Waterpipe and cigarette tobacco smoking and depressive symptoms among public school students in central Jordan

Abstract

PurposeTobacco is the most widely used substance in the world that has been linked to several psychological problems. Few studies have assessed the relationship between dual (waterpipe and cigarette) tobacco smoking. This study aims to examine the relationship between dual tobacco use and symptoms of depression amongst its users.Design/methodology/approachA cross-sectional study using a random sample of school students was conducted to assess youth tobacco smoking in the central region of Jordan. A self-reported questionnaire including biographical information, smoking status and experience of depression symptoms was used with a sample of 9th to 12th-grade students. χ2 and regression test were used to analyze the data.FindingsThe final sample comprised 576 school students, of whom 60% were males. The age range was between 16 and 18 years (mean = 15.84 years, SD ± 0.97). 30% of the participants were dual tobacco smokers. A significant difference was found between males and females, with males being more likely to be dual tobacco smokers compared to females. Two depressive symptoms (“feeling sad” and “having crying spells”) had a significant likelihood amongst the youth who were dual smokers.Originality/valueTo the best of the authors' knowledge, this is the first study that aims to report the relationship between dual tobacco smoking and depressive symptoms. Prevention programs are crucial for raising awareness of the harmful effects of dual tobacco smoking and smoking cessation amongst the youth

Waterpipe Nicotine Dependence and Depressive Symptoms among Adolescent Waterpipe and Dual Users

“…To our knowledge, this study is the first study to examine waterpipe nicotine dependence and depressive symptoms among adolescent dual tobacco users. Depressive mood has been linked to higher nicotine dependence among youth who use cigarettes [ 18 , 19 ] and usage of waterpipe [ 21 ], and this novel study highlights a similar pattern with waterpipe and dual users. This topic is of timely importance as waterpipe and dual tobacco use are becoming more common and customarily accepted among youth and women in Jordan [ 35 , 37 ] and the world [ 9 ].…”

“…The Arabic Youth Tobacco Use Composite Measure Questionnaire was utilized to collect the data, and it was designed as a single measure to assess the pattern of tobacco smoking among youth [ 34 , 35 ]. The questionnaire consisted of four sections: (a) demographics which includes age, grade, father/mother job, and academic achievements, (b) tobacco smoking status asking about applicable history of smoking habits and waterpipe smoking habits, (c) a depression symptoms scale [ 21 ], which includes 6 items assessing the presence of depression, and (d) the Waterpipe Nicotine Dependence Scale (WNDS) which measures the level of nicotine dependence among waterpipe smokers. Response options in the questionnaire varied based on the construct and items measuring that construct including Likert-type responses, yes/no responses, fill in the blank, and multiple-choice questions.…”

“…A similar approach was adopted with the Depressive Symptoms Scale, which had 6 questions, with 4 answer options ranging from (1) rarely or none of the time to (5) most or all of the time [ 21 , 35 ]. The answers were summed into one variable resulting in a scale ranging from 6 to 24, with 15 being the midpoint of the scale.…”

“…The questions included in the scale are from the CES-D scale; questions 5, 14, and 17–20 [ 36 ]. The brief scale was utilized and assessed previously in similar studies [ 21 , 35 ]. Generally, the higher the score, the higher the symptomology.…”

“…Additionally, exposure to nicotine at an early age of the person's developmental stages in childhood or adolescence could result in brain developmental impairments such as deficiency of working memory [ 17 ]. Furthermore, tobacco smoking (cigarettes and waterpipe) is linked to depression and depressive symptoms [ 18 – 21 ], as smokers are more susceptible to develop depressive symptoms compared to nonsmokers [ 21 , 22 ]. In Jordan, Malak and Khalifeh have reported 73.8% prevalence of depressive symptoms among adolescents aged 12–18 [ 23 ], while Ismayilova et al reported increased depressive symptoms among youth smokers [ 24 ].…”