Waterpipe Tobacco Smoking among university students in Turkey

Reasons for cigarette and tobacco product use, dual use, and poly use among university students

INTRODUCTION

Tobacco use remains a significant public health issue worldwide, causing over 7 million deaths annually. Polytobacco use has become a common phenomenon. This study aims to analyze reasons for cigarette and tobacco product use, dual use and poly use among university students by sex, in China and Cyprus, selected owing to their still high consumption rates.

METHODS

An online survey was conducted among 589 university students (55% women) with a mean age of 24.2 years from Guangzhou, China, and the Republic of Cyprus. Participants reported their use of cigarettes, e-cigarettes, and waterpipes, as well as their reasons for using these products. Statistical analyses included chi-squared tests, and effect sizes were computed using the phi (φ) coefficient.

RESULTS

The Chinese participants gave as reasons for using cigarettes: 'because of the taste', 'because it looks cool', 'to get high' and 'because friends and family use them'. These were less frequently given by the Cypriots who opted more for 'to relax and relieve tension'. Compared to the Cypriot participants, the more frequent reasons given for consuming e-cigarettes and waterpipes among Chinese students were: 'due to boredom', 'because it looks cool', 'to get high', 'because I am hooked', 'because friends or family members use them', 'because they are less harmful than regular cigarettes' and 'because friends of family members allow their use more'. Dual or poly users felt more addicted than those who practiced single use. Among e-cigarette users, dual users and poly users valued the taste of the product more than single users. In general, men found more reasons for tobacco use than women did.

CONCLUSIONS

This study shows substantial differences in the motivation for using these products according to the product type, number of tobacco/nicotine products used, country, and sex. Understanding the reasons for tobacco use can inform targeted interventions aimed at reducing tobacco consumption among young adults.

Social Acceptability and Health Concerns of Smoking and Vaping Among University Students: A Cross-Sectional Study

Objective

This study aimed to assess tobacco and vaping habits among university students, exploring awareness of university policies, attitudes, and behaviors related to smoking and vaping.

Methods

An online questionnaire was distributed among students from various universities, including institutions in Pakistan, covering demographics, smoking and vaping behaviors, awareness of policies, and beliefs. Data was analyzed using descriptive statistics, Binomial tests, Chi-square tests, and logistic regression.

Results

Out of the total 683 respondents, 65.02% were female, and 34.98% were male. Most participants were undergraduate students (71.31%), with Dentistry being the most represented field (50.36%). Most students perceived smoking or vaping as socially acceptable (58.3%) and were aware of university policies (59.3%). However, 46.6% were aware of cessation programs. Most of the students expressed concern about long-term vaping health risks (74.5%). Logistic regression identified gender (Male) and field of study (Dentistry) as significant predictors of policy awareness.

Conclusion

University students exhibit varied perceptions and behaviors related to smoking and vaping. The study highlights the importance of implementing effective policies and interventions to address tobacco and vaping use among them.

Shisha Consumption and Presence of Cotinine in Saliva Samples among Students in Public Universities in Coastal Kenya

Background

Despite the well-known adverse health effects of tobacco, shisha use among students in tertiary institutions remains a public health concern. In Kenya, the literature on status of shisha after the 2017 ban is scanty. This study sought to ascertain actual shisha use among university students along the coastal strip.

Methods

We investigated confirmed and self-reported shisha use. Using proportionate-to-size and snowball sampling methods, 380 respondents were enrolled from three universities. Sociodemographic characteristics and self-reported history of shisha use were documented using a participant-assisted questionnaire. Actual shisha use was determined qualitatively using 6 panel plus alcohol saliva test kit that detected cotinine use among other selected drugs.

Results

Of the 380 participants, 278 (73%) were males and their median (IQR) age was 22 (20-23) years. This study reports 29% current use based on testing positive for cotinine. Among those who reported current ever use of shisha, 19% tested positive for cotinine, respectively. In the multivariable analysis, being separated (adjusted risk ratio (aRR): 2.06 (95% CI: 1.45-2.94)) compared to being single and studying for a degree compared to a diploma (aRR: 1.32 (95% CI: 1.10-1.58)) were associated with cotinine positive. The 4th year of study (aRR: 1.68 (95% CI: 1.22-2.33)) compared to the 1st year and reported knowledge of shisha (aRR: 1.84 (95% CI: 1.18-2.87)) were associated with cotinine positive.

Conclusion

Nearly one-third of university students along the Kenyan coast are active shisha users. Saliva testing for cotinine is a more reliable method of reporting tobacco use. We recommend upscaling of health education, re-enforcement of the current ban on shisha consumption by concerned authorities, and saliva testing for cotinine while assessing current tobacco use.

Association between textual and pictorial warnings on tumbac (waterpipe tobacco) boxes and motivation to quit waterpipe smoking among Lebanese and Iraqi adolescents

BACKGROUND

Waterpipe tobacco smoking has increased tremendously at a global level among all age groups, particularly young people. Previous studies have examined the impact of waterpipe tobacco pictorial health warnings on adults but scarce studies were done on adolescents. The aim of this study was to assess the association of textual versus pictorial warnings on tumbac boxes and the motivation to quit waterpipe smoking among adolescents located in two Eastern Mediterranean countries Lebanon and Iraq.

METHODS

A cross-sectional study was conducted between May and November 2022, involving 294 adolescents waterpipe smokers from Lebanon and Iraq. The questionnaire included the Lebanese Waterpipe Dependence Smoking-11, the Depression, Anxiety and Stress Scale, the Waterpipe Harm Perception Scale, Waterpipe Knowledge Scale, Waterpipe Attitude Scale, the Fagerstrom Test for Nicotine Dependence, and the Motivation to Stop Scale.

RESULTS

When adjusting the results over confounding variables, the results showed that compared to finding the warnings to stop smoking not efficacious at all, adolescents who find the warnings moderately (aOR = 2.83) and very (aOR = 6.64) efficacious had higher motivation to quit. Compared to finding the warnings not increasing their curiosity for information about how to stop waterpipe smoking at all, participants who confessed that warnings increased their curiosity a little (aOR = 2.59), moderately (aOR = 3.34) and very (aOR = 3.58) had higher motivation to quit. Compared to not considering changing the tumbac brand if the company uses pictorial warnings, adolescents who would consider changing the tumbac brand (aOR = 2.15) had higher motivation to quit.

CONCLUSION

Pictorial and textual warnings on waterpipe packs were associated with higher motivation to stop waterpipe smoking. Public health education programs for this purpose seem warranted.

The effect of happiness-based education on women's success of water pipe smoking cessation and happiness: a quasi-experimental study

BACKGROUND

Water pipe smoking by women threatens their health. Therefore, it is necessary to take measures to reduce this unhealthy behavior. This study aimed to determine the effect of happiness-based education on women's success of water pipe smoking cessation and happiness.

METHODS

This quasi-experimental study was conducted on female water pipe smokers in Iran, from September to January 2021. The participants (n = 68) were selected using convenience sampling and assigned to the intervention and control groups (34 subjects per group) by blocked randomization. The intervention group received a happiness-based education for one month (eight sessions) based on the Fordyce happiness program. The control group did not receive any special education. Data were collected using the Water Pipe Dependence Scale and the Oxford Happiness Questionnaire before and two months after the intervention. Data were analyzed using descriptive statistics, Chi-square, Fisher's exact test, Independent t-test, Mann-Whitney, and Wilcoxon tests by SPSS software version 22.

RESULTS

Two months after the intervention, the mean change in the happiness score was significantly higher in the intervention group (2.32 ± 2.31) than that in the control group (-0.29 ± 1.81) (P < 0.001). Furthermore, the mean change in the score of water pipe dependence was significantly different between the intervention (-1.44 ± 1.4) and control (0.38 ± 0.85) groups (P < 0.001).

CONCLUSION

The results showed that education based on Fordyce happiness program can increase the success of water pipe smoking cessation and happiness in women. Therefore, it is recommended to use similar interventions in women's health promotion programs.