letter. 2008; 24(9): 1-4. Available at: ehis.ebscohost.com.central.ezproxy. cuny.edu:2048/ehost/pdfviewer/pdfviewer. 4. Centers for Disease Control and Prevention. Smoking and tobacco use: fact sheet: hookahs. 2011. Available at: www.cdc.gov/tobacco/data_statistics/ fact_sheets/tobacco_industry/hookahs/. 5. Lal P. Bidi—a short history. Current Science. 2009; 96(10): 1335-7. Avail-able at: www.ias.ac.in/currsci/may252009/1335.pdf. 6. Malson JL, Pickworth WB. Bidis—hand-rolled, Indian cigarettes: effects on physiological, biochemical, and subjectivity measures. Pharmacol Biochem Behav. 2002; 72(1,2): 443-7. Available at: www.sciencedirect.com. 7. Jayalekshumi PA, Gangadharan P, Akiba S, et al. Oral cavity cancer risk in relation to tobacco chewing and bidi smoking among men in Karunagap-pally, Kerala, India: Karunagappally cohort study. Cancer Science. 2011; 102(2): 460-7. Available at: onlinelibrary.wiley.com.citytech.ezproxy.cuny. edu. Toni-Ann Restivo is currently a second-year dental hygiene student at New York City College of Technology, Brooklyn, N.Y., with an expected graduation of June 2012. She also has an associate’s and bachelor’s degree in biology, with a minor in psychology, from the College of Staten Island. The faculty mentor for this edition of Strive is Susan Davide, RDH, MS, MSEd, assistant professor, Dental Hygiene Department at NYCCT. ■ Conclusion Smoking hookah and bidis has been a tradition dating back to as early as 16th and 17th century India. Upon their introduction they both became popular and started to spread worldwide as a social smoking trend. Though hookah and bidis are different means of smoking, they are similar in that they are available in a variety of À avors, making them more appealing for use. In addition it has been found that both are potential risk factors for various cancers, coronary heart disease, nicotine dependence and secondhand smoke. The role of a health care provider should be to identify users of alternative smoking using a hookah or bidi cigarettes through a pa-tient’s medical history. Due to the prevalence and increasing popu-larity of hookah lounges and bidi cigarettes becoming commercially available in the United States, it should be the responsibility of health care providers to evaluate patients’ medical histories and if they are smokers of either or both, to incorporate this concern into the treatment care plan. The treatment care plan should include patient education on the adverse health implications associated with consum-ing either tobacco product, along with tobacco cessation options. It is imperative that we as health care providers explain the various health risks associated with smoking bidis or hookah. At this time, the patient should become aware that the only way to prevent the risks imposed by either of these two products would be to avoid usage, or if using these products, to stop usage immediately to help restore normal cell function. 36%7'348-' -223:%8-32 &#1e;%=)%63*)<'-8-2+463(9'87%2( 78=0-7,2);033/7 3VEWGSTXMGMWTVSYHXSMRXVSHYGIXLIWIKVIEXRI[TVSHYGXWXSSYVPMRI SJE[EVH[MRRMRKXSSPWJSVHIRXMWXWERHL]KMIRMWXW*SVSZIV]IEVW
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