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Zamani-Alavijeh F, Heidari Z, Mostafavi F, Bashirian S, Makvandi Z, Kelishadi R. Psychometric evaluation of a new instrument to hookah tobacco smoking-related factors in the Iranian female university students based on the Extended Parallel Process Model. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 13:138. [PMID: 38784272 PMCID: PMC11114692 DOI: 10.4103/jehp.jehp_437_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 05/24/2023] [Indexed: 05/25/2024]
Abstract
BACKGROUND The higher prevalence of hookah tobacco smoking (HTS) has become worrisome in women. Thus, it is essential to identify and measure the perceptions associated with this unhealthy behavior as well as the type of response to risk messages to design the effective programs. This study aimed to psychometric evaluation of a new instrument, named the Extended Parallel Process Model-Hookah Tobacco Smoking Questionnaire (EPPM-HTSQ), for female university students. MATERIAL AND METHODS This methodological study was conducted in 2019-2020 in central and western Iran. The first version of the instrument was developed with 97 items. Face, Content, and construct validity methods were used to assess the EPPM-HTSQ validity. The data viability for factorability was guided through Kaiser-Meyer-Olkin (KMO) measure of sample adequacy (Values >0.7) and Bartlett's test of Sphericity (P < 0.05). The Exploratory Factor Analysis (EFA) method with varimax rotation and SPSS software was performed to identify the main factors of the questionnaire and interpretable factors. The internal consistency and external reliability were determined. The test-retest was used for evaluating the stability of tools. RESULTS During the assessment of the face and content validity 71 items remained in the questionnaire. EFA led to the extraction of nine dimensions: "Focusing on superior rewards," "Response Efficacy," "Perceived physical threat," "Perceived social threat," "Self-efficacy," "Fear control," "Attitude," "Fear," and "Intention" Kaiser-Meyer-Olkin (KMO) test (0.957) and Bartlett's test (P < 0.001). Cronbach's alpha (0.871-0.951) and ICC (0.985-0.998) were approved for scale dimensions. CONCLUSION Important findings of the present study were the development and validation of the EPPM-HTSQ for measuring EPPM variables in relation to HTS; introducing a new variable "focusing on superior rewards"; as well as, the new classification of the concept of "perceived threat." The final version of the EPPM-HTSQ is a valid and reliable tool, but it is suggested to be re-evaluated in other studies with different populations and sample sizes.
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Affiliation(s)
- Fereshteh Zamani-Alavijeh
- Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Heidari
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Firoozeh Mostafavi
- Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Saeed Bashirian
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Zeinab Makvandi
- Department of Public Health, Asadabad School of Medical Sciences, Asadabad, Iran
| | - Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
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Bhargava SS, Das S, Priya H, Mishra D, Shivabasappa S, Sood A, Hazarika CR, Gupta PC, Chakma JK, Swasticharan L, Sinha P, Munish VG, Gupta SR. The Burden and Correlates of Waterpipe (Hookah) Smoking among Adolescents and Youth: A Systematic Review. Subst Use Misuse 2023; 59:29-40. [PMID: 37907086 DOI: 10.1080/10826084.2023.2257320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
BACKGROUND This systematic review evaluated the available medical literature on the prevalence and trends of waterpipe tobacco smoking among adolescents and youth in jurisdictionally representative populations. METHODS PubMed, Embase, and Scopus were searched for relevant studies from inception until 31 December 2022 that reported the burden of waterpipe smoking among adolescents and youth (10-24 years of age). We extracted qualitative data on the demographic characteristics, burden, and correlates of waterpipe smoking (PROSPERO ID: CRD42022310982). RESULTS A total of 2,197 articles were screened and 62 were included in the analysis. The majority (29) of the studies was from the United States of America and there were no studies from the south-east Asian region. The prevalence of ever waterpipe smoking among the 10-24 years age group was noted to be 18.16% (95% CI, 18.03-18.29). The prevalence of current (30-day) waterpipe smoking was 6.43% (95% CI, 6.34-6.50). The age of initiation of waterpipe smoking was variable. The prevalence of waterpipe smoking was higher among males, among those who belong to the high- and middle-income groups, and among university students. The common risk factors of waterpipe smoking included cigarette smoking, alcohol, and substance use. Waterpipe smoking resulted in increased susceptibility to the use of conventional forms of tobacco (e.g. smoking) among those who were never smokers. CONCLUSION Waterpipe smoking usage was significantly high among adolescents and young adults. Developing regulatory guidelines for water-pipe smoking, surveillance of its use, intervention, and specific policy frameworks may be considered a public health priority.
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Affiliation(s)
- Stuti Sharad Bhargava
- Division of Non Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Saibal Das
- Indian Council of Medical Research - Centre for Ageing and Mental Health, Kolkata, India
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Harsh Priya
- Department of Public Health Dentistry, Centre for Dental Education and Research, All India institute of Medical Sciences, New Delhi, India
| | - Deepika Mishra
- Department of Oral Pathology and Microbiology, Centre for Dental Education and Research, All India institute of Medical Sciences, New Delhi, India
| | - Santhosh Shivabasappa
- Department of Clinical Pharmacology, Jawaharlal Institute of Postgraduate Medical Eductaion and Research, Puducherry, India
| | - Anubhuti Sood
- Translational Health Science and Technology Institute, Faridabad, India
| | - Chaya Rani Hazarika
- Socio-Behavioral Health Systems and Implementation Research Division, Indian Council of Medical Research, New Delhi, India
| | | | - Joy Kumar Chakma
- Division of Non Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Leimapokpam Swasticharan
- Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, New Delhi, India
| | | | | | - Shalini R Gupta
- Department of Oral Medicine and Radiology, Centre for Dental Education and Research, All India institute of Medical Sciences, New Delhi, India
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Nyman J, Tornivuori A, Salanterä S, Barroso T, Parisod H. Systematic review of digital interventions to support refusal self-efficacy in child and adolescent health promotion. Health Promot Int 2022; 37:6722695. [PMID: 36166268 DOI: 10.1093/heapro/daac085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Refusal self-efficacy protects against risky health behavior. Digital interventions have the potential to support self-efficacy due to the enactive experience provided by digital technologies. The aim of this systematic literature review was to evaluate the evidence of digital interventions to support refusal self-efficacy in child and adolescent health promotion. Following the Cochrane Collaboration guidelines, five electronic databases were searched from 2009 to 2020. The studies were assessed by two independent reviewers according to the eligibility criteria. Eligible studies were included in the review, assessed for risk of bias, synthesized narratively and assessed for evidence quality with the GRADE approach. Twenty-three studies, that examined 18 different interventions, were included in the review. The interventions included various digital elements as means to support the child and adolescent refusal self-efficacy (e.g. games, videos, feedback and activities for regulating feelings). The interventions improving refusal self-efficacy were more often used at home setting and addressed the four sources of self-efficacy with different digital elements regardless of intervention duration and intensity. Although the results on intervention effects varied and the evidence quality remained low, the overall evidence concerning these interventions was encouraging. Based on the subgroup analysis, the results were mainly encouraging among girls. When these interventions are implemented in health promotion, their benefits and weaknesses need to be considered comprehensively. The results provide information for designing and developing digital interventions to support child and adolescent refusal self-efficacy. Further research with larger sample sizes and more rigorous study designs is needed to strengthen the evidence of these interventions.
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Affiliation(s)
- Johanna Nyman
- Department of Nursing Science, FI-20014, University of Turku
| | - Anna Tornivuori
- Department of Nursing Science, FI-20014, University of Turku.,Turku University Hospital, Health Village, Turku, Finland
| | - Sanna Salanterä
- Department of Nursing Science, FI-20014, University of Turku.,Turku University Hospital, Turku, Finland
| | - Teresa Barroso
- Nursing School of Coimbra, Rua 5 de Outubro, Apartado 7001, 3046-851 Coimbra, Portugal
| | - Heidi Parisod
- Department of Nursing Science, FI-20014, University of Turku.,Nursing Research Foundation sr (NRF), Asemamiehenkatu 2, 00520 Helsinki, Finland
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Social Differences in Health Behaviours among Jordanian Adolescents. Eur J Investig Health Psychol Educ 2022; 12:1191-1204. [PMID: 36005232 PMCID: PMC9407352 DOI: 10.3390/ejihpe12080083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/15/2022] [Accepted: 08/17/2022] [Indexed: 11/16/2022] Open
Abstract
Social differences are evident in both developed and developing countries. During adolescence, there are limited differences in morbidity and mortality, but differences do appear in terms of health behaviours. This study aims to examine the relationship(s) between social differences and students’ health behaviours. A cross-sectional study was conducted in 2020 with a sample of high school students (N = 2741, aged 13–18 years) in Jordan. Besides descriptive statistics, bivariate logistic regression analysis was used to detect the odds risk for each social difference indicator. Females were engaged in more healthy dietary and hygienic behaviours and less engaged in smoking. Males were more physically active. Adolescents with a higher parental education level were more engaged in healthy behaviours; however, they drank carbonated soft drinks and ate fast food more often. Higher SES (socioeconomic status) self-evaluation was positively associated with eating breakfast and fruit and vegetables, being physically active, drinking carbonated soft drinks, eating fast food, and smoking. Our findings suggest that socioeconomic differences are important to understanding Jordanian adolescents’ health behaviours. While females tend to engage in more healthy behaviours, the role of parental education and perceived family affluence is not always beneficial in terms of adolescents’ dietary habits, hygienic behaviour, or smoking.
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Gautam P, Sharma E, Ebrahimi Kalan M, Li W, Ward KD, Sutherland MT, Cano MA, Li T, Maziak W. Prevalence and predictors of waterpipe smoking initiation and progression among adolescents and young adults in waves 1-4 (2013-18) of the Population Assessment of Tobacco and Health (PATH) study. Nicotine Tob Res 2022; 24:1281-1290. [PMID: 35196383 DOI: 10.1093/ntr/ntac051] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 02/15/2022] [Accepted: 02/21/2022] [Indexed: 11/14/2022]
Abstract
BACKGROUND Waterpipe tobacco (WPT) smoking has increased among the young population in the United States (US). This study assessed the extent and predictors of WPT smoking initiation and progression among US adolescents (12-17 years) and young adults (18-24 years) longitudinally. METHODS We analyzed data from 4 waves (2013-2018) of the Population Assessment of Tobacco and Health (PATH) study comprising 10,692 respondents (adolescents=5,428 and young adults=5,264). Kaplan-Meier survival method estimated probabilities of WPT initiation and progression. Cox proportional hazards regression models delineated predictors of the outcomes. RESULTS Between 2013 to 2018, 4.8% of adolescents initiated and 10.6% progressed WPT smoking. Among young adults, 18.5% initiated and 14.1% progressed WPT smoking during the same time interval. Predictors among adolescents included, WPT initiation: Hispanic ethnicity (adjusted odds ratio (aHR)=1.75, 95% confidence interval (CI)=1.23-2.49), lower harm perception (aHR=2.89, 95% CI=2.10-3.98), and other tobacco products use (aHR=3.97, 95% CI=2.73-5.78); WPT progression: illicit drug use (aHR=4.60, 95% CI=1.99-10.67). Predictors among young adults included, WPT initiation: non-Hispanic Black (aHR=2.31, 95% CI=1.78-3.00), Hispanic (aHR=1.77, 95% CI=1.34-2.33), lower harm perception (aHR=2.77, 95% CI=2.19-3.50), and other tobacco products use (aHR=3.14, 95% CI=2.25-4.38); WPT progression: non-Hispanic Black (aHR=1.51 95% CI=1.09-2.10), lower harm perception (aHR=1.80, 95% CI=1.41-2.30), and alcohol use (aHR=1.61, 95% CI=1.13-2.30). CONCLUSIONS Results indicate a high prevalence of WPT initiation and progression among adolescents and young adults over time, with minority racial/ethnic groups being at greater risk for both. WPT-specific risk communication interventions (e.g., educational campaigns and health warning labels) are warranted to limit WPT smoking among young people.
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Affiliation(s)
- Prem Gautam
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8thSt AHC5, 4thFloor, Miami, FL, 33199, USA
| | - Eva Sharma
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, 20850, USA
| | - Mohammad Ebrahimi Kalan
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, NC, USA.,Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC, USA
| | - Wei Li
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8thSt AHC5, 4thFloor, Miami, FL, 33199, USA
| | - Kenneth D Ward
- Syrian Center for Tobacco Studies, Tishreen Street, Sheehan, Aleppo, P.O.Box: 16542, Syria.,School of Public Health, University of Memphis, 3720 Alumni Ave, Memphis, TN 38152, USA
| | - Matthew T Sutherland
- Department of Psychology, Florida International University, 11101 S.W. 13 ST., Miami, FL 33199, USA
| | - Miguel Angel Cano
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8thSt AHC5, 4thFloor, Miami, FL, 33199, USA
| | - Tan Li
- Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St AHC5, 4th Floor, Miami, FL, 33199, USA
| | - Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8thSt AHC5, 4thFloor, Miami, FL, 33199, USA.,Syrian Center for Tobacco Studies, Tishreen Street, Sheehan, Aleppo, P.O.Box: 16542, Syria
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Babaie J, Ahmadi A, Abdollahi G, Doshmangir L. Preventing and controlling water pipe smoking: a systematic review of management interventions. BMC Public Health 2021; 21:344. [PMID: 33632181 PMCID: PMC7908788 DOI: 10.1186/s12889-021-10306-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 01/21/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Water pipe smoking (WPS) is re-gaining widespread use and popularity among various groups of people, especially adolescents. Despite different adverse health effects of WPS, many of the WPS interventions have failed to control this type of tobacco smoking. This study was conducted to identify experienced management interventions in preventing and controlling WPS worldwide. METHODS A systematic literature review was conducted. Electronic databases were searched for recordes which were published from beginning 1990 to August 2018. Studies aiming at evaluating, at least, one intervention in preventing and controlling WPS were included in this review, followed by performing the quality assessment and data extraction of eligible studies by two independent investigators. Finally, interventions that were identified from the content analysis process were discussed and classified into relevant categories. RESULTS After deleting duplications, 2228 out of 4343 retrieved records remained and 38 studies were selected as the main corpus of the present study. Then, the identified 27 interventions were grouped into four main categories including preventive (5, 18.51%) and control (8, 29.62%) interventions, as well as the enactment and implementation of legislations and policies for controlling WPS at national (7, 25.92%) and international (7, 25.92%) levels. CONCLUSION The current enforced legislations for preventing and controlling WPS are not supported by rigorous evidence. Informed school-based interventions, especially among adolescents can lead to promising results in preventing and controlling WPS and decreasing the effects of this important social and health crisis in the global arena.
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Affiliation(s)
- Javad Babaie
- Department of Health Policy& Management, Tabriz Health Services Management Research Centre, School of Management & Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ayat Ahmadi
- Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Abdollahi
- Department of Health Policy& Management, Tabriz Health Services Management Research Centre, School of Management & Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leila Doshmangir
- Department of Health Policy& Management, Tabriz Health Services Management Research Centre, School of Management & Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
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Vundavalli S, Alfawzan AA, Ramaiah VV, Alruwaithi M, AlMogbel A, Mathew M. Exposure to parental and sibling smoking and future intentions to smoke among 13-15 years old school age children in Saudi Arabia. Pan Afr Med J 2021; 38:158. [PMID: 33995765 PMCID: PMC8077676 DOI: 10.11604/pamj.2021.38.158.27825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 02/03/2021] [Indexed: 11/11/2022] Open
Abstract
Introduction prevalence of smoking in school children is alarming in Saudi Arabia and little is well-known about the aspects stimulating such behaviours in secondary school children. The aim of this study was to assess the association between influence of parent/sibling/peer smoking and future intentions to initiate smoke among 13-15 years old school children in Al Ras town, Saudi Arabia. Methods a cross sectional survey was conducted in Al Ras city during first quarter of 2019. Data was collected from 492 secondary school children who were selected through multistage stratified cluster sampling. Pretested, self-administered Arabic questionnaire was used to collect data about socio-demographic and prevalence of current smoking behaviours and associated factors. Descriptive statistics was done initially, following by binomial regression to assess the predictors of current smoking and future smoking intentions. Results the overall prevalence of smoking in respondents was 22.7% and statistically significant difference in smoking prevalence's between boys and girls was observed (40% vs 5.6%). Among the predictors of current smoking, smoking habits in siblings and getting pocket money over 200 Saudi riyals are found to be significant. Siblings smoking (odds ratio: 6.4) and poor academic performance (odds ratio: 3.2) were the two most important factors influencing children's intentions of smoking. Conclusion smoking prevalence in secondary school children of Al Ras was similar to national data. Since, influence of siblings, getting more pocket money and poor academic performance were found to important predictors of children smoking behaviours and attitudes, health education programs should address these factors to be effective.
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Affiliation(s)
- Sudhakar Vundavalli
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakakah, Saudi Arabia
| | - Ahmed Ali Alfawzan
- Department of Preventive Dentistry, College of Dentistry, Qassim University, Al Rass, Saudi Arabia
| | | | - Moataz Alruwaithi
- Eastern Riyadh Specialized Dental Center, Ministry Of Health, Riyadh, Saudi Arabia
| | - AbdulMajeed AlMogbel
- Department of Orthodontics and Pediatric Dentistry, College of Dentistry, Qassim University, Qassim, Saudi Arabia
| | - Merin Mathew
- Department of Prosthetic Dental Sciences, Dental Materials Division, College of Dentistry, Jouf University, Sakakah, Saudi Arabia
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Alzyoud S, Massoud F. Waterpipe and cigarette tobacco smoking and depressive symptoms among public school students in central Jordan. JOURNAL OF HEALTH RESEARCH 2020. [DOI: 10.1108/jhr-09-2019-0209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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
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Othman M, Aghamohammadi N, Nik Farid ND. Determinants of shisha use among secondary school students in Sudan. BMC Public Health 2019; 19:1390. [PMID: 31660934 PMCID: PMC6819635 DOI: 10.1186/s12889-019-7748-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 10/04/2019] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Shisha smoking has re-emerged in the Middle East in the last two decades and has spread rapidly in these communities. Information about shisha smoking in adolescents in Sudan is deficient. Hence, the aim of this study is to estimate the prevalence of shisha smoking among adolescents and determine the associated factors. METHODS This study is a school based cross sectional study among secondary school students in Khartoum State - Sudan that targets both male and female students aged 14-17 years. A total of 3387 students from 29 public and private schools were selected by multi stage random sampling. The participants completed an anonymous self-administered questionnaire which was based on Arabic version of the Global Youth Tobacco Survey (GYTS). RESULTS The response rate was 100% in schools and among participants, 57.3% were females and 51.6% were from public schools. The overall prevalence of those who had ever smoked shisha was 13.4%, and among male students the prevalence was 16.8%, while it was 10.9% in females. The associated factors were poor academic performance OR 2.90 CI 95% (1.21-6.94), friends smoking shisha OR 2.39 CI 95% (1.65-3.45), friends smoking cigarettes OR 2.76 CI 95% (1.90-4.01), peer pressure to smoke shisha OR 13.76 CI 95% (7.86-24.07) and unexpectedly restriction of selling shisha to minors OR 2.21 CI 95% (1.28-3.82). CONCLUSION The prevalence of those who had ever smoked shisha is among the lowest in Middle East region; therefore, regular surveillance system is needed. A well-structured peer based comprehensive tobacco control programmes that are supported by strict and rigorous anti-tobacco regulations which control both commercial and social resources of tobacco are needed to contain this issue among adolescents.
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Affiliation(s)
- Mohammed Othman
- Department of Social and Preventive medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nasrin Aghamohammadi
- Centre for Occupational and Environmental Health, Department of social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nik Daliana Nik Farid
- Department of Social and Preventive medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Determinants of Intentions toward Smoking Hookah in Iranian Adolescents Based on the Theory of Planned Behavior. IRANIAN JOURNAL OF PUBLIC HEALTH 2019; 48:1317-1325. [PMID: 31497554 PMCID: PMC6708534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Smoking hookah is considered a health problem among the adolescents, which currently has a high prevalence. The present study aimed to determine the reasons for tendency toward smoking hookah. METHODS Participants of this qualitative study were 24 adolescents from Tehran selected using purposeful sampling method in 2017. Data gathered through individual semi-structured interviews and two focus groups. Using directed content analysis approach 423 primary codes were categorized into 28 subcategories and 9 categories. RESULTS Most of the participants were 16 to 18 yr old (64%), male (58%) and had high school degree (58%) and 75% of them were student. In Theory of Planned Behavior, attitude toward smoking hookah contained categories of replacement for cigarette, the pleasurableness of hookah, easy access and spending the leisure times. Subjective norms contained the categories of family, friends and society. The construct of behavioral control contained the categories of personal and social factors. CONCLUSION Our Results could be helpful in policy-making and planning toward improving the awareness and changing the attitude and performance of the adolescents toward smoking hookah.
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Bashirian S, Barati M, Sharma M, Abasi H, Karami M. Water Pipe Smoking Reduction in the Male Adolescent Students: An Educational Intervention Using Multi-Theory Model. J Res Health Sci 2019; 19:e00438. [PMID: 31133627 PMCID: PMC6941630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Revised: 01/29/2019] [Accepted: 01/26/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Water pipe smoking (WPS) has increased and is becoming a major leisure pastime among young people in Iran. The aim of this study was to determine of efficacy of an educational intervention based on Multi-Theory Model (MTM) to reduce WPS in the male adolescent students in Iran. STUDY DESIGN A randomized controlled trial. METHODS Overall, 94 male adolescent students (grades 10, 11) smoked water pipe (WP) in the past month (current WP smokers) were selected, allocated randomly in two groups (47 students in intervention group and 47 students in control group), in two different schools in 2018 in Hamadan City, western Iran. Data were collected utilizing a valid and reliable questionnaire based on MTM constructs and demographic variables. Educational intervention was designed in five 45-min sessions. Two groups were followed-up three-months after completion of intervention. The collected data were analyzed using SPSS 22 software through Chi-square test, independent-sample t-test, paired-samples t-test, and Friedman test. RESULTS There were significant differences between the mean score of participatory dialogue, behavioral confidence, emotional transformation and practice for change in the intervention group compared with the control group after the intervention (P<0.001). In addition, significant reductions in the frequency of WPS (from 14.9% to 4.3%) were observed in the intervention group compared to the control group (P<0.001). CONCLUSION The developed educational intervention based on MTM constructs was efficacious and can be replicated for effectiveness studies to reduce WPS in the male adolescent students in Iran.
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Affiliation(s)
- Saeed Bashirian
- 1 Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Majid Barati
- 1 Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Manoj Sharma
- 2 Behavioral & Environmental Health, School of Public Health, Jackson State University, Jackson, MS, USA
| | - Hamid Abasi
- 3 Department of Public Health, School of Health, Hamadan University of Medical Sciences, Hamadan, Iran
,Correspondence: Hamid Abasi (MSc) Tel: +98 81 38380360 Fax: +98 81 38380360 E-mail:
| | - Manoochehr Karami
- 4 Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
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Bashirian S, Barati M, Abasi H, Sharma M, Karami M. The role of sociodemographic factors associated with waterpipe smoking among male adolescents in western Iran: A cross-sectional study. Tob Induc Dis 2018; 16:29. [PMID: 31516429 PMCID: PMC6659475 DOI: 10.18332/tid/91601] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 05/12/2018] [Accepted: 05/24/2018] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Waterpipe smoking (WPS) is an increasingly popular leisure activity among young people in Iran. The purpose of this study was to identify the role of sociodemographic factors associated with WPS among male adolescents in Iran. METHODS The study used a cross-sectional design. It included 730 high school male students (Grades 10–12) recruited through multistage random sampling conducted in 2017 in Hamadan city, western Iran. The self-administered questionnaires included information on demographic variables and behavioral risk factors related to WPS. Descriptive statistics and multinomial logistic regression modeling were conducted using SPSS. RESULTS The student mean age, and standard deviation (SD), and age at WPS initiation were 16.41 (0.84) and 13.31 (2.43) years, respectively. The percentages of never, former and current WPS were 37.3%, 36.4% and 26.3%, respectively. We found that ever cigarette smoking (OR=5.14, 95% CI: 2.56–10.32) and WPS family (OR=2.55, 95% CI: 1.40–4.64) were significantly associated with former WPS. Furthermore, being 18 years, studying in technical fields, reporting ever and current smoking of cigarettes and family usage of WP were significantly associated with current WPS. Friends with WPS (OR= 0.50, 95% CI: 0.34–0.72) however played a protective role on former WPS. CONCLUSIONS The results indicate that the prevalence of former and current WPS was high in Hamadan city. Thus, designing and implementing interventions for increasing students’, friends’ and family’s awareness regarding the harms of WPS and cigarette smoking are necessary to facilitate behavior change.
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Affiliation(s)
- Saeed Bashirian
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Majid Barati
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Hamid Abasi
- Department of Public Health, School of Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Manoj Sharma
- Behavioral & Environmental Health School of Public Health, Jackson State University, Jackson, United States
| | - Manoochehr Karami
- Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
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Pénzes M, Foley KL, Nădășan V, Paulik E, Ábrám Z, Urbán R. Bidirectional associations of e-cigarette, conventional cigarette and waterpipe experimentation among adolescents: A cross-lagged model. Addict Behav 2018; 80:59-64. [PMID: 29355818 DOI: 10.1016/j.addbeh.2018.01.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 01/10/2018] [Accepted: 01/10/2018] [Indexed: 01/02/2023]
Abstract
PURPOSE With an increasingly diverse tobacco product market, it is imperative to understand the trajectories of product experimentation in order to design effective prevention programs. This study aims to explore the bidirectional associations of conventional cigarette, e-cigarette and waterpipe experimentation in a large adolescent sample. METHODS Longitudinal assessment of conventional cigarette, e-cigarette and waterpipe use initiation was conducted in a school-based cohort of 1369 9th graders (mean age=14.88 SD=0.48 at baseline) during fall 2014 and reassessed 6-months later using online self-reported questionnaires. Autoregressive cross-lagged analysis within structural equation modeling framework was performed to simultaneously estimate the initiation of these products over a six-month period, controlling for age, gender, and participation in an intervention program to reduce conventional cigarette initiation. RESULTS Tobacco product lifetime use was prevalent at baseline in the sample: conventional cigarettes (48.4%), e-cigarettes (35.8%), and waterpipe (20.8%). At six-month follow-up, trying conventional cigarettes predicted trying e-cigarette (adjusted odds ratio (AOR)=3.78, CI95%: 2.66-5.37) and trying waterpipe (AOR=2.82, CI95%: 2.00-3.97). Trying e-cigarette predicted trying conventional cigarette (AOR=3.57, CI95%: 1.96-6.49) and trying waterpipe (AOR=1.51, CI95%: 1.07-2.14). Although trying waterpipe predicted trying e-cigarette at follow-up (AOR=2.10, CI95%: 1.30-3.40), its use did not predict trying conventional cigarette (AOR=0.55, CI95%: 0.24-1.30). CONCLUSIONS The high rates of poly-tobacco use and the bidirectionality of tobacco product experimentation demands comprehensive tobacco control and prevention programs that address the increasingly diverse tobacco product market targeting adolescents.
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Park SH, Duncan DT, Shahawy OE, Shearston JA, Lee L, Tamura K, Sherman SE, Weitzman M. Analysis of State-Specific Prevalence, Regional Differences, and Correlates of Hookah Use in U.S. Adults, 2012-2013. Nicotine Tob Res 2017; 19:1365-1374. [PMID: 27613949 PMCID: PMC5896515 DOI: 10.1093/ntr/ntw229] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 09/02/2016] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To investigate the state-specific prevalence, regional differences, and correlates of hookah use among U.S. adults. METHODS We analyzed the most recent nationally representative data of adults from the National Adult Tobacco Survey (NATS) 2012-2013 (n = 60192). State-specific prevalence of lifetime and current hookah use was calculated and mapped. Multivariate logistic regression was performed to determine the association between sociodemographic characteristics, regional differences, and hookah use. RESULTS Among U.S. adults (≥18 years), overall prevalence of lifetime hookah use was 12.3%, while current use was 3.9%. Mapping of state-specific prevalence revealed that the West tended to have higher rates of use, while the South tended to have lower ones. In the adjusted model, we observed that current hookah use was positively associated with younger adults, males, non-Hispanic adults, those with higher education and income statuses, being single, those living in the West, and current cigarette use. CONCLUSION The prevalence of hookah use varies by state, region, and sociodemographic characteristics among adults. Future research, including longitudinal studies, are needed to identify geographic and sociodemographic characteristics and trends among hookah users, investigate hookah-related health outcomes, and evaluate targeted public health efforts aimed at this emerging threat. IMPLICATIONS This study investigates state-level prevalence, regional differences, and sociodemographic characteristics of hookah use among U.S. adults, using the most recent NATS. Hookah use was positively associated with younger adults and those living in the West. This study adds to the understanding of the geographic and sociodemographic factors underlying hookah use, which can be used to develop much needed evidence-based regulations and programs that are responsive to the needs of different risk groups.
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Affiliation(s)
- Su Hyun Park
- Department of Pediatrics, New York University School of Medicine, New York, NY
| | - Dustin T Duncan
- Department of Population Health, New York University School of Medicine, New York, NY
- College of Global Public Health, New York University, New York, NY
| | - Omar El Shahawy
- Department of Population Health, New York University School of Medicine, New York, NY
- New York University in Abu Dhabi, Public Health Research Center, Abu Dhabi, UAE
| | - Jenni A Shearston
- Department of Population Health, New York University School of Medicine, New York, NY
- College of Global Public Health, New York University, New York, NY
- New York University in Abu Dhabi, Public Health Research Center, Abu Dhabi, UAE
| | - Lily Lee
- Department of Pediatrics, New York University School of Medicine, New York, NY
- Brooklyn College, New York, NY
| | - Kosuke Tamura
- Department of Population Health, New York University School of Medicine, New York, NY
| | - Scott E Sherman
- Department of Population Health, New York University School of Medicine, New York, NY
- College of Global Public Health, New York University, New York, NY
- New York University in Abu Dhabi, Public Health Research Center, Abu Dhabi, UAE
| | - Michael Weitzman
- Department of Pediatrics, New York University School of Medicine, New York, NY
- College of Global Public Health, New York University, New York, NY
- New York University in Abu Dhabi, Public Health Research Center, Abu Dhabi, UAE
- Department of Environmental Medicine, New York University, New York, NY
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Liu J, Zhao S, Chen X, Falk E, Albarracín D. The influence of peer behavior as a function of social and cultural closeness: A meta-analysis of normative influence on adolescent smoking initiation and continuation. Psychol Bull 2017; 143:1082-1115. [PMID: 28771020 PMCID: PMC5789806 DOI: 10.1037/bul0000113] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Although the influence of peers on adolescent smoking should vary depending on social dynamics, there is a lack of understanding of which elements are most crucial and how this dynamic unfolds for smoking initiation and continuation across areas of the world. The present meta-analysis included 75 studies yielding 237 effect sizes that examined associations between peers' smoking and adolescents' smoking initiation and continuation with longitudinal designs across 16 countries. Mixed-effects models with robust variance estimates were used to calculate weighted-mean Odds ratios. This work showed that having peers who smoke is associated with about twice the odds of adolescents beginning (OR ¯ = 1.96, 95% confidence interval [CI] [1.76, 2.19]) and continuing to smoke (OR ¯ = 1.78, 95% CI [1.55, 2.05]). Moderator analyses revealed that (a) smoking initiation was more positively correlated with peers' smoking when the interpersonal closeness between adolescents and their peers was higher (vs. lower); and (b) both smoking initiation and continuation were more positively correlated with peers' smoking when samples were from collectivistic (vs. individualistic) cultures. Thus, both individual as well as population level dynamics play a critical role in the strength of peer influence. Accounting for cultural variables may be especially important given effects on both initiation and continuation. Implications for theory, research, and antismoking intervention strategies are discussed. (PsycINFO Database Record
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Affiliation(s)
- Jiaying Liu
- Annenberg School for Communication, University of Pennsylvania
| | - Siman Zhao
- Department of Human Development and Family Studies, Purdue University
| | - Xi Chen
- Department of Human Development and Family Studies, University of Illinois at Urbana-Champaign
| | - Emily Falk
- Annenberg School for Communication, University of Pennsylvania
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Shojaeifar M, Niknami S, Mirbalochzahi A, Khammarnia M, Khorram A. Comparison of the effect of educational methods on students' knowledge, attitude and behavior about hookah smoking. Electron Physician 2017; 9:3870-3877. [PMID: 28465820 PMCID: PMC5410919 DOI: 10.19082/3870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 10/16/2016] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Smoking tobacco by hookah may seriously affect the health of smokers and those exposed to smoke. This study aimed to compare the effect of educational digital media versus pamphlets on the reduction of hookah use among male high school students in Zahedan, Iran. METHODS A semi-experimental study was conducted on 200 male high school students of Zahedan using multi-stage random sampling for three months in 2014. The samples were divided into two groups - the test (educated using digital films) and the control (educated using pamphlets) groups, and measurement was performed before and after intervention. The data collection instrument was a 53-item questionnaire consisting of demographic, knowledge, attitude, behavior and self-efficacy questions. Its validity and reliability were confirmed. The results before and after the intervention were analyzed using SPSS version 18, Mann-Whitney U test, Pearson-product moment correlation coefficient and Chi square test as well as one directional variance analysis. RESULTS There was no significant relation between demographic and basic variables before intervention (p>0.05); however, the mean scores of knowledge, attitude, self-efficacy, and hookah using preventive behavior were significantly different between the two groups after the intervention (p<0.05). Moreover, there was a meaningful relation among the demographic characteristics including age and attitude- the previous educational year's GPA and self-efficacy; and there was a significant relation between father education and self-efficacy. Moreover, there was a significant relation between the main variables of the study, concerning the relation of knowledge and attitude- knowledge and self-efficacy, and attitude and self-efficacy. CONCLUSION Educational digital media is more efficient than the pamphlet in the reduction of hookah use among the students; and that the media may be applied to prevent of hookah use among students.
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Affiliation(s)
- Maryam Shojaeifar
- M.Sc. Student of Health Education, Department of Health Education, Tarbiat Modares University, Tehran, Iran
| | - Shamsodin Niknami
- Ph.D. of Health Education, Associate Professor, Department of Health Education, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Ali Mirbalochzahi
- Instructor of Health Education, Faculty Member, Iranshahr University of Medical Sciences, Iranshahr, Iran
| | - Mohammad Khammarnia
- Ph.D. of Health Care Management, Assistant Professor, Department of Public Health, Faculty of Health, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Alireza Khorram
- M.Sc. Student of Epidemiology, Department of Epidemiology, Faculty of Health, Zahedan University of Medical Sciences, Zahedan, Iran
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Correlates of nicotine dependence among adolescent waterpipe smokers. Drug Alcohol Depend 2016; 168:230-238. [PMID: 27716576 PMCID: PMC5086296 DOI: 10.1016/j.drugalcdep.2016.09.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 09/19/2016] [Accepted: 09/20/2016] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Waterpipe smoking is addictive and its use is increasing globally among youth, yet little is known about the factors associated with nicotine dependence (ND) among waterpipe smokers. We investigated the factors associated with ND symptoms among a sample of Lebanese adolescents who smoke a waterpipe. METHODS We collected data on factors potentially associated with ND (individual, socio-demographic, environmental, smoking patterns) among 160 current (past 30days) waterpipe smokers recruited from 8th and 9th school grades in Lebanon. We assessed the loss of autonomy over tobacco using the Hooked on Nicotine Checklist (HONC), ND using the International Classification of Diseases, 10th revision (ICD-10), and the number of ND symptoms endorsed. RESULTS Depressive symptoms, lower self-esteem, and having at least one sibling who smokes a waterpipe were associated with the presence of ND symptoms, while enrollment in public schools, smoking a waterpipe ≥30min per session, and believing that cigarette smoking is harmful to health were associated with endorsement of a higher number of ND symptoms. Smoking a whole waterpipe head without sharing and being in 9th grade in this study were associated with the presence and endorsement of a higher number of ND symptoms. CONCLUSIONS We identified specific social and psychological characteristics, waterpipe smoking patterns, and beliefs about harmful effects of smoking associated with the presence of ND among adolescent waterpipe smokers. Considering these factors when planning policies to prevent ND among waterpipe smokers is warranted.
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Nabipour AR, Alizadeh A, Saadat-Hosseini M, Mansouri Z, Shamsoddini L, Nakhaee N. Correlates of waterpipe smoking among Iranian university students and the role of religiosity. Int J Psychiatry Med 2016. [PMID: 28629297 DOI: 10.1177/0091217417696735] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Waterpipe smoking among youth and adolescents in Iran has gained in popularity. The aim of this study was to investigate the relationship between waterpipe smoking and different dimensions of religiosity in a sample of students attending two major universities in South East Iran. A total of 682 students completed a waterpipe and cigarette smoking questionnaire along with the Duke University Religion Index. The lifetime prevalence of dual cigarette and waterpipe use was 48.3%, with prevalence of current use (within the last 30 days) of 24.9%. The proportions of lifetime and current waterpipe-only users were 27.0% and 18.8%, respectively. Students who participated more often in private religious activities were less likely to report engaging in waterpipe smoking (odds ratio: 0.82; 95% confidence interval: 0.71-0.98). A higher level of attendance of religious services was negatively associated with dual cigarette and waterpipe smoking (odds ratio: 0.71; 95% confidence interval: 0.54-0.93). Waterpipe-only use was significantly higher among males, students who had lower grade point averages, those who reported having a close friend or a family member who was a waterpipe smoker. To conclude, it is possible that religious observance may have a protective role in lowering waterpipe usage among Iranian university students.
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Affiliation(s)
- Amir Reza Nabipour
- 1 Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | | | | | | | | | - Nouzar Nakhaee
- 1 Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran
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Jiang N, Ho SY, Wang MP, Leung LT, Lam TH. Waterpipe smoking among secondary school students in Hong Kong. Int J Public Health 2016; 61:427-34. [PMID: 26873908 DOI: 10.1007/s00038-016-0796-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 12/28/2015] [Accepted: 01/27/2016] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES To examine the prevalence of waterpipe smoking and its associated factors among adolescents in Hong Kong. METHODS We analyzed data of the School-based Survey on Smoking among Students 2012/2013 from a representative sample of 45,857 secondary school students in Hong Kong (mean age 14.8, SD 1.9). We conducted Chi-square tests and t test to compare current (past 30 days) waterpipe users and nonusers by sociodemographic variables and other covariates. Univariate and multivariable logistic regression models were used to examine the factors associated with current waterpipe smoking. RESULTS Overall, 1.2 % of students reported current waterpipe smoking, of whom 43 % reported concurrent use of cigarettes. Waterpipe was the most popular alternative tobacco product (non-cigarette) used by students. Current waterpipe smoking was associated with older age, male sex, higher self-perceived family financial status, poor knowledge about the harm of cigarette smoking, positive attitudes toward smoking, current cigarette smoking, other tobacco use, and alcohol consumption. CONCLUSIONS Waterpipe smoking was the most popular alternative tobacco product among Hong Kong adolescents. Despite the low prevalence, it should be routinely monitored. Education programs and cessation interventions need to address waterpipe smoking in addition to cigarette smoking.
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Affiliation(s)
- Nan Jiang
- School of Public Health, The University of Hong Kong, 5/F William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong
| | - Sai Yin Ho
- School of Public Health, The University of Hong Kong, 5/F William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong.
| | - Man Ping Wang
- School of Nursing, The University of Hong Kong, 4/F William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong
| | - Lok Tung Leung
- School of Public Health, The University of Hong Kong, 5/F William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong
| | - Tai Hing Lam
- School of Public Health, The University of Hong Kong, 5/F William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong
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Veeranki SP, Alzyoud S, Dierking L, Kheriallah K, Mzayek F, Pbert L, Ward KD. Associations of Adolescents' Cigarette, Waterpipe, and Dual Tobacco Use With Parental Tobacco Use. Nicotine Tob Res 2015; 18:879-84. [PMID: 26438651 DOI: 10.1093/ntr/ntv224] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 09/25/2015] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Previous studies have demonstrated the influence of parental (both mother and father) cigarette smoking on adolescents' cigarette smoking. Little is known, however, about how parental tobacco use is related to waterpipe and dual waterpipe/cigarette use, which is increasing dramatically in the Arab countries. METHODS Study data (n = 34 788, N = 6 109 572) were obtained from nationally representative Global Youth Tobacco Surveys in 17 Arab countries. Study outcome was adolescents' tobacco use categorized into none, cigarette smoking only, waterpipe smoking (WPS) only, and dual use. Primary exposure included parental tobacco use categorized into 10 groups-maternal (mother) cigarette smoking only, maternal WPS only, maternal dual use, paternal (father) cigarette smoking only, paternal WPS only, paternal dual use, parental (both mother and father) cigarette smoking only, parental WPS only, parental dual use, and none. Weighted multinomial regression models were conducted to assess the relationships. RESULTS Adolescents reported smoking WPS only (5.7%), cigarettes only (2.9%), and dual use (3.5%). Compared to adolescent with no exposure to parental tobacco use, adolescent exposure to parental dual use was associated with significant increase in WPS only (OR = 6.08, 95% CI = 2.38-15.51) and dual use (OR = 3.86, 95% CI = 1.43-10.43). Effect modification of the relationship by adolescents' sex was observed. CONCLUSIONS This is the first study to examine adolescent cigarette, waterpipe, and dual use with parental tobacco use. Study findings may help development of cessation interventions targeting parental tobacco use to prevent the rising waterpipe and dual use strain of the global tobacco epidemic. IMPLICATIONS (1) Influence of parents' cigarette smoking on adolescents' smoking has been demonstrated in earlier studies, however, little is known about how tobacco use behaviors of mother and father influences an adolescent's cigarette, waterpipe and dual cigarette/waterpipe use. (2) Associations of parental (both mother and father) tobacco use with adolescents' tobacco use differed significantly if the adolescent is a waterpipe smoker or dual user compared to an adolescent cigarette smoker. (3) Adolescents' exposed to their mothers' WPS or dual use were more likely to be a waterpipe smoker or dual user. High likelihood of adolescents' cigarette, waterpipe and dual use is found in homes where parental tobacco use is rampant with both parents smoking either cigarette, waterpipe or both.
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Affiliation(s)
- Sreenivas P Veeranki
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX;
| | - Sukaina Alzyoud
- Department of Community and Mental Health, Faculty of Nursing, Hashemite University, Zarqa, Jordan
| | - Leah Dierking
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX
| | - Khalid Kheriallah
- Deparment of Public Health, Jordan University of Science and Technology, Irbed, Jordan
| | - Fawaz Mzayek
- Division of Epidemiology, Biostatistics and Environmental Health, School of Public Health, University of Memphis, Memphis, TN
| | - Lori Pbert
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA
| | - Kenneth D Ward
- Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, TN; Syrian Center for Tobacco Studies, Aleppo, Syria
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Waterpipe Use and Susceptibility to Cigarette Smoking Among Never-Smoking Youth. Am J Prev Med 2015; 49:502-11. [PMID: 26143951 DOI: 10.1016/j.amepre.2015.03.035] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2014] [Revised: 03/23/2015] [Accepted: 03/23/2015] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Susceptibility to cigarette smoking, defined as the lack of a firm decision against smoking, is a strong predictor of regular smoking and addiction. Several modifiable risk factors have been identified among never cigarette smokers, and one potential factor of interest is waterpipe use. The purpose of this study is to determine the association of waterpipe use with susceptibility to cigarette smoking among never-smoking youth. METHODS In a pooled analysis of 17 Arab nations with nationally representative Global Youth Tobacco Surveys conducted during 2002-2011, tobacco-related information was obtained from 30,711 never-smoking adolescents representing 4,962,872 youth. Study outcome was susceptibility to cigarette smoking, and primary exposure was waterpipe use. Data were analyzed in 2014 using weighted logistic regression models, including stratified models by gender, to determine the odds of susceptibility to cigarette smoking with waterpipe use, adjusting for confounders. RESULTS Overall, 20% of never-smoking youth were susceptible to cigarette smoking, ranging from 13.1% in Oman to 32.6% in Somalia; 5.2% currently used waterpipe, ranging from 0.3% in Morocco to 23.5% in Kuwait. The estimated odds of susceptibility to cigarette smoking were 2.5 (95% CI=1.9, 3.4) times higher for adolescents who used waterpipe in the past month compared with those who did not, controlling for confounders. Estimates were similar when stratified by gender. CONCLUSIONS Waterpipe use is associated with susceptibility to cigarette smoking. Study findings identify a novel risk factor for never smokers to initiate smoking and will help the public health community develop and implement policies around waterpipe use prevention.
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Jaber R, Madhivanan P, Veledar E, Khader Y, Mzayek F, Maziak W. Waterpipe a gateway to cigarette smoking initiation among adolescents in Irbid, Jordan: a longitudinal study. Int J Tuberc Lung Dis 2015; 19:481-7. [PMID: 25860006 PMCID: PMC4423386 DOI: 10.5588/ijtld.14.0869] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
SETTING According to anecdotal evidence, waterpipe smoking may lead to the initiation of cigarette smoking among young people. This hypothesis is yet to be examined using an appropriate study design and a theoretical model for behavioral change. OBJECTIVE To compare the risk of cigarette smoking initiation among waterpipe-only smokers and never smokers in a school-based sample of adolescents from Irbid, Jordan. METHODS A total of 1454 cigarette-naïve participants were drawn from a longitudinal study on smoking behavior conducted in Irbid among 1781 seventh graders who were enrolled at baseline (2008) and completed the study questionnaire on smoking behavior annually until 2011. Grouped time-survival analysis was used to compare the risk of subsequent initiation of cigarette smoking between waterpipe smokers (n = 298) and never smokers (n = 1156) using adjusted hazard ratios (aHRs) and 95% confidence intervals (95%CI). RESULTS Risk of initiation of cigarette smoking among waterpipe smokers was significantly higher than among never smokers after adjusting for potential confounders (aHR 1.67, 95%CI 1.46-1.92). The association between waterpipe and cigarette smoking initiation was dose-dependent. The risk of initiating cigarette smoking increased with increase in the frequency of waterpipe smoking (P for linear trend < 0.001). CONCLUSIONS Waterpipe smoking led to the initiation of cigarette smoking among this cohort of Jordanian adolescents; the effect was dose-dependent.
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Affiliation(s)
- R Jaber
- Florida International University, Miami, Florida, USA
| | - P Madhivanan
- Florida International University, Miami, Florida, USA
| | - E Veledar
- Florida International University, Miami, Florida, USA; Emory University, Atlanta, Georgia, USA; Baptist Health South Florida, Miami, Florida, USA
| | - Y Khader
- Jordan University of Science and Technology, Irbid, Jordan
| | - F Mzayek
- Syrian Center for Tobacco Studies, Aleppo, Syria; University of Memphis, Memphis, Tennessee, USA
| | - W Maziak
- Florida International University, Miami, Florida, USA; Syrian Center for Tobacco Studies, Aleppo, Syria
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