***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 A nonr and om sampIe of 2972 Kuwaitis answered a question naire about smoking behaviour and beliefs . More than one-third ( 35 % ) were nonsmokers , 45 % smoked only the waterpipe , 12 % only cigarettes and 8 % both waterpipe and cigarettes . Compared with cigarette smokers , waterpipe smokers were more likely to be female and to be unskilled manual workers than professionals or students . Waterpipe smokers started the habit at an older age on average than cigarette smokers . Most waterpipe smokers smoked only 1 bowl per day , and smoked mostly at coffee houses . Factor analysis of beliefs about waterpipe smoking result ed in 4 groups of beliefs which explained 50 % of the variance . The results are discussed in terms of public health policy and possible risk reduction strategies Cigarette smoking was measured in a naive tenth grade population under conditions expected to influence the student 's willingness to admit smoking . All students were tested for smoking both by question naire and by expired-air carbon monoxide assessment . The carbon monoxide data were used to test the equivalence of the study groups and to partition the sample into smokers and nonsmokers . Of the smokers those who were advised in advance of the biological test were twice as likely to admit cigarette use in the past week compared to those who were advised of the testing procedure only after they had completed their question naire . A live explanation and demonstration of the biological testing procedure proved as effective as a videotaped message . These data support earlier reports of the ' bogus pipeline ' effect . Several method ological issues are discussed which may explain previous failures to replicate this finding 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 ] ; RR for BSS , 7.4 [ CI , 3.4 to 16.4 ] ) . Equivalence between the treatments could not be established . In the BSS+ group , 275 of 606 patients ( 45.4 % [ CI , 41.4 % to 49.4 % ] ) achieved continuous abstinence compared with 254 of 620 ( 41.0 % [ CI , 37.1 % to 45.0 % ] ) in the BSS group and 52 of 615 ( 8.5 % [ CI , 6.4 % to 10.9 % ] ) in the usual care group . There was substantial heterogeneity of program effects across clusters . LIMITATIONS Imbalances in the urban and rural proportions and smoking habits among treatment groups , and inability to confirm adherence to bupropion treatment and vali date longer-term abstinence or the effect of smoking cessation on tuberculosis outcomes . CONCLUSION Behavioral support alone or in combination with bupropion is effective in promoting cessation in smokers with suspected tuberculosis . PRIMARY FUNDING SOURCE International Development Research Centre BACKGROUND Waterpipe use has increased dramatically in the Middle East and other parts of the world . Many users exhibit signs of dependence , including withdrawal and difficulty quitting , but there is no evidence base to guide cessation efforts . METHODS We developed a behavioral cessation program for willing-to-quit waterpipe users , and evaluated its feasibility and efficacy in a pilot , two arm , parallel group , r and omized , open label trial in Aleppo , Syria . Fifty adults who smoked waterpipe ≥3 times per week in the last year , did not smoke cigarettes , and were interested in quitting were r and omized to receive either brief ( 1 in-person session and 3 phone calls ) or intensive ( 3 in-person sessions and 5 phone calls ) behavioral cessation treatment delivered by a trained physician in a clinical setting . The primary efficacy end point of the developed interventions was prolonged abstinence at three months post-quit day , assessed by self-report and exhaled carbon monoxide levels of < 10 ppm . Secondary end points were 7 day point-prevalent abstinence and adherence to treatment . RESULTS Thirty percent of participants were fully adherent to treatment , which did not vary by treatment group . The proportions of participants in the brief and intensive interventions  with prolonged abstinence at the 3-month assessment were 30.4 % and 44.4 % , respectively . Previous success in quitting ( OR=3.57 ; 95 % CI=1.03 - 12.43 ) predicted cessation . Higher baseline readiness to quit , more confidence in quitting , and being unemployed predicted a better adherence to treatment ( all p-values < 0.05 ) . CONCLUSIONS Brief behavioral cessation treatment for waterpipe users appears to be feasible and effective INTRODUCTION There is a rising prevalence of waterpipe smoking worldwide , but still a paucity of information on perceptions toward quitting waterpipe use . We set out to establish the beliefs and perceptions of café waterpipe smokers toward quitting waterpipe smoking in the Kingdom of Bahrain . METHODS A cross-sectional study . A r and om sample of 20 of 91 cafés serving waterpipe tobacco in Bahrain was taken . A question naire was administered in each café to 20 participants aged 18 and above . RESULTS Three hundred eighty participants completed question naires from waterpipe smokers . Eighty-four percent of participants were Bahraini and 71 % had a university degree . Mean age was 28.9 years . Average age of waterpipe smoking initiation was 20.3 years . The majority of waterpipe users chose flavored tobacco . Sixty-one percent smoked waterpipe tobacco daily with a mean smoking time of 2.6hr/day . Seventy-two percent considered waterpipe tobacco as harmful as or more harmful than cigarettes , but 67 % considered cigarettes as more addictive . Eighty-two percent stated that they could  quit waterpipe at any time , but only 40 % were interested in quitting . Interest in quitting smoking was related to 4 variables : a physician mentioning the need to quit smoking , being non-Bahraini , having a family with a hostile attitude toward waterpipe smoking , and not considering oneself " hooked " on waterpipe tobacco . CONCLUSIONS Waterpipe smokers in Bahrain cafés are frequent and high users . Health professionals must consider waterpipe smoking in all consultations and health promotion messages . A partnership between health professionals and disapproving members of families may be an effective strategy in encouraging waterpipe smokers to quit A pilot study of  narghile water-pipe smokers in a cafe in the Hamra neighborhood of Beirut , Lebanon , was conducted to develop a preliminary model of narghile water-pipe smoking behavior for use in laboratory smoking machine studies . The model is based on data gathered from smoking sessions of 30 min or longer duration from 52 smoker volunteers using a differential pressure puff topography instrument  , as well as anonymous visual observations of 56 smokers in the same cafe . Results showed that the " average " water-pipe cafe smoking session consists of one hundred seventy-one 530-ml puffs of 2.6-s duration at a frequency of 2.8 puffs/min . The implication s of this comparatively high-intensity puffing regimen on the production of toxic smoke constituents are discussed OBJECTIVES To determine the prevalence and predictors of smoking  nargileh and /or cigarettes among school students in Greater Beirut , Lebanon . METHODS A proportionate r and om sample of 2443 students from 13 public and private schools was selected and asked to complete self-administered anonymous question naires . RESULTS The prevalence of smoking cigarettes only , nargileh only , and both was 2.5 % , 25.6 % , and 6.3 % , respectively . Stepwise regression analyses revealed that the predictors of smoking for either type are different , whereby nargileh smoking is more culturally accepted than cigarette smoking . CONCLUSIONS Design interventions to increase awareness towards the hazards of the misconceived harmless effects of nargileh smoking UNLABELLED The aim of this study is to analyse the acute effect of  water-pipe smoking on heart rate , blood pressure and the baroreflex control of heart rate . SUBJECTS AND METHODS Non-invasive continuous methods were used for investigating inter-beat interval ( IBI ; ms ) , systolic blood pressure ( SBP ; mm Hg ) , diastolic blood pressure ( DBP ; mm Hg ) , pulse pressure ( PP ; mm Hg ) , mean blood pressure ( MBP ; mm Hg ) ; baroreflex sensitivity in ms/mm Hg ( BRS ) and baroreflex sensitivity in Hz/mm Hg ( BRSf ) , were determined by spectral analysis , in 20 normotensive volunteers age of 27+/-6 years ( mean+/-S.D. ) who served as their own control . The measurements 
    Output:
    
Although the literature on waterpipe cessation interventions remains sparse , the review ed studies provide a basis for developing interventions in this area .