***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: INTRODUCTION We explored the differential effect of cessation interventions ( behavioral support sessions with [ BSS+ ] and without [ BSS ] bupropion ) between hookah and cigarette smokers . METHODS We reanalyzed the data from a major cluster-r and omized controlled trial , ASSIST ( Action to Stop Smoking In Suspected Tuberculosis ) , which consisted of 3 conditions : ( a ) behavioral support sessions ( BSS ) , ( b ) behavioral support sessions plus 7 weeks of bupropion therapy ( BSS+ ) , and ( c ) controls receiving usual care . The trial originally recruited 1,955 adult smokers with suspected tuberculosis from 33 health centers in the Jhang and Sargodha districts of Pakistan between 2010 and 2011 . The primary endpoint was continuous 6-month smoking abstinence , which was determined by carbon monoxide levels . Subgroup-specific relative risks ( RRs ) of smoking abstinence were computed and tested for differential intervention effect using log binomial regression ( generalized linear model ) between 3 subgroups ( cigarette-only : 1,255 ; mixed : 485 ; and hookah-only : 215 ) . RESULTS The test result for homogeneity of intervention effects between the smoking forms was statistically significant ( p-value for BSS+ : .04 and for BSS : .02 ) . Compared to the control , both interventions appeared to be effective among hookah smokers ( RR = 2.5 ; 95 % CI = 1.3 - 4.7 and RR = 2.2 ; 95 % CI = 1.3 - 3.8 , respectively ) but less effective among cigarette smokers ( RR = 6.6 ; 95 % CI = 4.6 - 9.6 and RR = 5.8 ; 95 % CI = 4.0 - 8.5 ) , respectively . CONCLUSIONS The differential intervention effects on hookah and cigarette smokers were seen ( a ) because the behavioral support intervention was design ed primarily for cigarette smokers ; ( b ) because of differences in demographic characteristics , behavioral , and sociocultural determinants ; or ( c ) because of differences in nicotine dependency levels between the 2 groups INTRODUCTION Tobacco use in low- to middle-income countries is a major public health concern for both smokers and those exposed to environmental tobacco smoke ( ETS ) . Egypt has made important strides in controlling tobacco use , but smoking and ETS remain highly prevalent . This r and omized intervention sought to improve the target population 's knowledge regarding the hazards of smoking and ETS and to change attitudes and smoking behaviors within the community and the household . METHODS In this 2005 - 2006 study in Egypt 's Qalyubia governorate , trained professionals visited schools , households , mosques , and health care centers in rural villages r and omly selected for the intervention to discuss the adverse effects of smoking and ETS exposure and ways to reduce one 's ETS exposure . Data collected in interviewer-facilitated surveys before and after the intervention period were analyzed in pairwise comparisons with data from control villages to assess the effectiveness of the intervention in achieving its aims . RESULTS The intervention group showed a greater increase in underst and ing the dangers associated with smoking cigarettes and waterpipes  and became more proactive in limiting ETS exposure by asking smokers to stop , avoiding areas with ETS , and enacting smoking bans in the home . However , the intervention had little to no impact on the number of smokers and the amount of tobacco smoked . CONCLUSIONS Results are consistent with previous studies showing that changing smokers ' behavior can be difficult , but community-wide efforts to reduce ETS exposure through smoking bans , education , and empowering people to ask smokers to stop are effective . The method can be generalized to other setting Introduction A survey conducted by the German Federal Centre for Health Education in 2012 showed that 35.2 % of all young adults ( 18–25 years ) and 12.0 % of all adolescents ( 12–17 years ) in Germany are regular cigarette smokers . Most smoked their first cigarette in early adolescence . We recently reported a significantly positive short-term effect of a physician-delivered school-based smoking prevention programme on the smoking behaviour of schoolchildren in Germany . However , physician-based programmes are usually very expensive . Therefore , we will evaluate and optimise Education against Tobacco ( EAT ) , a widespread , low-cost programme delivered by about 400 medical students from 16 universities in Germany . Methods and analysis A prospect i ve quasi-experimental study design with two measurements at baseline ( t1 ) and 6 months post-intervention ( t2 ) to investigate an intervention in 10–15-year-olds in grade s 6–8 at German secondary schools . The intervention programme consists of two 60-min school-based medical-student-delivered modules with ( module 1 ) and without the involvement of patients with tobacco-related diseases and control groups ( no intervention ) . The study question naire measuring smoking status ( water pipe and cigarette smoking ) , smoking-related cognitions , and gender , social and cultural aspects was design ed and pre-tested in advance . The primary end point is the prevalence of smokers and non-smokers in the two study arms at 6 months after the intervention . The percentage of former smokers and new smokers in the two groups and the measures of smoking behaviour will be studied as secondary outcome measures . Ethics and dissemination In accordance with Good Epidemiologic Practice ( GEP ) guidelines , the study protocol was su bmi tted for approval by the responsible ethics committee , which decided that the study does not need ethical approval ( Goethe University , Frankfurt-Main , Germany ) . Findings will be disseminated in peer- review ed journals , at conferences , within our scientific advisory board and through medical students within the EAT project Background Among Arab citizens in Israel , cigarette and nargila ( hookah , waterpipe ) smoking is a serious public health problem , particularly among the young adult population . With the dramatic increase of Internet and computer use among Arab college and university students , a Web-based program may provide an easy , accessible tool to reduce smoking rates without heavy re source dem and s required by traditional methods . Objective The purpose of this research was to examine the acceptability and feasibility of a pilot Web-based program that provides tailored feedback to increase smoking knowledge and reduce cigarette and nargila smoking behaviors among Arab college/university students in Israel . Methods A pilot Web-based program was developed , consisting of a self-administered question naire and feedback system on cigarette and nargila smoking .  Arab university students were recruited to participate in a mixed- methods study , using both quantitative ( pre-/posttest study design ) and qualitative tools . A posttest was implemented at 1 month following participation in the intervention to assess any changes in smoking knowledge and behaviors . Focus group sessions were implemented to assess acceptability and preferences related to the Web-based program . Results A total of 225 participants —response rate of 63.2 % (225/356)—completed the intervention at baseline and at 1-month post study , and were used for the comparative analysis . Statistically significant reductions in nargila smoking among participants ( P=.001 ) were found . The intervention did not result in reductions in cigarette smoking . However , the tailored Web intervention result ed in statistically significant increases in the intention to quit smoking ( P=.021 ) . No statistically significant increases in knowledge were seen at 1-month post study . Participants expressed high satisfaction with the intervention and 93.8 % ( 211/225 ) of those who completed the intervention at both time intervals reported that they would recommend the program to their friends , indicating excellent acceptability and feasibility of the intervention . This was further emphasized in the focus group sessions . Conclusions A tailored Web-based program may be a promising tool to reduce nargila smoking among Arab university students in Israel . The tailored Web intervention was not successful at significantly reducing cigarette smoking or increasing knowledge . However , the intervention did increase participants ’ intention to quit smoking . Participants considered the Web-based tool to be an interesting , feasible , and highly acceptable strategy . Trial Registration Trial Registration : IS RCT N registry IS RCT N59207794 ; http://www.is rct n.com/IS RCT N59207794 ( Archived by WebCite at http://www.webcitation.org/6VkYOBNOJ ) Introduction Gender composition and the soaring trends of drug and tobacco dependency reveal the priority of social skills training related to drug avoidance self-efficacy among female students . The aim of this study was to verify the impact training high school female students to have the social skills needed to avoid the use of drugs . Methods This study was conducted from September 2012 to May 2013 in two high schools in Ahvaz City in southwest Iran . The participants were divided r and omly into two groups of 60 students , one experimental group and one control group using the multi-stage simple sampling method . Two question naires , i.e. the ASES and TISS question naires , were completed before and after the intervention . Descriptive statistics , chi squared , paired- sample s t-test , and the independent- sample s t-test were used . Results The participants had a mean age of 14.93 years . Among the 120 participants , 90.8 % indicated that they had never smoked a cigarette , and 51.7 % of the participants denied having smoked a hookah . There was no significant relationship between the self-sufficiency means of drug avoidance in the two groups of girls before intervention ( p ≥ 0.05 ) . However , after intervention , a significant difference was found in test score of self-efficacy of drug avoidance between the two groups , i.e. , 94.91 ± 8.3 for the control group versus 99.16 ± 3.8 for the experimental group , p < 0.05 ) . Significant increases were observed for the pre- and post-test scores of self-efficacy of drug avoidance in the experimental group compared to the control group ( 99.16 ± 3.8 ( p = 0.001 ) vs. 96.58 ± 6.98 ( p > 0.05 ) . The mean values of the pre- and post-test scores of social skill before and after intervention increased significantly only for the experimental group ( 97.60 ± 19.19 vs. 100.58 ± 12.37 , p = 0.03 ) . Conclusion Educational intervention can significantly enhance social skills for drug avoidance self-efficacy , so it is recommended that such skills be taught in the high school curriculum OBJECTIVE To examine baseline characteristics and biochemically verified 1- , 4- , and 6-month tobacco quit rates among college students enrolled in a Quit and Win cessation trial , comparing those who concurrently smoke both hookah and cigarettes with those who deny hookah use . METHODS Analyses were conducted on data from 1217 college students enrolled in a Quit and Win tobacco cessation r and omized clinical trial from 2010 - 2012 . Multivariable logistic regression ( MLR ) analyses examined group differences in baseline characteristics and cotinine verified 30-day abstinence at 1 , 4 , and 6-month follow-up , adjusting for baseline covariates . RESULTS Participants smoked 11.5(±8.1 ) cigarettes per day on 28.5(±3.8 ) days/month , and 22 % smoked hookah in the past 30days .  Hookah smokers ( n=270 ) were more likely to be male ( p<0.0001 ) , younger ( p<0.0001 ) , report more binge drinking ( p<0.0001 ) and score higher on impulsivity ( p<0.001 ) . MLR results indicate that hookah users , when compared to non-users , had a 36 % decrease in odds of self-reported 30-day abstinence at 4-months ( OR=0.64 , 95 % CI=0.45 - 0.93 , p=0.02 ) and a 63 % decrease in odds in biochemically verified continuous abstinence at 6-months ( OR=0.37 , CI=0.14 - 0.99 , p=0.05 ) . CONCLUSION College cigarette smokers who concurrently use hookah  display several health risk factors and demonstrate lower short and long-term tobacco abstinence rates BACKGROUND Tobacco use is responsible for a large proportion of the total disease burden from tuberculosis . Pakistan is one of the 10 high-burden countries for both tuberculosis and tobacco use . OBJECTIVE To assess the effectiveness of a behavioral support intervention and bupropion in achieving 6-month continuous abstinence in adult smokers with suspected pulmonary tuberculosis . DESIGN Cluster r and omized , controlled trial . ( Current Controlled Trials : IS RCT N08829879 ) SETTING Health centers in the Jhang and Sargodha districts in Pakistan . PATIENTS 1955 adult smokers with suspected tuberculosis . INTERVENTION Health centers were r and omly assigned to provide 2 brief behavioral support sessions ( BSS ) , BSS plus 7 weeks of bupropion therapy ( BSS+ ) , or usual care . MEASUREMENTS The primary end point was continuous abstinence at 6 months after the quit date and was determined by carbon monoxide levels in patients . Secondary end points were point abstinence at 1 and 6 months . RESULTS Both treatments led to statistically significant relative risks ( RRs ) for abstinence compared with usual care ( RR for BSS+ , 8.2 [ 95 % CI , 3.7 to 18.2 ] ; 
    Output:
    
Interventions focusing on reducing hookah pipe use are limited .
Counselling and educational support sessions seem to be the most feasible and potentially successful approaches for intervention