Waterpipe tobacco smoking prevalence and illegal underage use in waterpipe-serving premises: a cross-sectional analysis among schoolchildren in Stoke-on-Trent

Perceptions of Waterpipe Smoking among Young Adults: A Phenomenological Study

BACKGROUND

Waterpipe tobacco smoking is becoming increasingly popular in the West among young people. Given the associated health risks of this behaviour, we aimed to investigate why young adults take up waterpipe tobacco smoking and their attitudes to the associated risks.

METHODS

This was a qualitative study, with a phenomenological perspective. Focus groups and face-to-face semi-structured interviews were conducted among waterpipe smokers aged 20-30 years living in London, UK. Transcripts were analysed using constant comparison and cycling between the data and analysis. Data collection continued until thematic saturation was achieved.

RESULTS

Sixteen smokers attended focus groups and face-to-face interviews. Seven main themes emerged encompassing four main dimensions relating to: lack of knowledge, perceived risk, affordability, and social addiction. Waterpipe was perceived to be safer than cigarette smoking due to the pleasant odour, fruity flavours, and belief that water filtered the toxins. The waterpipe had become a "social addiction" enhancing group atmosphere, was cheap and did not have the dangers of violence or hallucinations associated with other addictions like alcohol and drugs. Because of their intermittent smoking patterns and the lack of statutory warnings, none felt they were not at risk of any adverse side effects.

CONCLUSIONS

Waterpipe smoking is a growing public health problem; the social environment associated with its use is perceived to be a positive outlet by smokers who do not consider it harmful to their health. These perceptions need to be addressed urgently by anti-smoking policies.

Use of Tobacco Products in Turkish Children and Young People: Is there an Alarm for Hookah Use?

OBJECTIVES

In the recent years, it has been observed that the use of hookah, a tobacco product, has increased in children and young people in Turkey. This study was conducted to determine the prevalence of cigarette and hookah use in children and young people specific to age and gender and to define the factors relevant to the use of hookah.

MATERIALS AND METHODS

The study was conducted with secondary/high school students between 11 and 17 years of age (Survey 1, n=4718) and with university students between 18 and 23 years of age (Survey 2, n=1588) as two groups, which made a total of 6306 students. The students were asked to fill in a questionnaire which consisted of questions about socio-demographic data and the use of tobacco and tobacco products.

RESULTS

It was determined that the use of cigarette and hookah was high in males, and it increased as the age increased in both genders (p<0.05). It was also determined that parents and friends using cigarette and hookah affected the use of cigarette and hookah in the study groups in both surveys (p<0.05). Additionally, it was determined that the educational level of the parents and being of a high social class were the social determiners of hookah use (p<0.05).

CONCLUSION

It is important that we fight against the use of all tobacco products, especially in young people. Education about the damages of tobacco and applying tobacco products should start at an early age, and accurate tobacco control models may provide support in this field.

Comparison of peri-implant clinical and radiographic inflammatory parameters among cigarette and waterpipe (narghile) smokers and never-smokers

BACKGROUND

The authors hypothesized that peri-implant clinical and radiographic inflammatory parameters are worse in waterpipe smokers (WS) and cigarette smokers (CS) compared with never-smokers (NS). The aim of the present retrospective study is to compare peri-implant clinical and radiographic inflammatory parameters among WS, CS, and NS.

METHODS

Forty-four CS (group 1), 41 WS (group 2), and 43 NS (group 3) were included. Demographic data were collected using a questionnaire. Peri-implant plaque index (PI), bleeding on probing (BOP), and probing depth (PD) were measured, and crestal bone loss (CBL) was assessed on standardized digital radiographs. Sample size was estimated, and statistical analyses were performed using Kruskal-Wallis and Wilcoxon rank-sum tests. For multiple comparisons, Bonferroni post hoc test was performed. P values < 0.05 were considered statistically significant.

RESULTS

Peri-implant PI and PD were higher in groups 1 (P < 0.05) and 2 (P < 0.05) compared with group 3. Peri-implant BOP was significantly higher in group 3 compared with individuals in groups 1 (P < 0.01) and 2 (P < 0.01). Peri-implant total marginal bone loss was significantly higher in groups 1 (P < 0.05) and 2 (P < 0.05) compared with group 3. There were differences in PI, BOP, PD, and CBL among participants in groups 1 and 2.

CONCLUSIONS

Peri-implant soft tissue inflammatory parameters and CBL are worse in CS and WS compared with NS. There is no difference in these parameters between CS and WS.

Waterpipe tobacco smoking prevalence among young people in Great Britain, 2013-2016

Background

One percent of adults in Great Britain use waterpipe tobacco at least monthly, however national epidemiological evidence among young people is absent. This study aims to assess waterpipe tobacco prevalence and correlates among young people in Great Britain.

Methods

Data were analyzed from online surveys conducted annually from 2013 to 2016 with weighted national samples of 11 to 18-year olds in Great Britain (annual n = 1936-2059). Primary outcome measures were at least monthly waterpipe tobacco use and lifetime waterpipe tobacco use. Binary logistic regression models tested the association between these outcomes and age, sex, country of residence and other tobacco consumption.

Results

Between 2013 and 2016, 1.7% (95% CI 1.5-2.1%) used waterpipe tobacco at least monthly and 9.9% (95% CI 9.2-10.7%) used waterpipe in their lifetime. There were no changes in prevalence over time. At least monthly use was associated with older age groups [16-18 years vs. 11-15 years, adjusted odds ratio (AOR) 2.63, 95% CI 1.55-4.46], male sex (AOR 1.82, 95% CI 1.23-2.71) and other tobacco consumption (e.g. lifetime cigarette use AOR 10.30, 95% CI 5.22-20.29). Lifetime use had similar correlates, but was not associated with male sex (AOR 0.97, 95% CI 0.80-1.17).

Conclusions

One in 10 young people in Great Britain have tried waterpipe tobacco, though more frequent use appears low. We found no evidence of increasing or decreasing prevalence of waterpipe use between 2013 and 2016. Being male, older and a concurrent user of other tobacco products were correlated with waterpipe tobacco use.

Features of the waterpipe tobacco industry: A qualitative study of the third International Hookah Fair

Background: Little research has been done to uncover the features of the waterpipe tobacco industry, which makes designing effective interventions and policies to counter this growing trend challenging. The objective of this study is to describe the features of the waterpipe industry. Methods: In 2015, we randomly sampled and conducted semi-structured interviews with representatives of waterpipe companies participating in a trade exhibition in Germany. We used an inductive approach to identify emerging themes. Results: We interviewed 20 representatives and four themes emerged: industry growth, cross-industry overlap, customer-product relationship, and attitude towards policy. The industry was described as transnational, generally decentralized, non-cartelized, with ad hoc relationships between suppliers, distributors and retailers. Ties with the cigarette industry were apparent. The waterpipe industry appeared to be in an early growth phase, encroaching on new markets, and comprising of mainly small family-run businesses. Customer loyalty appears stronger towards the waterpipe apparatus than tobacco. There was a notable absence of trade unionism and evidence of deliberate breaches of tobacco control laws. Conclusion: The waterpipe industry appears fragmented but is slowly growing into a mature, globalized, and customer-focused industry with ties to the cigarette industry. Now is an ideal window of opportunity to strengthen public health policy towards the waterpipe industry, which should include a specific legislative waterpipe framework.

Features of the waterpipe tobacco industry: A qualitative study of the third International Hookah Fair

Background: Little research has been done to uncover the features of the waterpipe tobacco industry, which makes designing effective interventions and policies to counter this growing trend challenging. The objective of this study is to describe the features of the waterpipe industry. Methods: In 2015, we randomly sampled and conducted semi-structured interviews with 20 representatives of waterpipe companies participating in a trade exhibition in Germany. We used an inductive approach to identify emerging themes. Results: We interviewed representatives and four themes emerged: industry globalisation, cross-industry overlap, customer-product relationship, and attitude towards policy. The industry was described as transnational, generally decentralized, non-cartelized, with ad hoc relationships between suppliers, distributors and retailers. Ties with the cigarette industry were apparent. The waterpipe industry appeared to be in an early growth phase, encroaching on new markets, and comprising of mainly small family-run businesses. Customer loyalty appears stronger towards the waterpipe apparatus than tobacco. There was a notable absence of trade unionism and evidence of deliberate breaches of tobacco control laws. Conclusion: The waterpipe industry appears fragmented but is slowly growing into a mature, globalized, and customer-focused industry with ties to the cigarette industry. Now is an ideal window of opportunity to strengthen public health policy towards the waterpipe industry, which should include a specific legislative waterpipe framework.

Prevalence and determinants of tobacco use among young people in The Gambia

Introduction

Tobacco consumption and consequent morbidity and mortality are expected to grow most markedly over coming decades in low-income and middle-income countries (LMICs). Preventing tobacco experimentation and uptake among young people in LMICs is therefore vital. However, data on smoking in these countries, particularly in sub-Saharan Africa, remain sparse.

Method

We used two-stage cluster random sampling to select students in upper and senior secondary schools throughout The Gambia, and a self-administered questionnaire to collect data on their tobacco use, risk factors and demographic details.

Results

Of 10 392 eligible students, 10 289 (99%; 55% girls and 44% boys, age 12–20 years) participated. The prevalence of ever smoking cigarettes, cigars or pipes was 16.7% (25.7% boys and 9.4% girls) and current (past 30 days) smoking 4.5% (7.9% boys and 1.5% girls). Smoking was more common among students attending private schools (OR 1.69, 95% CI 1.29 to 2.22), of Christian or other faiths compared with Muslims, living with parents (OR 1.39, 95% CI 1.06 to 1.81), who had smoking allowed in their homes (OR 1.67, 95% CI 1.30 to 2.13), with family members who smoked or had one or more friends who smoked. Most (55.6%) smokers want to stop, but only 22% received any stop smoking support. Ever smoking of shisha, at 8.1%, was unexpectedly high, and relatively prevalent among girls (11.4% of boys and 5.4% of girls).

Conclusions

Tobacco use is common among young people in The Gambia. Shisha smoking is also common in this population, and in relative terms especially among girls. Further work is required to determine whether this is a problem local to The Gambia or reflects a wider pattern of tobacco use in sub-Saharan Africa.