Waterpipe dependence in university students and effect of normative beliefs: a cross-sectional study

Abstract

ObjectivesThe objective of this study was to measure the correlates, including normative beliefs, associated with waterpipe (WP) and cigarette smoking prevalence and dependence.SettingA cross-sectional study was carried out using a proportionate cluster sample of Lebanese students in 17 public and private universities.ParticipantsOf the 4900 distributed questionnaires, 3384 (69.1%) were returned to the field worker. All available students during break times were approached, with no exclusion criteria.Primary and secondary outcome measuressociodemographic variables, detailed active and passive smoking, in addition to items of the tobacco dependence scales were all evaluated.ResultsCorrelates to WP smoking were studying in a private university (adjusted OR, aOR=1.50 (1.26 to 1.79); p<0.001) and ever smoking cigarettes (aOR=1.80(1.44 to 2.26); p<0.001); friends’ and societal influence were found on smoking behaviour and dependence. Although the role of parents was not visible in decreasing the risk of smoking WP, their protective influence seemed more important on WP dependence (β=−1.09(−1.79 to −0.28); p<0.001), a behaviour that is considered more deleterious for health. Parents’ and friends’ disagreement with smoking had a protective effect on cigarette smoking and dependence (aOR<1; p<0.01), while thinking that idols and successful people smoke increased the risk of both cigarette smoking and dependence (aOR>1; p<0.01).ConclusionsIn conclusion, WP smoking and dependence are influenced by parents’ and friends’ opinions, and idols’ smoking status. Future research is necessary to further improve our understanding of motives for WP smoking and dependence.

Waterpipe and cigarette tobacco smoking among Palestinian university students: a cross-sectional study

“…This evidence reveals varying degrees of WTS use and popularity in different contexts, which could partially be due to existing tobacco laws and in part due to the social and cultural acceptability of WTS among youth [33, 34]. In addition, when considering the higher reported prevalence of WTS among our study sample in comparison with the prevalence in countries such as the U.S. and the U.K., it is worth pointing out that WTS has been linked to social class and prestige in the Middle Eastern culture, while the opposite was true in Western countries [8, 9, 19, 35–38]. Some studies in the U.S. have also found a higher WTS prevalence among university students from Arab or Middle Eastern decent in comparison to students from other backgrounds [31, 39].…”

Waterpipe Use and Cognitive Susceptibility to Cigarette Smoking Among Never-Cigarette Smoking Jordanian Youth: Analysis of the 2009 Global Youth Tobacco Survey

“…30 A recent study conducted among Jordanian youth indicated a high prevalence of dual tobacco smoking particularly among girls. 13 This may indicate that once WP smoking is initiated, youth become more likely to use other forms of tobacco, in this case cigarettes, as a substitute nicotine source to avoid withdrawal symptoms.…”

Varenicline versus placebo for waterpipe smoking cessation: a double‐blind randomized controlled trial

“…Our trial participants were generally older, smoked daily and frequently and used traditional waterpipes (hookah) with unflavoured tobacco in social settings common in rural Punjab. Such characteristics and smoking behaviours are remarkably different from many other countries, where most waterpipe smokers are younger, use waterpipe tobacco mixed with flavoured molasses and often smoke intermittently in bars and cafes . This limits the external validity of our trial findings.…”