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Jehi T, Sabado P, Beeson L, Matta D, Herring P, Sharma A, Emory K, Serban P. Identifying the Determinants of Hookah Smoking Among the Youth; A Mixed-Methods Study. J Community Health 2024:10.1007/s10900-024-01374-1. [PMID: 39003669 DOI: 10.1007/s10900-024-01374-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2024] [Indexed: 07/15/2024]
Abstract
Hookahs have been rising in popularity in the United States (U.S.) especially among the youth yet not much research has been carried out to understand the various predictors of hookah use among youth. We have thus conducted a cross-sectional study with a mixed-methods triangulation design to identify the hookah use determinants at different levels of the Social Ecological Model among youth. Participants between the ages of 18-24 years were sampled purposively, between April to November 2023, following a snowballing technique from various communities in Virginia and California, United States. Data were collected via a survey, one-on-one interviews, and focus groups. The study had a total sample size of 20. We found that participants smoked for a median of 5 times in the past 30 days. The main determinants of hookah smoking included the limited knowledge of health effects and addiction, positive attitude, family and peer influence, use as a means to socially connect with others, culture, social acceptability, lack of education at school and work place, access to hookah bars and smoke shops, and lack of strict enforcement of laws to ban smoking of youth. Educational interventions should be implemented by public health authorities to target the youth, their social and communities to provide education on hookah harm and addictiveness and to restrict access to- and the production, distribution, marketing and sales of hookahs.
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Affiliation(s)
- Tony Jehi
- School of Public Health and Health Sciences, Cal State University Dominguez Hills, Dominguez Hills, 1000 E Victoria St, Carson, CA, 90747, USA.
| | - Parichart Sabado
- School of Public Health and Health Sciences, Cal State University Dominguez Hills, Dominguez Hills, 1000 E Victoria St, Carson, CA, 90747, USA
| | - Lawrence Beeson
- Department of Nutrition & Dietetics, School of Allied Health Professions, Loma Linda University, Loma Linda, CA, USA
| | - Dania Matta
- School of Public Health, Loma Linda University, Loma Linda, CA, USA
| | - Patti Herring
- School of Public Health, Loma Linda University, Loma Linda, CA, USA
| | - Archana Sharma
- School of Public Health and Health Sciences, Cal State University Dominguez Hills, Dominguez Hills, 1000 E Victoria St, Carson, CA, 90747, USA
| | - Kristen Emory
- School of Public Health and Health Sciences, Cal State University Dominguez Hills, Dominguez Hills, 1000 E Victoria St, Carson, CA, 90747, USA
| | - Pamela Serban
- School of Public Health, Loma Linda University, Loma Linda, CA, USA
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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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Maraqa B, Nazzal Z, Baker NA, Khatib H, Zeyad M, Aburayyan O. Factors contributing to the rising prevalence of waterpipe smoking dependence among university students: a cross-sectional study. BMC MEDICAL EDUCATION 2024; 24:164. [PMID: 38378525 PMCID: PMC10880219 DOI: 10.1186/s12909-024-05156-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 02/09/2024] [Indexed: 02/22/2024]
Abstract
INTRODUCTION Waterpipe smoking (WPS) has been associated with a variety of adverse health effects, consequences, and symptoms of nicotine dependence. This study aims to determine the prevalence of WPS dependence among Palestinian university waterpipe smoking students, their normative beliefs about WPS, and their relationship to dependence. METHODS A cross-sectional study of current WPS university students at five major Palestinian universities was conducted from September to December 2022. Participants were recruited using convenient sampling, and data collection was carried out via an interviewer-administered questionnaire. We assessed students' WPS dependence using the Lebanese Waterpipe Dependence Scale. We used the Poisson regression model with robust variance to analyze factors independently associated with high WPS dependence. RESULTS The study included 746 current WPS university students. Results revealed a high prevalence of WPS dependence, with 69.4% (95%CI: 66.0-72.7%) exhibiting high dependence. Factors contributing to high WPS dependence included dual cigarette smoking (aPR: 1.18; 95%CI: 1.12-1.25), studying medical sciences (aPR: 1.13; 95%CI: 1.10-1.18), friends' approval of WPS (aPR: 1.25; 95%CI: 1.17-1.34), daily WPS frequency (aPR: 1.98; 95%CI: 1.39-2.23), spending more than 50% of daily allowance on WPS (aPR: 1.37; 95%CI: 1.10-1.64), and morning WPS sessions (aPR: 1.97; 95%CI: 1.31-2.27). The study highlighted the influence of social factors, such as peers' approval and perceived prevalence, on WPS dependence. CONCLUSIONS WPS dependence is prevalent among university students, and it is associated with morning WPS, dual smoking, and increased WPS frequency. Notably, peer and cultural factors are essential primary motivators. As a result, it is critical to incorporate WPS considerations into Palestine's antismoking health promotion program. Therefore, it is vital to incorporate WPS into the Palestinian antismoking health promotion policy, and the health education of adolescents regarding the dangers of WPS should coincide with antismoking initiatives.
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Affiliation(s)
- Beesan Maraqa
- Department of Medicine, Faculty of Medicine, Hebron University, Hebron, Palestine
- Primary HealthCare, Ministry of Health, Hebron, Palestine
| | - Zaher Nazzal
- Community Medicine, Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
| | - Noor Abu Baker
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Heyam Khatib
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Marwa Zeyad
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Omar Aburayyan
- Department of Medicine, Faculty of Medicine and Health Sciences, Al-Quds University, Al-Quds, Palestine
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Bteddini D, Nakkash RT, Chalak A, Jawad M, Khader Y, Abu-Rmeileh NME, Mostafa A, Abla R, Awawda S, Salloum RG. Economic research in waterpipe tobacco smoking: reflections on data, demand, taxes, equity and health modelling. Tob Control 2023; 33:116-121. [PMID: 35902224 DOI: 10.1136/tc-2022-057383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 07/22/2022] [Indexed: 11/03/2022]
Abstract
Economic evaluation of tobacco control policies is common in high-income settings and mainly focuses on cigarette smoking. Evidence suggests that increasing the excise tax of tobacco products is a consistently effective tool for reducing tobacco use and is an efficient mechanism for increasing government revenues. However, less research has been conducted in low/middle-income countries where other tobacco forms are common. This paper presents insights from our work on the economics of waterpipe tobacco smoking conducted in the Eastern Mediterranean Region where waterpipe smoking originated and is highly prevalent. The specific areas related to economics of waterpipe smoking considered herein are: price elasticity, taxation, government revenue, expenditure and healthcare costs. This paper aims to provide practical guidance for researchers investigating the economics of waterpipe tobacco with potential implications for other novel tobacco products. We present lessons learnt across five thematic areas: data, demand, taxes, equity and health modelling. We also highlight knowledge gaps to be addressed in future research. Research implications include designing comprehensive assessment tools that investigate heterogeneity in waterpipe smoking patterns; accounting for cross-price elasticity of demand with other tobacco products; exploring the change in waterpipe tobacco smoking in response to a tax increase and analysing the equity impact of waterpipe tobacco control interventions.
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Affiliation(s)
- Dima Bteddini
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, Florida, USA
| | - Rima T Nakkash
- Department of Health Promotion and Community Health, American University of Beirut, Beirut, Lebanon
- Department of Global and Community Health, George Mason University College of Health and Human Services, Fairfax, Virginia, USA
| | - Ali Chalak
- Department of Agriculture, American University of Beirut, Beirut, Lebanon
| | - Mohammed Jawad
- Public Health Policy Evaluation Unit, Imperial College London, London, UK
| | - Yousef Khader
- Department of Community Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | | | - Aya Mostafa
- Department of Community, Environmental, and Occupational Medicine, Ain Shams University Faculty of Medicine, Cairo, Egypt
| | - Ruba Abla
- Department of Health Promotion and Community Health, American University of Beirut, Beirut, Lebanon
| | - Sameera Awawda
- Institute of Community and Public Health, Birzeit University, Birzeit, Palestine
| | - Ramzi G Salloum
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, Florida, USA
- Department of Health Promotion and Community Health, American University of Beirut, Beirut, Lebanon
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Soliman D, Akram SA, AlMutairi A, AlShammari K, Al Hubaidah M, AlMaayoufi M, AlMutairi M, AlDaihani S, AlKhudher S, Alkandari AF. Prevalence of Tobacco Smoking and Associated Risk Factors Among Public Sector Employees in Kuwait: A Cross-Sectional Study. Cureus 2023; 15:e35925. [PMID: 37038574 PMCID: PMC10082552 DOI: 10.7759/cureus.35925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2023] [Indexed: 03/11/2023] Open
Abstract
Introduction There needs to be more evidence about the tobacco products utilized by individuals who smoke and the primary determinants contributing to the development of smoking behavior. Our study aimed to assess the prevalence and factors associated with using one or more tobacco products among employees from various ministries in Kuwait. Methods A cross-sectional study was conducted among employees in different ministries in Kuwait from December 27, 2018, to January 3, 2019. A questionnaire about smoking status and socio-demographic variables was used. Results There was a total of 1057 participants in this study. Of the participants, 26% (n=275) reported using at least one tobacco product. The proportion of smoking of at least one tobacco product was higher among men (n=243, 46.5%) than women (n=32, 6%). Among smokers, 1.5%, 5.9%, and 18.6% reportedly use only three, two, and one tobacco products, respectively. Of the study participants, 26% were smokers, 20.3% were exclusively cigarette smokers, and 21.8% reportedly started cigarette smoking at the age of 15 years or less. Male compared to female workers had higher odds of being smokers of at least one tobacco product (adjusted OR= 15.3, 95% CI= 10.0-23.4). Participants were significantly (p= 0.009) more likely to use at least one tobacco product if their monthly income in Kuwaiti Dinars ranged from 501-1000 KD (adjusted OR= 1.9, 95% CI= 1.2-3.0) or 1501-2000 KD (adjusted OR= 2.3, 95% CI= 1.2-4.5) compared to those who had monthly income range 500 KD or less. Conclusion The male gender and high income of the participants were significant predictors of the use of at least one tobacco product. Anti-smoking campaigns, mass media interventions, and increasing tobacco product taxes may minimize this population's tobacco consumption.
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Jafaralilou H, Latifi A, Khezeli M, Afshari A, Zare F. Aspects associated with waterpipe smoking in Iranian youths: a qualitative study. BMC Public Health 2021; 21:1633. [PMID: 34493239 PMCID: PMC8422668 DOI: 10.1186/s12889-021-11675-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 08/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Waterpipe is one of the oldest methods of tobacco smoking, which has become the public health challenge, especially in the Eastern Mediterranean countries such as Iran. This study aimed to investigate the waterpipe smoking (WPS) in the young people of Kermanshah in 2020, using a qualitative method. METHODS This was a qualitative study conducted with the approach of content analysis. Participants were young waterpipe user aged 17 to 25 years selected by purposeful sampling method in Kermanshah city, located in the west of Iran. Data were collected through semi-structured interviews in face-to-face and audio-recorded methods based on an interview guideline during June to August 2020. Then researchers transcribed verbatim and analyzed the content of the interviews thematically. RESULTS In this study, 23 young people who were waterpipe users at the time of the study participated. The results showed that social aspects in three sub-categories were involved in WPS including "socio-cultural aspects", "socio-environmental aspects", and "social relations". Individual aspects of waterpipe use as second category also consisted of two sub-categories including "motivational aspects" and "lack of psycho-protective aspects". CONCLUSIONS It seems that the implementation of the policy of reducing access to waterpipe in public environments is effective in reducing waterpipe consumption. It is suggested that educational and interventions, based on targeted models and theories be implemented in order to increase young people's belief and perception on dangers of WPS, and to improve their self-efficacy to smoking cessation.
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Affiliation(s)
- Hamid Jafaralilou
- Department of Public Health, Khoy University of Medical Sciences, Khoy, Iran
| | - Arman Latifi
- Department of Public Health, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Mehdi Khezeli
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Atefeh Afshari
- Department Of Community Health Nursing, School of Nursing And Midwifery, Nursing Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farahnaz Zare
- Clinical Research Development Center, Imam Khomeini and Mohammad Kermanshahi and Farabi Hospitals, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Afrashteh S, Ansarifar A, Vali M, Nami Nazari L, Keshtkar N, Memar S, Mohebbi E, Hadji M, Ostovar A, Zendehdel K, Marzban M. Geographic distribution and time trends of water-pipe use among Iranian youth and teenage students: A meta-analysis and systematic review. J Ethn Subst Abuse 2021; 22:285-315. [PMID: 34486927 DOI: 10.1080/15332640.2021.1943097] [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: 10/20/2022]
Abstract
Water-pipe tobacco smoking is harmful to health, yet its rate of prevalence remains uncertain. Recent evidence has shown that the prevalence of water-pipe smoking among students is higher than in the general population. In this study, a systematic review of related literature on water-pipe use was conducted, and for this purpose, 76 articles were examined in the study. In this vein, geographic distribution and time trends of water-pipe consumption in Iran were considered. The results of this study showed that lifetime, last-year, and last-month prevalence of water-pipe smoking use among Iranian students were 28.78 (25.07-32.49), 20.84 (16.01-25.66), and 16.36 (11.86-20.85), respectively. The results also showed a wide variation by the region and sex in Iran. This study has shown the importance of addressing public prevention and alerting programs in schools and universities.
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Affiliation(s)
- Sima Afrashteh
- Department of Public Health, School of Public Health, Bushehr University of Medical Sciences, Bushehr, Iran
| | | | - Mohebat Vali
- Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | - Sara Memar
- Bushehr University of Medical Sciences, Bushehr, Iran
| | - Elham Mohebbi
- Tehran University of Medical Sciences, Tehran, Iran.,Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Hadji
- Health Unit, Faculty of Social Science, Tampere University, Tampere, Finland
| | | | | | - Maryam Marzban
- Department of Epidemiology, School of Public Health, Bushehr University of Medical Sciences, Bushehr, Iran.,The Persian Gulf Martyrs, Bushehr University of Medical Sciences, Bushehr, Iran
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Naghavi M, Nakhaee N. Associations between Childhood Abuse, Resilience, Mindfulness, and Waterpipe Smoking: Implications for Cessation Interventions. J Smok Cessat 2021; 2021:6648779. [PMID: 34429784 PMCID: PMC8356016 DOI: 10.1155/2021/6648779] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 05/16/2021] [Accepted: 07/23/2021] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION Recent research has established a link between childhood abuse and later drug abuse. For waterpipe smoking (WPS), such a role has not been adequately clarified. AIMS To explore the mediating effect of resilience and mindfulness on the association between childhood abuse and current WPS among college students. METHODS A cross-sectional study was conducted among a consecutive sample (n = 776) of college students in Kerman, Iran. The Adverse Childhood Experiences Abuse Short Form, the 14-item Resilience Scale, and the Freiburg Mindfulness Inventory were used. Structural equation modeling was used to examine the complex associations between variables. RESULTS Nearly 95% of participants were aged between 18 and 27 years, and the mean (SD) age of students was 22.2 (3.1). Most of them were single (84.4), and 52.7% were female. Prevalence of lifetime and current WPS among students was 49.6% and 33.4%, respectively. Less than one-third (n = 228) of lifetime users first tried smoking by the age of 18. The risk of current WPS was significantly higher in males than females (β = 0.25, P < 0.001). Childhood abuse was directly associated with current WPS (β = 0.20, P < 0.001) and resilience (β = -0.12, P < 0.05). Adverse childhood experiences were also indirectly (mediated by the effect of the resilience, path coefficient = 0.06, P < 0.001) associated with the risk of WPS. No relationship was seen between trait mindfulness and current WPS (β = -0.02, P = 0.393). Resilience was negatively associated with current WPS (β = -0.47, P < 0.001). CONCLUSION The study revealed the potential importance of childhood abuse and low resilience as risk factors precipitating the onset of WPS. Further studies are warranted to examine the implications of this study for quitting WPS.
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Affiliation(s)
- Mohammadreza Naghavi
- Social Determinants of Health Research Center, Institute of Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Nouzar Nakhaee
- Research Center for Health Services Management, Institute of Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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Kheirallah KA, Shugaa Addin N, Alolimat MM. Trends of maternal waterpipe, cigarettes, and dual tobacco smoking in Jordan. A decade of lost opportunities. PLoS One 2021; 16:e0253655. [PMID: 34242237 PMCID: PMC8270187 DOI: 10.1371/journal.pone.0253655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 06/09/2021] [Indexed: 11/18/2022] Open
Abstract
Background Maternal tobacco use is a global public health problem. In the literature, the focus was mainly on cigarette smoking, minimally on waterpipe use, and totally ignored dual use among pregnant women. We estimated the prevalence of current maternal tobacco use by tobacco product (cigarette, waterpipe, and dual use) over a period of ten years (2007 to 2017), and examined the socio-demographic patterning of maternal tobacco use. Methods A secondary analysis of Jordan DHS four data waves was conducted for women who reported to be pregnant at the time of the survey. Current cigarette and waterpipe tobacco use were investigated. Prevalence estimates for cigarette-only, waterpipe-only, and dual use, as well as for cigarette, regardless of waterpipe, and waterpipe, regardless of cigarette, were reported. The effect of independent variables on cigarette smoking, waterpipe use, and dual use was assessed. Logistic regression models assessed the adjusted effects of socio-demographic variables on cigarette smoking, waterpipe use, and on dual use. For each outcome variable, a time-adjusted and a time-unadjusted logistic models were conducted. Results Over the last decade, the prevalence estimates of current cigarette-only smoking slightly decreased. The prevalence estimates of current waterpipe-only use exceeded those for cigarette-only after 2007 and showed a steady overall increase. Current dual use showed a continuous rise especially after 2009. Gradual increase in cigarette smoking (4.1%, in 2007, and 5.7% in 2017) and in waterpipe use (2.5% to 6.4%) were detected. Education showed an inverse relationship with cigarette and waterpipe smoking. Household wealth demonstrated a positive association with cigarette and waterpipe smoking. Conclusions Tobacco use epidemic is expanding its roots among pregnant women in Jordan through not only waterpipe use but also dual cigarette–waterpipe smoking. Maternal and child services should consider tobacco counseling and cessation.
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Affiliation(s)
- Khalid A. Kheirallah
- Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
- * E-mail:
| | - Nuha Shugaa Addin
- Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Maan M. Alolimat
- Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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Comparison between Smoking and Nonsmoking Palestinian Medical Students in the Health-Promoting Behaviors and Lifestyle Characteristics. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5536893. [PMID: 33860032 PMCID: PMC8009719 DOI: 10.1155/2021/5536893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 03/07/2021] [Accepted: 03/10/2021] [Indexed: 01/09/2023]
Abstract
Objectives This study was aimed at comparing the predictors of health-promoting lifestyle behaviors between smoking and nonsmoking medical students at An-Najah National University located in Palestine. Methods A descriptive cross-sectional study was performed during the academic year 2017/2018. Medical students were asked to complete a self-reported questionnaire that involved the predictors of Health-Promoting Lifestyle Profile-II. With the use of a suitable available sample composed of a total of 430 medical students, 400 had successfully completed the questionnaire and were included in the study. The data was analyzed by using SPSS version 24 software. Results The sample included 400 medical students with a mean age of 18.7 years, 311 (77.7%) were females, and 89 (22.3%) were males. The prevalence of smokers in the sample was 110 (27.5%). For the health status of over half the students, 211 (52.8%) were excellent. The total HPLP-II score for smoking students resulted to be significantly lower in comparison to nonsmoking students (131.2 versus 135.7). This significant difference was clear in the interpersonal relation subscale (25.6 versus 26.8) for smoking and nonsmoking students, respectively. The score differences in other subscales were generally lower in smoking students. However, these differences were not consistent with statistical significance. Conclusion The significant lower total Health-Promoting Lifestyle Profile-II score in smoking students necessitates the urgent need for awareness programs, not only towards smoking but also on how to enhance student health-promoting lifestyle behaviors.
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Perceptions of Waterpipe Smoking among Young Adults: A Phenomenological Study. Dent J (Basel) 2020; 8:dj8040134. [PMID: 33321834 PMCID: PMC7763057 DOI: 10.3390/dj8040134] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 11/11/2020] [Accepted: 12/08/2020] [Indexed: 11/16/2022] Open
Abstract
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.
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Naghavi M, Khosropour F. Childhood Trauma Linked to Adult Waterpipe Smoking: A Survey of Health Science Students in Iran. ADDICTION & HEALTH 2020; 12:196-204. [PMID: 33244396 PMCID: PMC7679491 DOI: 10.22122/ahj.v12i3.270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Background Explaining the risk and protective factors of waterpipe tobacco smoking (WTS) is the most important principle in designing preventive interventions. This study examined the relationship between self-reported childhood abuse and WTS among health science students in Iran. Methods This cross-sectional study was conducted among 776 health science students in Kerman City, located in southeast of Iran, who were selected by quota sampling approach. The study was performed using two valid short instruments for measuring WTS and child abuse including physical, emotional, and sexual abuse using a self-report method. Findings The prevalence of ever use and current use (last 30 days) of WTS among participants was 49.6% and 33.4%, respectively. The initiation age of WTS in 60% of students was < 18 years. Child sexual abuse (CSA) was [odds ratio (OR) = 3.05, 95% confidence interval (CI): 2.06-4.52, P < 0.001] the main predictor for WTS among students. Conclusion Protecting children during childhood to prevent them from becoming victims may be an essential primordial preventive strategy for WTS.
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Affiliation(s)
| | - Farshid Khosropour
- Department of Psychology, Zarand Branch, Islamic Azad University, Zarand, Iran
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Al-Sheyab NA, Alyahya MS, Almomani F, Tazlat AM. Risk perception of waterpipe smoking among undergraduate medical and nursing students in Jordan. JOURNAL OF SUBSTANCE USE 2020. [DOI: 10.1080/14659891.2020.1841843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Nihaya A. Al-Sheyab
- Faculty of Applied Medical Sciences, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammad S. Alyahya
- Faculty of Medicine, Department of Health Management and Policy, Jordan University of Science and Technology, Irbid, Jordan
| | - Fida Almomani
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Amani M. Tazlat
- MSN, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
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Salehi L. Popular water pipe smoking, medical sciences students' awareness, perceptions, and motivations. Int J Adolesc Med Health 2020; 33:401-407. [PMID: 32549155 DOI: 10.1515/ijamh-2019-0153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 07/15/2019] [Indexed: 11/15/2022]
Abstract
Objectives This study was done to investigate popularity, awareness, perceptions, and motivations regarding water pipe smoking (WPS) among medical sciences students in 2017. Methods This cross sectional study was done among 385 medical sciences student in 2017.The systematic random sampling was used to recruit subjects. Multidimensional questionnaire (demographic characteristics, awareness, perceptions, action, and water pipe motivators) was used. t-test, ANOVA, X2, and logistic regression was used to analyze the data by SPSS. Results The mean ages of participants were 22 ± 2.64 and 89% were male. The majority of the study sample was from health school. Most participants reported having smoked before. Family entertainment was found to be the most common motivator for WPS. The second one was to be fun. WPS use was significantly associated with age (odds ratio [OR], 0.17; 95% Confidence Interval [CI], 0.04-0.61); awareness (OR, 1.55; 95% CI, 1.35-1.78); and perception (OR, 0.71; 95% CI, 0.65-0.78). Conclusions Results show that WPS is very popular among Iranian youth. In designing public health programs, policy makers should consider the motivators for inclination to WPS. Intervention should focus on addressing students' perception and awareness regarding WPS.
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Affiliation(s)
- Leili Salehi
- Research Center for Health, Safety and Environment, Health Education and Promotion, Alborz University of Medical Sciences, Karaj, Islamic Republic of Iran
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Lee JJ, Wu Y, Wang MP, Yeung KCY, Wong JYH, Smith R. Waterpipe smoking among university students in Hong Kong: a cross-sectional study. BMC Public Health 2020; 20:543. [PMID: 32316942 PMCID: PMC7175508 DOI: 10.1186/s12889-020-08686-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 04/13/2020] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Waterpipe smoking has gained global popularity in recent years, especially among young people. However, there is a lack of empirical investigation into waterpipe smoking in East Asia. This study aimed to investigate the demographical and psycho-social characteristics and patterns of waterpipe smoking (WPS) among university students in Hong Kong. METHODS A cross-sectional survey was conducted via online questionnaires administered to 1288 Hong Kong university students (mean age: 22.4 [SD = 3.8]). Logistic regressions were used to compute adjusted odd ratios (aOR) for waterpipe ever-smoking in relation to respondents' characteristics. Moreover, multinomial logistic regression yielded adjusted RR (aRR) for four different smoking status (i.e., never, waterpipe-only, cigarette-only, and dual smoking) regarding the characteristics. RESULTS 23.8% of participants reported having ever smoked a waterpipe (vs. cigarette ever-smoking: 21.1%). Factors including being female (aOR:1.57; 95% CI: 1.22-2.02), older age (≥24 years: 4.17; 1.35-12.93), frequent alcohol consumption (>monthly: 26.02; 10.91-62.09), and higher sensation-seeking behaviours (high level: 2.98;1.46-6.08) were associated with waterpipe ever-smokers. The study also identified that demographical and psycho-social characteristics were variably associated with students' smoking status. Particularly, more frequent alcohol consumption was most significantly associated with waterpipe-only smoking (aRR:45.73; 95% CI:11.44-182.73) (vs. cigarette-only smoking: 3.01; 1.76-5.14). CONCLUSIONS WPS is the most common form of tobacco smoking among university students in Hong Kong, and characteristics unique to the population were identified. There is no legislation of relevant policies on WPS despite its concerning significance in public health among young people, therefore immediate action to monitor and control WPS is needed in Hong Kong.
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Affiliation(s)
- Jung Jae Lee
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong
| | - Yongda Wu
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong
| | - Man Ping Wang
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong
| | - Karly Cheuk-Yin Yeung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong
| | - Janet Yuen-Ha Wong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong
| | - Robert Smith
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong
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Hallit S, Haddad C, Bou Malhab S, Khabbaz LR, Salameh P. Construction and validation of the water pipe harm perception scale (WHPS-6) among the Lebanese population. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:3440-3448. [PMID: 31845251 DOI: 10.1007/s11356-019-07247-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 12/02/2019] [Indexed: 05/26/2023]
Abstract
Compared to cigarettes, water pipe is misconceived as being less addictive and containing less nicotine. This study aimed at constructing and validating a water pipe harm perception scale among a sample of the Lebanese population. A cross-sectional study was carried out between February and December 2017 using a proportionate cluster sample of Lebanese adults (492 participants). The water pipe harm scale items converged over a solution of one factor that had an eigenvalue over 1, explaining a total of 66.75% of the variance. The model used was adequate (Kaiser-Meyer-Olkin measure = 0.862 and Bartlett's test of sphericity p < 0.001). The reliability of all scale's items was high (Cronbach's alpha = 0.896). Higher cigarette dependence (LCD score) was significantly associated with higher water pipe harm perception scores, whereas exclusive water pipe smokers (Beta = - 2.142) and dual water pipe and cigarette smokers (Beta = -2.142) compared to nonsmokers, as well as those with high monthly income compared to a low one (Beta = -0.614), were significantly associated with lower water pipe harm perception scores. We constructed the first scale for measuring water pipe harm perception: the WHPS-6. The results of the present study demonstrate that the WHPS-6 can be used in clinical practice and research to assess the harm perception induced by water pipe smoking.
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Affiliation(s)
- Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
- INSPECT-LB:, Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon.
| | - Chadia Haddad
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Sandrella Bou Malhab
- Ecole Doctorale des Sciences et Technologie, Lebanese University, Hadat, Lebanon
- Laboratoire de Pharmacologie, Pharmacie clinique et Contrôle de Qualité des Médicaments (LPCQM), Pôle Technologie- Santé (PTS) Faculté de Pharmacie, Beirut, Lebanon
- Ecole Doctorale Sciences et Santé, Université Saint-Joseph, Rue de Damas - Beyrouth, Lebanon
| | - Lydia Rabbaa Khabbaz
- Laboratoire de Pharmacologie, Pharmacie clinique et Contrôle de Qualité des Médicaments (LPCQM), Pôle Technologie- Santé (PTS) Faculté de Pharmacie, Beirut, Lebanon
- Faculty of Pharmacy, Saint-Joseph University, Beirut, Lebanon
| | - Pascale Salameh
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
- Faculty of Medicine, Lebanese University, Hadat, Lebanon
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Joveini H, Rohban A, Eftekhar Ardebili H, Dehdari T, Maheri M, Hashemian M. The effects of an education program on hookah smoking cessation in university students: an application of the Health Action Process Approach (HAPA). JOURNAL OF SUBSTANCE USE 2019. [DOI: 10.1080/14659891.2019.1664655] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Hamid Joveini
- Department of Health Education and Promotion, School of Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Alireza Rohban
- Department of Rehabilitation Management, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hassan Eftekhar Ardebili
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Tahereh Dehdari
- Department of Health Education and Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mina Maheri
- Department of Public Health, School of Health, Reproductive Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Masoumeh Hashemian
- Department of Health Education and Promotion, School of Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
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Miri-Moghaddam M, Shahrakipour M, Nasseri S, Miri-Moghaddam E. Higher prevalence of water pipe compared to cigarette smoking among medical students in Southeast Iran. Cent Eur J Public Health 2019; 27:188-194. [PMID: 31580552 DOI: 10.21101/cejph.a5615] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 08/14/2019] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Smoking of water pipe (WP) and cigarettes has recently turned into a major global health burden. The present study aimed at assessing WP and cigarette smoking among Zahedan University of Medical Sciences (ZUMS) students in Iran. METHODS A cross-sectional survey was conducted on 500 students in ZUMS (182 males, 318 females). The subjects were selected through randomized cluster sampling. Morgan's chart was applied to calculate the sample size; 96.6% of the attendees completed a questionnaire designed to address the aims of the study. RESULTS The mean age of the subjects was 21.2 ± 2.4 years. WP and cigarette smoker rates were at 31.2% and 15.2%, respectively. The age of smoking initiation ranged between 15 and 20 years. Friends played crucial roles in triggering the smoking in both groups of WP and cigarette smokers (78% and 54%, respectively). The main reasons for WP and cigarette smoking were entertainment followed by curiosity. Furthermore, males used more cigarette (26.5 vs. 8.7%) and WP (50.6 vs. 20.4%) than females. Among father and mother smokers, respectively, 54.2% and 60% of children were also WP smokers (p = 0.001). Also, 21.9% and 60% of children smoking cigarettes had father and mother smokers, respectively (p = 0.05). CONCLUSION Tobacco use, especially for WP seems to be at alarming rates among medical students in Iran. It is highly recommended to control the progressive prevalence of WP smoking by governmental/academic preventive measures as educational and smoking cessation activities.
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Affiliation(s)
- Masoud Miri-Moghaddam
- Student Research Centre, Faculty of Dentistry, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mahnaz Shahrakipour
- Department of Biostatistics and Epidemiology, Oral and Dental Disease Research Centre, Health Faculty, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Saeed Nasseri
- Cellular and Molecular Research Centre, Birjand University of Medical Sciences, Birjand, Iran
| | - Ebrahim Miri-Moghaddam
- Department. of Molecular Medicine, Cardiovascular Research Centre, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
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Naddafi K, Nabizadeh R, Baghani AN, Fazlzadeh M. Bioaerosols in the waterpipe cafés: genera, levels, and factors influencing their concentrations. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:20297-20307. [PMID: 31098913 DOI: 10.1007/s11356-019-05413-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 05/07/2019] [Indexed: 05/05/2023]
Abstract
This study was conducted in order to assess the exposure to bacterial and fungal bioaerosols in the air of waterpipe cafés (AWPCs), in the hose of waterpipe (HWP), and in the water bowl of the waterpipe (WBWP) and to investigate the factors influence increasing the contamination levels in waterpipe cafés in Ardabil. From all the 50 cafés studied, the samples were taken from air and from water contained in water bowl and hose for bacterial and fungal analyses. The results demonstrated that the mean numbers of bacteria and fungi in the indoor air of café, hose, and water bowl were 33.90 ± 14.86 and 25.24 ± 1.99 CFU/m3, 72.16 ± 29.55 and 72.78 ± 42.45 CFU/plate, 53.7 ± 25.46 and 25.26 ± 13.94 CFU/ml, respectively. The predominant bacterial genera in waterpipe cafés were Pseudomonas and Bacillus in air, Staphylococcus and Pseudomonas in the hose, and Staphylococcus and Pseudomonas in the water bowl, respectively. The predominant fungal species in waterpipe cafés were Penicillium and Cladosporium in air, yeast and Fusarium in the hose, and Paecilomyces and yeast in the water bowl, respectively. The results of statistical analysis showed that there was a significant relationship between the mean concentrations of bacterial aerosol and qualitative variables such as type of heating system, materials of wall and ceiling, traditional restaurants, interior supermarkets, moisturized walls, the number of people, area of cafés, and temperature. But there was no significant relationship between these variables and the mean concentration of fungal aerosols. The results also showed that the levels of bioaerosols were high in the air, hose, and water bowl of the waterpipe. Therefore, cafés can be a potential source for the transmission of pathogenic agents and increase the risk of respiratory diseases among waterpipe smoking individuals.
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Affiliation(s)
- Kazem Naddafi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Nabizadeh
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Norouzian Baghani
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Fazlzadeh
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran.
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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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Dehdari T, Mirzaei N, Taghdisi MH, Khosropour A, Zare N. Psychometric Properties of the Iranian Brief Version of the Transtheoretical Model Instrument in Terms of Hookah Tobacco Smoking Cessation. ADDICTION & HEALTH 2019; 10:102-111. [PMID: 31069034 PMCID: PMC6494985 DOI: 10.22122/ahj.v10i2.563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Background Transtheoretical model (TTM) has been recognized as a common theoretical model in researches in terms of addictive behaviors. The aim of this study was to examine the psychometric properties of the Persian brief version of the TTM for hookah tobacco smoking cessation in a sample of Iranian rural adults who were in the preparation stage for hookah cessation. Methods This was a validation study on Iranian rural adult hookah smokers by the TTM instrument. First, to translate the questionnaire items from English to Persian, backward-forward procedure was used. Face and content validity of the instrument items were assessed. Confirmatory factor analysis (CFA) was performed to determine the construct validity of the instrument. For this aim, 300 participants completed the instrument. Cronbach's alpha coefficient and intraclass correlation coefficient (ICC) were calculated to examine the internal consistency and reliability of the subscales of the instrument. Findings The content validity index (CVI) and content validity ratio (CVR) of the items were ≥ 0.80 and ≥ 0.60, respectively. Based on CFA, the data fitted the TTM model. root mean square error of approximation (RMSEA), the goodness of fit index (GFI), adjusted GFI, and comparative fit index (CFI) were 0.037, 0.960, 0.910, and 0.950, respectively. At this stage, 6 items were deleted. The ICC and Cronbach's alpha of the subscales ranged between 0.60-0.74 and 0.71-0.86, respectively. The final instrument with 29 items was confirmed. Conclusion The findings suggest that translating Persian brief version of the TTM instrument was a reliable and valid tool to identify the determinants of hookah smoking cessation among Iranian rural adults.
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Affiliation(s)
- Tahereh Dehdari
- Assistant Professor, Department of Health Education and Health Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Nasim Mirzaei
- PhD Student, Department of Health Education and Health Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mohamad Hossein Taghdisi
- Professor, Department of Health Education and Health Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Ashkan Khosropour
- Department of Mathematics, School of Mathematics, Firoozabad Branch, Islamic Azad University, Firoozabad, Iran
| | - Najaf Zare
- Professor, Department of Biostatistics, School of Medicine AND Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Saravanan C, Attlee A, Sulaiman N. A Cross Sectional Study on Knowledge, Beliefs and Psychosocial Predictors of Shisha Smoking among University Students in
Sharjah, United Arab Emirates. Asian Pac J Cancer Prev 2019; 20:903-909. [PMID: 30912413 PMCID: PMC6825792 DOI: 10.31557/apjcp.2019.20.3.903] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: Smoking is now prohibited in all educational institutions and other public places in the United Arab Emirates (UAE), but shisha smoking is considered as one of the major problems among the students population. This study aimed to identify the (a) prevalence of ever shisha, current shisha and shisha dependency smokers among university students in the University of Sharjah (UOS), (b) knowledge and belief differences among ever shisha, current shisha as well as shisha dependency smoking students, (c) relationship between precipitating factors and shisha dependency and (d) precipitating factors (stimulation, handling, pleasure, tension reduction, addiction (dependency), automatism (habit) and social interaction, parents smoking behavior, knowledge and beliefs about smoking predict shisha dependency among students in UOS. Materials and Methods: In this cross sectional study, 633 students participated from UOS, UAE. Knowledge and Belief scale, Modified Reason for Smoking Scale and Fagerstrom Test for Nicotine Dependence (FTND) were used to measure knowledge, beliefs, shisha dependency and predictive factors of smoking behavior among undergraduate students in UOS. Results: Nearly103 (16.3%) of students were addictive to shisha smoking based on FTND. Students had adequate knowledge that smoking led to cardiac problems; however, their knowledge about the other consequences of smoking was inadequate and believed that smoking was not harmful. There was a significant positive relationship between addiction, pleasure, social interaction, habit, parental smoking behavior and shisha dependency behavior among current shisha dependency students. Habit, addiction, pleasure, social interaction and parental smoking were the predictors of shisha smoking dependency among this population. Step wise multiple regressions showed that social interaction was the highest significant predictor for shisha dependency behavior. Conclusions: Hence, there is a need to enhance the knowledge and modify irrational beliefs about shisha smoking as these students possess inadequate knowledge about consequences of shisha smoking.
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Affiliation(s)
- Coumaravelou Saravanan
- Department of Family and Community Medicine and Behavioral Sciences, College of Medicine, University of Sharjah, United Arab Emirates.
| | - Amita Attlee
- College of Food and Agriculture, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Nabil Sulaiman
- Department of Family and Community Medicine and Behavioral Sciences, College of Medicine, University of Sharjah, United Arab Emirates.
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Sighaldeh SS, Baheiraei A, Dehghan S, Charkazi A. Persistent use of hookah smoking among Iranian women: A qualitative study. Tob Prev Cessat 2018; 4:38. [PMID: 32411864 PMCID: PMC7205117 DOI: 10.18332/tpc/99507] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 10/23/2018] [Accepted: 11/01/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Hookah smoking is the most common method of tobacco smoking among Iranian women and its rate has significantly increased over the past few decades. This study aimed to explore reasons behind persistent use of hookah smoking among Iranian women. METHODS This qualitative study was conducted from December 2014 to March 2016. Participants were 38 Iranian women living in Tehran, the capital of Iran. They were hookah smokers at the time of this study or at least had a history of its use. Data were collected using semi-structured face-to-face interviews and were analyzed using the qualitative content analysis method. RESULTS The main factors for persistent use of hookah smoking from the perspective of women were entertainment, a pretext to gather with old friends and family members, and a method for the creation of social networks. Hookah smoking has been described as entertainment and fun. CONCLUSIONS Strategies aimed to curb the social issue of hookah smoking by women need to focus on the provision of appropriate entertainment methods with the consideration of advantages, such as gathering with friends and family members and consolidating relationships.
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Affiliation(s)
- Shirin Shahbazi Sighaldeh
- Department of Reproductive Health, Prenatal and Delivery, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Azam Baheiraei
- Department of Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Abdurrahman Charkazi
- Health Education and Promotion, Environmental Health Research Center, Golestan University of Medical Sciences, Gorgan, Iran
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Kalan ME, Ben Taleb Z. Waterpipe tobacco smoking: A reality or hidden iceberg for Iranian women. Health Promot Perspect 2018; 8:252-254. [PMID: 30479977 PMCID: PMC6249491 DOI: 10.15171/hpp.2018.35] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 07/20/2018] [Indexed: 11/09/2022] Open
Affiliation(s)
- Mohammad Ebrahimi Kalan
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Florida, USA
| | - Ziyad Ben Taleb
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Florida, USA
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Social Norms and Self-Efficacy to Quit Waterpipe Use: Findings from a Tobacco Study among Male Smokers in Rural Viet Nam. J Smok Cessat 2018. [DOI: 10.1017/jsc.2017.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Introduction: Waterpipe use is a significant health concern in low- and middle-income countries like Viet Nam, yet there is a lack of research on factors that may influence use and self-efficacy to quit among adults.Aims: This study examined the relationship between social norms related to waterpipe use and self-efficacy to quit among male waterpipe smokers in Viet Nam.Methods: A cross-sectional survey was conducted with 214 adult male waterpipe smokers enrolled in a large cluster–randomised controlled trial conducted in a rural province in Viet Nam. Associations between social norms related to waterpipe smoking and the participants’ confidence to quit waterpipes were assessed using hierarchical regression models to account for differences among study sites and other covariates.Results: Self-efficacy to quit smoking was positively associated with immediate family members’ not minding participants smoking and with extended family's encouragement to quit smoking.Conclusions: The findings suggest the need for a more comprehensive understanding of the functions and characteristics of the social context of waterpipe smoking, including the social networks of waterpipe smokers, to inform effective cessation interventions for waterpipe smokers.
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Nakkash R, Lotfi T, Bteddini D, Haddad P, Najm H, Jbara L, Alaouie H, Al Aridi L, Al Mulla A, Mahfoud Z, Afifi RA. A Randomized Controlled Trial of a Theory-Informed School-Based Intervention to Prevent Waterpipe Tobacco Smoking: Changes in Knowledge, Attitude, and Behaviors in 6th and 7th Graders in Lebanon. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1839. [PMID: 30149668 PMCID: PMC6163698 DOI: 10.3390/ijerph15091839] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 08/16/2018] [Accepted: 08/17/2018] [Indexed: 12/11/2022]
Abstract
Waterpipe tobacco smoking (WTS) is spreading worldwide. Research has indicated health consequences of WTS similar to cigarettes. Prevalence of WTS is high among young people. In Lebanon, current use rates of 35% have been documented among 13⁻15 year olds. We evaluated a school-based intervention. Method: We conducted a randomized-controlled-trial of a theory-informed WTS intervention. The intervention consisted of ten sessions based on social cognitive theory and the social influences approach. Thirty-one schools participated: 14 intervention and 17 control; a total of 1279 students completed pre and post assessments. We measured knowledge, attitudes and self-reported behaviors related to WTS using Chi-square tests and regression analyses to compare results between the two study arms. Results: The intervention increased knowledge of intervention group compared to control group participants-about WTS constituents and health consequences; and shifted attitudes of intervention group participants to be even more unfavorable towards WTS. We found no impact of the intervention on WTS behaviors. Discussion: The effectiveness of the intervention on knowledge and attitudes supports previous research. The lack of intervention effect on behavior is not surprising given the timing of the post assessment immediately after the intervention, and the social context that was supportive of waterpipe use.
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Affiliation(s)
- Rima Nakkash
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut 1107-2020, Lebanon.
| | - Tamara Lotfi
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut 1107-2020, Lebanon.
| | - Dima Bteddini
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut 1107-2020, Lebanon.
| | | | - Hala Najm
- Soins Infirmiers et Développement Communautaire (SIDC), Sin El Fil 1100, Lebanon.
| | - Lina Jbara
- Academic Coordinator, Sorbonne University Abu Dhabi, 38044 Abu Dhabi, United Arab Emirates.
| | - Hala Alaouie
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut 1107-2020, Lebanon.
| | | | - Ahmad Al Mulla
- Department of Medicine, Hamad Medical Corporation, Doha 4147, Qatar.
| | - Ziyad Mahfoud
- Department of Global and Public Health, Weill-Cornell Medicine, Doha 24144, Qatar.
| | - Rima A Afifi
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut 1107-2020, Lebanon.
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, IA 52242, USA.
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Abu-Rmeileh NM, Alkhuffash O, Kheirallah K, Mostafa A, Darawad M, Al-Farsi Y, Yusufali A, Thomas J, Salama M, Hamadeh RR, Nakkash R, Salloum RG. Harm perceptions of waterpipe tobacco smoking among university students in five Eastern Mediterranean Region countries: A cross-sectional study. Tob Induc Dis 2018; 16:20. [PMID: 31516420 PMCID: PMC6659482 DOI: 10.18332/tid/89966] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 04/10/2018] [Accepted: 04/16/2018] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Waterpipe tobacco smoking (WTS) continues to be very common in the Eastern Mediterranean Region (EMR), partially because of cultural acceptance but also because of misconceptions of its harm. This paper aimed to describe the beliefs towards waterpipe harm of university students who smoked waterpipe in five EMR countries. METHODS This study was conducted in 2016 across five EMR countries: Egypt, Jordan, Occupied Palestinian Territories, Oman and United Arab Emirates (UAE). Participants were recruited from among university students in each country. Students' characteristics, smoking behavior, flavor preference and knowledge of WTS harm were collected using an internet-based survey. Participants were included if they were ever waterpipe tobacco smokers and between 18 and 29 years of age. Bivariate analyses assessed variations in student-perceived WTS harm across the countries. Linear regression analysis was used to assess WTS perceived harm differences between students in the different countries. RESULTS A total of 2 544 university students participated from the five countries. Among ever smoking students, 66% reported WTS in the past 30 days, with the highest proportions (40%) from Occupied Palestinian Territories (OPT) and (41%) Jordan. Dual smoking of waterpipe and cigarettes was highest among students from Egypt. Most participants from the five countries had high level of perceived harm related to WTS during pregnancy. Less than 50% of the students believed that WTS could lead to the death of the smoker, can be harmful for non-smokers and have an addictive effect. Female students, those older than 22 years, and those who didn't smoke waterpipe in the last 30 days significantly had a higher level of WTS perceived harm. Participating students believed that cigarettes are more addictive and contain more nicotine compared to waterpipe. CONCLUSIONS Misperceptions of waterpipe harm are common among university students in the five EMR countries. Immediate public health action is needed, including enforcement of waterpipe tobacco control regulations along with awareness campaigns.
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Affiliation(s)
- Niveen M.E. Abu-Rmeileh
- Institute of Community and Public Health, Birzeit University, Occupied Palestinian Territories
| | - Ola Alkhuffash
- Statistic Department, Hacettepe University, Ankara, Turkey
| | - Khalid Kheirallah
- Department of Public Health, Medical School, Jordan University of Science and Technology, Irbid, Jordan
| | - Aya Mostafa
- Department of Community Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | | | | | | | | | - Randah R. Hamadeh
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Rima Nakkash
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Ramzi G. Salloum
- Department of Health Outcomes and Policy, College of Medicine, University of Florida, Gainesville, Florida, United States
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Al-Rawi NH, Alnuaimi AS, Uthman AT. Shisha Smoking Habit among Dental School Students in the United Arab Emirates: Enabling Factors and Barriers. Int J Dent 2018; 2018:2805103. [PMID: 29666646 PMCID: PMC5831876 DOI: 10.1155/2018/2805103] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 11/21/2017] [Accepted: 12/06/2017] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES The objective of the present study was to assess shisha smoking among dental school students in Sharjah, United Arab Emirates (UAE). In addition, the role of suggested barriers and enabling factors in shisha smoking was also evaluated. METHODS A cross-sectional questionnaire-based survey was conducted at the College of Dental Medicine, University of Sharjah, between February and May 2016. The questions were adapted from previously published water pipe smoking studies. The collected data were analyzed to identify the relationship between shisha smoking and sociodemographic characteristics. Relevant questions were further categorized as enabling factors and barriers for shisha smoking. RESULTS Three enabling questionnaire items related to social environment were significantly associated with an increased risk of being a current smoker. The most powerful is peer pressure ("friends smoke shisha"), which increased the odds ratio of shisha smoking 11.3 times, followed by smoker sibling with increase in odd ratio by 4.52 times, then the belief of social acceptance with increase in odd ratio by 4.31 times. CONCLUSION Shisha smoking is a serious problem among university students. Any intervention program in the university curricula should consider teaching students that shisha is no less risky than cigarettes and is addictive.
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Affiliation(s)
| | | | - Asmaa T. Uthman
- College of Dental Medicine, Gulf Medical University, Ajman, UAE
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Bahtouee M, Maleki N, Nekouee F. The prevalence of chronic obstructive pulmonary disease in hookah smokers. Chron Respir Dis 2017; 15:165-172. [PMID: 28534421 PMCID: PMC5958464 DOI: 10.1177/1479972317709652] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide. Hookah smoking is growing worldwide and particularly in Iran. The aim of this study was to determine the prevalence of obstructive pulmonary dysfunction in hookah smokers. We conducted a population-based study in Bushehr Province, Iran. A total of 245 subjects aged 35 years or older who were taking hookah for at least 15 years and 245 healthy controls were enrolled in the study and spirometry was done. Statistical analyses were performed using SPSS for windows software version 19. The prevalence of COPD among the exposed group of hookah smoke was 10.2%, with the rate being significantly higher in the patients with older age (p < 0.001), duration of hookah smoking (p < 0.001), men (p = 0.026), ≥3 hookahs/day (p = 0.006), history of cough for ≥2 years (p = 0.002), in patients with a history of sputum for ≥2 years (p = 0.031), and in patients with a history of dyspnea for ≥2 years (p = 0.001). The results of the logistic regression analysis demonstrated that older age, male gender, smoking, and occupational exposure were independent predictive factors for COPD. The results of our study suggest that hookah smoking significantly increases the risk of COPD. Given the importance of COPD in the global burden of diseases, it is necessary to carry out further studies on the relationship between hookah use and COPD.
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Affiliation(s)
- Mehrzad Bahtouee
- 1 Department of Internal Medicine, Shohadaye Khalije Fars Hospital, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Nasrollah Maleki
- 2 Department of Endocrine and Metabolic Diseases, The Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Fatemeh Nekouee
- 1 Department of Internal Medicine, Shohadaye Khalije Fars Hospital, Bushehr University of Medical Sciences, Bushehr, Iran
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Singh SK, Enzhong L, Reidpath DD, Allotey P. Shisha (waterpipe) smoking initiation among youth in Malaysia and global perspective: a scoping review (2006-2015). Public Health 2017; 144:78-85. [PMID: 28274388 DOI: 10.1016/j.puhe.2016.11.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 11/07/2016] [Accepted: 11/28/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To explore the initiating factors of waterpipe tobacco smoking (WTS) among youth. STUDY DESIGN The analytic framework for this scoping review was performed using the methodology outlined by Arksey and O'Malley, which includes identification of the research question, study selection, charting the data, collating, summarizing and reporting the results that were primarily guided by the research question; 'what is known about the initiation of shisha smoking among youth?' METHODS Electronic databases such as Cochrane, MEDLINE and PsycINFO were used to search for relevant articles. Articles included were all in English and published within the year of 2006 to 2015. Inclusion criteria; i) age range of 10 to 29 years; ii) examined the reasons why youth started or tried WTS; iii) in full text. Therefore, 26 articles were included in this scoping review. RESULTS This review has identified and classified the initiating factors of WTS among youth in four subtopics: individual factors, interpersonal influences, cigarettes and alcohol use, and media influences. Individual factors and interpersonal influences played an important role in initiation factors of WTS among youth. CONCLUSION This study concludes that public health professionals within the Southeast Asia region need to promote innovative preventive measures through peer-to-peer led interventions that are also easily assessable on social media platforms. The public health messages need to address the misconceptions of risk associated to WTS use.
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Affiliation(s)
- S K Singh
- Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500 Subang Jaya, Selangor, Malaysia; Perdana University-Royal College of Surgeons in Ireland School of Medicine, MAEPS Building, MARDI Complex, Jalan MAEPS Perdana, 43400 Serdang, Selangor, Malaysia.
| | - L Enzhong
- Perdana University-Royal College of Surgeons in Ireland School of Medicine, MAEPS Building, MARDI Complex, Jalan MAEPS Perdana, 43400 Serdang, Selangor, Malaysia
| | - D D Reidpath
- Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500 Subang Jaya, Selangor, Malaysia
| | - P Allotey
- Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500 Subang Jaya, Selangor, Malaysia
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Othman N, Kasem AO, Salih FA. Waterpipe Smoking among University Students in Sulaimaniyah, Iraqi Kurdistan: Prevalence, Attitudes, and Associated Factors. TANAFFOS 2017; 16:225-232. [PMID: 29849676 PMCID: PMC5960227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Waterpipe smoking is increasingly becoming the most common method of tobacco use among adolescents in the Eastern Mediterranean Region. This study was undertaken in Iraqi Kurdistan to estimate its prevalence among students and investigate attitudes and factors associated with it. MATERIALS AND METHODS In a cross-sectional survey at Sulaimani Polytechnic University, 1160 students were approached in a two-stage design using a self-administered questionnaire. Data was entered into Epidata and analysis was done in Stata. RESULTS Prevalence of cigarette smoking was 10% and waterpipe smoking was 28% (male 49%, female 10%). Waterpipe smoking was initiated prior to joining the university in 74% of the cases and 22% of waterpipe smokers smoked every day. The most common place for smoking was coffee shops (52%) and 71% of smokers shared the pipe. The significant risk factors were smoking cigarettes (OR 10.3, 95% CI 7.0-15.0), male gender (OR 5.7, 95% CI 3.9-8.2), non-Kurdish ethnicity (OR 3.0, 95% CI 1.6-15.9), city residence (OR 1.5, 95% CI 1.0-2.1), and use of alcohol and other substances (OR 2.8 95% CI 1.4-5.6). CONCLUSION Waterpipe smoking is highly prevalent among students in Iraqi Kurdistan, especially among males, and is becoming a public health problem. Tobacco control interventions should be designed specifically to address this problem among adolescents and the youth.
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Affiliation(s)
- Nasih Othman
- Kurdistan Institution for Strategic Studies and Scientific Research, Sulaimaniyah, Iraq,Correspondence to: Othman N, Address: Kurdistan Institution for Strategic Studies and Scientific Research, Sulaimaniyah, Iraq, Email address:
| | - Attallah O. Kasem
- Department of Community Health, Sulaimani Technical Institute, Sulaimani Polytechnic University, Sulaimaniyah, Iraq
| | - Faisal A. Salih
- Department of Medical Laboratory, Technical College of Health, Sulaimani Polytechnic University, Sulaimaniyah, Iraq
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Roman NV, Schenck C, Jacobs L, September SJ. Hookah Use: Could Families Be A Risk Factor for Future Addiction? JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2016. [DOI: 10.1080/1067828x.2016.1175985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abbasi-Ghahramanloo A, Rahimi-Movaghar A, Zeraati H, Safiri S, Fotouhi A. Prevalence of Hookah Smoking and Its Related Factors Among Students of Tehran University of Medical Sciences, 2012 - 2013. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2016; 10:e4551. [PMID: 27803724 PMCID: PMC5088357 DOI: 10.17795/ijpbs-4551] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Revised: 10/09/2015] [Accepted: 11/26/2015] [Indexed: 12/19/2022]
Abstract
Background Hookah smoking has increased worldwide, especially among young people. Objectives The aim of the present study was to determine the prevalence of hookah use and related factors in a sample of Iranian students of medical sciences. Materials and Methods A cross-sectional study was conducted on 1992 randomly selected sample of students of Tehran University of Medical Sciences during 2012 - 2013. A multistage sampling method was used and anonymous structured questionnaires were distributed to the students of each selected class. Chi-square test, Fisher's exact test and multiple binary logistic regression analyses were performed and P < 0.05 was considered as a significance level. Results Lifetime, last year and last month prevalence rates of hookah smoking were 26.6% (95% CI: 24.7 - 28.6), 17.8% (95% CI: 16.1 - 19.5) and 8.9% (95% CI: 7.7 - 10.2), respectively. The results of logistic regression model showed that male gender [odds ratio (OR) = 2.8, 95% CI: 1.86 - 4.21], cigarette smoking in the past year (OR = 5.6, 95% CI: 3.21 - 9.83), alcohol use in the past year (OR = 7.4, 95% CI: 4.01 - 13.06), cigarette or hookah smoking in the family members (OR = 1.7, 95% CI: 1.13 - 2.51), cigarette or hookah smoking among friends (OR = 4.4, 95% CI: 2.69 - 7.33), alcohol use by friends in the past year (OR = 1.9, 95% CI: 1.20 - 3.14), and illicit substance use among friends (OR = 2.2, 95% CI: 1.22 - 4.05) were associated with hookah smoking. Conclusions The results of our study indicate a relatively high prevalence of hookah smoking among Iranian students. The findings emphasize the importance of planning preventive interventions by considering different high-risk behaviors simultaneously.
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Affiliation(s)
| | - Afarin Rahimi-Movaghar
- Iranian National Center for Addiction Studies (INCAS), Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences Tehran, IR Iran
| | - Hojjat Zeraati
- School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Saeid Safiri
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Akbar Fotouhi
- School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran
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Factors Affecting Hookah Smoking Trend in the Society: A Review Article. ADDICTION & HEALTH 2016; 8:123-135. [PMID: 27882210 PMCID: PMC5115646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
BACKGROUND An increase in hookah smoking is considered to be a serious health problem in societies withdifferent cigarette smoking patterns. Thus, determinants of increase in this behavior are needed to beidentified. This study aimed to review the articles related to the causes of hookah smoking in the society. METHODS This study reviewed the scientific references of authentic databases and journals, including Web ofScience, PubMed, Iranian Databases, Elsevier, Embase, Scopus, MEDLINE, CINAHL, CDC, and WorldHealth Organization (WHO). Overall, 84 scientific studies conducted during 1990-2015 were collected. FINDINGS Several studies on the prevalence of smoking hookah and its associated factors in the societysuggested that numerous factors played a role in interest in smoking hookah. The most common reasons forindividuals' inclination to smoke hookah were positive viewpoints toward smoking hookah, wrong beliefsabout its low risks, presumed lack of addiction, social acceptance, ease of access, wrong cultural habits, andregulative weakness. CONCLUSION Evidence indicated that a large spectrum of individual and social factors was effective in variouslevels of hookah consumption. Besides, it seems that single-component interventions and those solely basedon individual factors could not result in effective prevention. On the other hand, interventions based onecological approaches are suggested in this regard. Overall, it is essential to focus on the exclusion of positiveviewpoints toward hookah, develop the ability to say "no," relaxation, and resistance against temptations tosmoke hookah, culturalization, and regulation of strong laws.
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Roohafza H, Kasaei Z, Heidari K, Omidi R, Alinia T, Naji M, Jaberifar M, Sadeghi M. Better view on attitudes and perceived parental reactions behind waterpipe smoking among Iranian students. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2016; 20:1032-8. [PMID: 26941805 PMCID: PMC4755088 DOI: 10.4103/1735-1995.172812] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Because of the increasing usage of waterpipe globally, we need to know more about the different factors related to waterpipe and cigarette smoking. Therefore, the present study aims at gaining more insight on waterpipe and cigarette smoking based on perceived parental reaction and appeal and repellent of smoking among adolescents. Materials and Methods: A cross-sectional survey entitled “Isfahan Tobacco Use Prevention Program” (ITUPP) was conducted among 5,500 adolescents in Isfahan Province, Iran in 2010 using a self-administered anonymous questionnaire. Demographic factors, cigarette and waterpipe smoking status, appeal and repellent of smoking, perceived parental reactions, and the main reasons behind the increase in waterpipe smoking were measured. Chi-square, univariate logistic regression, and multiple logistic regression were used. For all analyses, we defined statistical significance a priori with a two-tailed alpha of 0.05. Statistical analyses were conducted using the Statistical Package for the Social Sciences (SPSS) version 15. Results: 50% of the sample was female and 89% lived in urban areas. The average age of the respondents was 14.37 ± 1. 70 years. While a majority of cigarette smokers (70.9%) were waterpipe smokers, only 35.7% of waterpipe smokers smoked cigarettes. The incidence of smoking was high in those who expected less extensive parental reaction with odds ratio (OR) = 1.89 [95% confidence interval (CI): 1.35-2.63] (P < 0.001) among cigarette smokers and OR = 2.75 (95% CI: 2.16-3.50) (P < 0.001) among waterpipe smokers. “Taste” was rated the most attractive feature by waterpipe and cigarette smokers 2.83-fold (95% CI: 2.06, 3.90) (P < 0.001). Most waterpipe smokers compared to nonsmokers believed that the main reason behind waterpipe popularity was habit. Conclusion: The factors related to waterpipe smoking were different from those in cigarette smoking; so we need to implement different interventions to overcome the surging usage of tobacco use.
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Affiliation(s)
- Hamidreza Roohafza
- Tobacco Control Unit, Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Kasaei
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Kamal Heidari
- Isfahan Province Health Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Razieh Omidi
- Isfahan Province Health Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Tahereh Alinia
- Department of Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mojtaba Naji
- Expert Prevention of Isfahan Welfare Organization, Isfahan, Iran
| | - Morid Jaberifar
- Isfahan Province Health Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoumeh Sadeghi
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Hadaegh F, Derakhshan A, Mozaffary A, Hasheminia M, Khalili D, Azizi F. Twelve-Year Cardiovascular and Mortality Risk in Relation to Smoking Habits in Type 2 Diabetic and Non-Diabetic Men: Tehran Lipid and Glucose Study. PLoS One 2016; 11:e0149780. [PMID: 26930192 PMCID: PMC4773225 DOI: 10.1371/journal.pone.0149780] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Accepted: 02/04/2016] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION To examine the associations between smoking and cardiovascular disease (CVD) / coronary heart disease (CHD) and all-cause mortality events in men with and without type 2 diabetes (T2D) in a Middle Eastern cohort during a median follow-up of 12 years. METHODS The study population included 2230 subjects aged ≥ 40 years, free from CVD, comprised of 367 participants with diabetes (21.2% current smokers) and 1863 without (27.3% current smokers). Multivariate Hazard ratios (HR) and 95% confidence intervals (CI) were calculated for smoking (considering different definitions) for those with and without diabetes. Potential confounding factors including age, body mass index, estimated Glomerular Filtration Rate, hypertension, hypercholesterolemia and educational level were entered in the multivariate analysis. RESULTS In men with diabetes, the HR (95% CI) of comparing current and non-smokers was 1.25 (0.74-2.12) for incident CHD, 1.52 (0.96-2.40) for CVD and 2.10 (1.27-3.47) for mortality events; the corresponding values for men without diabetes were 1.65 (1.24-2.20), 1.70 (1.30-2.22) and 1.72 (1.14-2.58), respectively (all P values for interactions > 0.46). After pooling past smokers with current smokers, among diabetic individuals there was no significant risk for CVD [1.29 (0.89-1.86)] or mortality events [1.25 (0.81-1.92)]; however, among non-diabetic individuals the HRs of current/past smokers reached significant levels for CVD [1.53 (1.23-1.91)] but not for mortality outcomes (all P values for interactions > 0.51). CONCLUSIONS The strength of the associations between smoking habits and incident CVD/CHD and mortality events from all causes did not differ significantly among diabetic and non-diabetic participants. Therefore, a comprehensive community-based smoking prevention program is important, given the increasing trend of smoking among the Iranian population regardless of diabetes status.
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Affiliation(s)
- Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- * E-mail:
| | - Arash Derakhshan
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amirhossein Mozaffary
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mitra Hasheminia
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Davood Khalili
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Zhou S, Behrooz L, Weitzman M, Pan G, Vilcassim R, Mirowsky JE, Breysee P, Rule A, Gordon T. Secondhand hookah smoke: an occupational hazard for hookah bar employees. Tob Control 2016; 26:40-45. [PMID: 26811352 DOI: 10.1136/tobaccocontrol-2015-052505] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 12/01/2015] [Accepted: 12/09/2015] [Indexed: 11/04/2022]
Abstract
BACKGROUND Despite the increasing popularity of hookah bars, there is a lack of research assessing the health effects of hookah smoke among employees. This study investigated indoor air quality in hookah bars and the health effects of secondhand hookah smoke on hookah bar workers. METHODS Air samples were collected during the work shift of 10 workers in hookah bars in New York City (NYC). Air measurements of fine particulate matter (PM2.5), fine black carbon (BC2.5), carbon monoxide (CO), and nicotine were collected during each work shift. Blood pressure and heart rate, markers of active smoking and secondhand smoke exposure (exhaled CO and saliva cotinine levels), and selected inflammatory cytokines in blood (ineterleukin (IL)-1b, IL-6, IL-8, interferon γ (IFN-γ), tumour necrosis factor (TNF-α)) were assessed in workers immediately prior to and immediately after their work shift. RESULTS The PM2.5 (gravimetric) and BC2.5 concentrations in indoor air varied greatly among the work shifts with mean levels of 363.8 µg/m3 and 2.2 µg/m3, respectively. The mean CO level was 12.9 ppm with a peak value of 22.5 ppm CO observed in one hookah bar. While heart rate was elevated by 6 bpm after occupational exposure, this change was not statistically significant. Levels of inflammatory cytokines in blood were all increased at postshift compared to preshift testing with IFN-Υ increasing from 0.85 (0.13) to 1.6 (0.25) (mean (standard error of the mean; SEM)) pg/mL (p<0.01). Exhaled CO levels were significantly elevated after the work shift with 2 of 10 workers having values >90 ppm exhaled CO. CONCLUSIONS These results demonstrate that hookah bars have elevated concentrations of indoor air pollutants that appear to cause adverse health effects in employees. These data indicate the need for further research and a marked need for better air quality monitoring and policies in such establishments to improve the indoor air quality for workers and patrons.
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Affiliation(s)
- Sherry Zhou
- Department of Internal Medicine, University of Michigan School of Medicine, Ann Arbor, Michigan, USA
| | | | - Michael Weitzman
- Department of Pediatrics, New York University School of Medicine, New York, New York, USA.,Department of Environmental Medicine, New York University School of Medicine, New York, New York, USA.,NYU College of Global Public Health, New York, New York, USA
| | - Grace Pan
- Department of Environmental Medicine, New York University School of Medicine, New York, New York, USA
| | - Ruzmyn Vilcassim
- Department of Environmental Medicine, New York University School of Medicine, New York, New York, USA
| | | | - Patrick Breysee
- Department of Environmental Health Sciences, Johns Hopkins University, Baltimore, Maryland, USA
| | - Ana Rule
- Department of Environmental Health Sciences, Johns Hopkins University, Baltimore, Maryland, USA
| | - Terry Gordon
- Department of Environmental Medicine, New York University School of Medicine, New York, New York, USA.,NYU College of Global Public Health, New York, New York, USA
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Hedayati-Moghaddam MR, Fathimoghadam F, Eftekharzadeh-Mashhadi I, Pourafzali SJ. Epidemiology of Tobacco and Substance Abuse Among University Students in Mashhad, Northeast of Iran, in 2008. RAZAVI INTERNATIONAL JOURNAL OF MEDICINE 2015. [DOI: 10.17795/rijm27085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Baheiraei A, Shahbazi Sighaldeh S, Ebadi A, Kelishadi R, Majdzadeh SR. Psycho-social Needs Impact on Hookah Smoking Initiation among Women: A Qualitative Study from Iran. Int J Prev Med 2015; 6:79. [PMID: 26425334 PMCID: PMC4564902 DOI: 10.4103/2008-7802.163374] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Accepted: 04/13/2015] [Indexed: 11/23/2022] Open
Abstract
Background: In Iranian women, the use of hookah is the most common method of tobacco smoking. This study aimed to find the role of psycho-social needs and gaps as a possible risk factor for hookah smoking initiation in women. Methods: This qualitative study was conducted during 2012–2013 in Tehran, Iran. Thirty-six women participated in the study. They were current or former users of hookah. Data were collected through in-depth individual interviews and was analyzed through content analysis. Results: Four main categories were identified from the data. This study focused on the category: Psycho-social needs and gaps. This category has five sub-categories which explain why women begin to smoke hookah including curiosity; desire for non-feminine, forbidden, and negative activities; need for amusement and recreation; for others: To show off; attract attention; satisfy and join others and protection. Conclusions: From this study, a variety of factors which contribute to the initiation of hookah smoking among women have been identified. Keeping young girls and women away from seemingly happy gatherings of hookah smokers; Providing appropriate recreational facilities for young women and training families on how to help their children in the event of a crisis-like intention to take up smoking behavior, can be some effective ways for reducing hookah smoking initiation among women.
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Affiliation(s)
- Azam Baheiraei
- Community-Based Participatory Research Center, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Shahbazi Sighaldeh
- Department of Reproductive Health, Prenatal and Delivery, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center and Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Roya Kelishadi
- Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyed Reza Majdzadeh
- School of Public Health and Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Akl EA, Ward KD, Bteddini D, Khaliel R, Alexander AC, Lotfi T, Alaouie H, Afifi RA. The allure of the waterpipe: a narrative review of factors affecting the epidemic rise in waterpipe smoking among young persons globally. Tob Control 2015; 24 Suppl 1:i13-i21. [PMID: 25618895 PMCID: PMC4345979 DOI: 10.1136/tobaccocontrol-2014-051906] [Citation(s) in RCA: 139] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Objective The objective of this narrative review is to highlight the determinants of the epidemic rise in waterpipe tobacco smoking (WTS) among youth globally. The Ecological Model of Health Promotion (EMHP) was the guiding framework for the review. Data sources The following electronic databases were searched: Cochrane library, MEDLINE, EMBASE, PsycINFO, Web of Science and CINAHL Plus with Full Text. Search terms included waterpipe and its many variant terms. Study selection Articles were included if they were published between 1990 and 2014, were in English, were available in full text and included the age group 10–29 years. Data extraction Articles which analysed determinants of WTS at any of the levels of the EMHP were retained regardless of methodological rigour: 131 articles are included. Articles were coded in a standard template that abstracted methods as well as results. Data synthesis The review found that methodologies used to assess determinants of WTS among youth were often conventional and lacked rigor: 3/4 of the studies were cross-sectional surveys and most enrolled non-representative samples. Within the framework, the review identified determinants of WTS at the intrapersonal, interpersonal, organisational, community and policy levels. Conclusions The review suggests potential interventions to control WTS among youth, with emphasis on creative utilisation of social media, and tobacco control policies that include the specificities of WTS. The review further suggests the need for rigorous qualitative work to better contextualise determinants, and prospective observational and experimental studies that track and manipulate them to assess their viability as intervention targets.
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Affiliation(s)
- E A Akl
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - K D Ward
- School of Public Health, University of Memphis, Memphis, Tennessee, USA
| | - D Bteddini
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - R Khaliel
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - A C Alexander
- School of Public Health, University of Memphis, Memphis, Tennessee, USA
| | - T Lotfi
- Faculty of Medicine, Clinical Research Institute, American University of Beirut, Beirut, Lebanon
| | - H Alaouie
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - R A Afifi
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
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BAHEIRAEI A, SHAHBAZI SIGHALDEH S, EBADI A, KELISHADI R, MAJDZADEH R. Factors that Contribute in the First Hookah Smoking Trial by Women: A Qualitative Study from Iran. IRANIAN JOURNAL OF PUBLIC HEALTH 2015; 44:100-10. [PMID: 26060781 PMCID: PMC4449996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/24/2014] [Accepted: 09/15/2014] [Indexed: 11/11/2022]
Abstract
BACKGROUND Hookah smoking is growing in popularity especially among women but little is known about the determinants influencing on hookah smoking initiation. In order to address this emerging health risk, a qualitative study was conducted to explore the factors that contribute in the first hookah smoking trial by women. METHODS This qualitative study was conducted during 2012 to 2013 in Tehran, Iran. Participants were recruited to represent diversity in smoking status, ethnicity, age groups and residence. Data was collected through in-depth individual interviews and was analyzed through content analysis. RESULTS Four main themes were identified from the qualitative data including: Positive attitude toward hookah smoking; Social and family facilitators; Psychosocial needs and gaps and Sensory characteristic of hookah. CONCLUSION From this study, a variety of factors which contribute to the initiation of hookah smoking among women have been identified. Since one of the major causes of increased hookah smoking may be its ordinary use, all factors causing the ordinary use should be eliminated, and efforts should be made in opposition to hookah smoking promotions.
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Affiliation(s)
- Azam BAHEIRAEI
- 1. Community-Based Participatory Research Center, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin SHAHBAZI SIGHALDEH
- 2. Dept. of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas EBADI
- 3. Behavioral Sciences Research Center (BSRC) & Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Roya KELISHADI
- 4. Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Reza MAJDZADEH
- 5. School of Public Health and Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Abstract
OBJECTIVES Prevalence of hookah use is increasing significantly among adolescents. This study aimed to delineate demographic and socioeconomic correlates of hookah use among high school seniors in the United States. We hypothesized that more impoverished adolescents and those who smoked cigarettes would be more likely to use hookahs. METHODS Data were examined for 5540 high school seniors in Monitoring the Future (years 2010-2012), an annual nationally representative survey of high school students in the United States. Using data weights provided by Monitoring the Future, we used multivariable binary logistic regression to delineate correlates of hookah use in the last 12 months. RESULTS Eighteen percent of students reported hookah use in the past year. Compared with white students, black students were at lower odds for use (adjusted odds ratio [AOR] = 0.27, P < .0001). High parent education increased the odds for use (AOR = 1.58, P < .001), and student weekly income from a job of >$50/week (AOR = 1.26, P < .05) or $11 to $50 per week from other sources (AOR = 1.35, P < .01) also increased odds for use. Males and urban students were also at higher odds for use, as were users of alcohol, marijuana, and other illicit substances. Former cigarette smokers were at higher risk, and current smokers were at highest risk for use. CONCLUSIONS Adolescents of higher socioeconomic status appear to be at particularly high risk for hookah use in the United States. Prevention efforts must target this group as prevalence continues to increase.
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Affiliation(s)
| | - Sherry Zhou
- Pediatrics and Environmental Medicine, New York University Langone Medical Center, New York, New York
| | | | - Michael Weitzman
- Pediatrics and Environmental Medicine, New York University Langone Medical Center, New York, New York
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Mousawi AA. The prevalence of smoking among karbala/iraq university students in iraq in 2005. Tob Use Insights 2014; 7:9-14. [PMID: 25741180 PMCID: PMC4335460 DOI: 10.4137/tui.s12238] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Revised: 10/28/2013] [Accepted: 10/29/2013] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Tobacco use is considered one of the largest public health threats facing the world. The estimated number of current smokers in the world exceeds 1.3 billion, which means that one third of the world’s population above 15 years are smokers. Smoking prevalence is increasing in the developing world but monitoring of this trend is poor in these countries. Studies on smoking in Iraq are scarce, with the current smoking prevalence rate reported to be 15–25% for males and 1–10% for females in surveys conducted in the past ten years. OBJECTIVES This study aimed to find the prevalence of smoking among Karbala University students in Iraq and determine its associations with participants’ demographic and other related predictors, including other substance use behaviors, to help inform and develop future prevention and control programs. MATERIAL AND METHODS A categorical random sample included 2298 students at Karbala University in Iraq who answered a self-completed questionnaire. The questionnaire was based on the Drug Abuse Program questionnaire and was piloted before implementation. Descriptive and analytic statistical tools (SPSS-20) were used to assess significant associations at P < 0.001 to compensate for multiple comparisons. RESULTS The prevalence of current smoking among Karbala University students was 10.5%, shisha smoking 4.4% and previous smoking (having ceased smoking for more than 30 days) 1.0%. Approximately half of the smokers surveyed (45.7%) started smoking before the age of 18. Smoking was positively related to male gender, increasing age, being unmarried, college, drinking alcohol, having a positive attitude toward smoking and higher fathers’ educational level. CONCLUSION Lifetime smoking prevalence was found to be approximately two out of ten students. Significant positive association was found between smoking and other substance use behaviours. Additionally it was associated with positive attitudes toward substance use. Significant predictors were determined. Further studies are needed to explore the prevalence of smoking among Iraqi youths to find trends and help to guide the implementation scientifically based control and prevention programs.
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Affiliation(s)
- Ali Al Mousawi
- Lecturer at Karbala Medical College/Iraq, PhD student at the University of Chester, UK
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Methodology of isfahan tobacco use prevention program: first phase. Adv Prev Med 2014; 2013:182170. [PMID: 24383007 PMCID: PMC3870653 DOI: 10.1155/2013/182170] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 10/19/2013] [Accepted: 10/22/2013] [Indexed: 12/02/2022] Open
Abstract
Background. Tobacco use continues to be the leading global cause of preventable death. The majority of smokers begin using tobacco products at teen ages. The aims of this study were providing a methodology of Isfahan Tobacco Use Prevention Program and investigating the prevalence of tobacco use and its related factors. Method. It was a cross-sectional study among guidance and high school students in Isfahan province. Initiation, social, psychological (depression and self-efficacy), family, and attitudinal and belief factors and school policy toward smoking (cigarettes and water-pipe) were investigated. Saliva qutinin was given from 5% of participants for determination of accuracy of responses. A self-administered anonymous questionnaire was used for gathering all data. Results. Of all 5500 questionnaires distributed, about 5408 completed questionnaires were returned (with response rate of 98.3%). Of all participants, 2702 (50.0%) were girls and 2706 (50.0%) were boys. Respectively, 4811 (89.0%) and 597 (11.0%) were from urban and rural. Of all participants, 2445 (45.2%) were guidance school and 2962 (54.8%) were high school students. Conclusion. This study will provide a unique opportunity to study prevalence of smoking cigarettes and water-pipe (ghelyan) among guidance and high school students in Isfahan province and determine the role of initiation, social, psychological, family, and attitudinal and belief factors and school policy toward smoking.
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Ehteshami-Afshar S, Momenan A, Hajshekholeslami F, Azizi F, Hadaegh F. The impact of smoking status on 9.3 years incidence of cardiovascular and all-cause mortality among Iranian men. Ann Hum Biol 2013; 41:249-54. [DOI: 10.3109/03014460.2013.853834] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Akl EA, Jawad M, Lam WY, Co CN, Obeid R, Irani J. Motives, beliefs and attitudes towards waterpipe tobacco smoking: a systematic review. Harm Reduct J 2013; 10:12. [PMID: 23816366 PMCID: PMC3706388 DOI: 10.1186/1477-7517-10-12] [Citation(s) in RCA: 203] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2010] [Accepted: 06/26/2013] [Indexed: 11/10/2022] Open
Abstract
Background In spite of the negative health effects of waterpipe tobacco smoking, its use is becoming more common. The objective of this study is to systematically review the medical literature for motives, beliefs and attitudes towards waterpipe tobacco smoking. Methods We electronically searched MEDLINE, EMBASE, and the ISI the Web of Science in January 2012. We included both quantitative and qualitative studies. We selected studies and abstracted data using standard systematic review methodology. We synthesized data qualitatively. Results We included 58 papers reporting on 56 studies. The main motives for waterpipe tobacco smoking were socializing, relaxation, pleasure and entertainment. Peer pressure, fashion, and curiosity were additional motives for university and school students while expression of cultural identity was an additional motive for people in the Middle East and for people of Middle Eastern descent in Western countries. Awareness of the potential health hazards of waterpipe smoking was common across settings. Most but not all studies found that the majority of people perceived waterpipe smoking as less harmful than cigarette smoking. Waterpipe smoking was generally socially acceptable and more acceptable than cigarette smoking in general. In Middle Eastern societies, it was particularly more acceptable for women’s use compared to cigarette use. A majority perceived waterpipe smoking as less addictive than cigarette smoking. While users were confident in their ability to quit waterpipe smoking at any time, willingness to quit varied across settings. Conclusions Socializing, relaxation, pleasure and entertainment were the main motives for waterpipe use. While waterpipe users were aware of the health hazards of waterpipe smoking, they perceived it as less harmful, less addictive and more socially acceptable than cigarette smoking and were confident about their ability to quit.
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Affiliation(s)
- Elie A Akl
- Department of Medicine, State University of New York at Buffalo ECMC-DKM C216, Buffalo, NY 14215, USA.
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Daniels KE, Roman NV. A descriptive study of the perceptions and behaviors of waterpipe use by university students in the Western Cape, South Africa. Tob Induc Dis 2013; 11:4. [PMID: 23394683 PMCID: PMC3600009 DOI: 10.1186/1617-9625-11-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Accepted: 02/04/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Waterpipe smoking started as a cultural phenomenon but has become a social phenomenon. Hookah cafes are an increasingly popular venue for socializing. Studies suggest that waterpipe users perceive smoking the waterpipe as less addictive and harmful than cigarette smoking. The aim of this study was to assess the beliefs, and associated behaviours, regarding the health-risk of smoking the waterpipe. METHODS A cross-sectional descriptive study was conducted with a sample of first year students at a historically black university in the Western Cape, South Africa. A self-administered questionnaire was constructed from the College Health Behaviour Survey. The final sample was 389 university students, 64% (250) females and 36% (139) males. The sample had a mean age of 22.2 years (SD = 5.04). RESULTS Waterpipe users perceived the health risks of smoking the waterpipe to be exaggerated (48%) and less addictive (58%) than non-users (13% and 17%, p<.001). Additionally, the findings confirm that waterpipe smoking is conducted in a social setting (61%). This social setting included smoking on campus (28%), in the family home (11%), at a party (9%), at a friend's place (6%) and in a restaurant (1%). Of concern was the majority of users smoked the waterpipe on a daily basis (70%) and that the tobacco mix was easily available (90%). The most common self-reported reason for smoking the waterpipe was for relaxation. CONCLUSION As with previous studies, the results of this study confirm the false perception that smoking the waterpipe is not a health risk and is socially acceptable. Additionally, the findings of the study raise concerns and an awareness of smoking the waterpipe in the family home and implications for children. The results of this study provide important information for tobacco control and substance abuse policies in South Africa. These findings highlight the need for further research to determine the extent of waterpipe smoking at other universities in South Africa.
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Affiliation(s)
- Karin E Daniels
- Department of Social Work, University of the Western Cape, Modderdam Road, Bellville, Cape Town 7435, South Africa
| | - Nicolette V Roman
- Department of Social Work, University of the Western Cape, Modderdam Road, Bellville, Cape Town 7435, South Africa
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Nguyen T, Hlangothi D, Martinez RA, Jacob D, Anthony K, Nance H, Saleh MA. Charcoal burning as a source of polyaromatic hydrocarbons in waterpipe smoking. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART. B, PESTICIDES, FOOD CONTAMINANTS, AND AGRICULTURAL WASTES 2013; 48:1097-102. [PMID: 24007487 DOI: 10.1080/03601234.2013.824300] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Polyaromatic hydrocarbons (PAH) content from seven commercial waterpipe charcoals were determined during the smoking process to estimate how much PAHs would not be trapped by the water trap and could reach the lungs of the smokers. Naphthalene, 2-methylnaphthalene, acenaphthylene, acenaphthene, phenanthrene and fluoranthene were the most abundant PAH compounds produced during smoking. Naphthalene was the highest in all of the smoke contents and levels of 5 to 405 μg/15 minutes could be inhaled by the smoker. The amounts of PAHs produced during the smoking events in absence of tobacco varied greatly among different brands of charcoal. The amount and composition of the emitted PAH were not related to the amount and composition of the original chemicals in the charcoal prior to burning. Our findings suggest that public health agencies should regulate smoked charcoal products alongside tobacco.
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Affiliation(s)
- Thao Nguyen
- Department of Chemistry, Texas Southern University, Houston, TX 77004, USA
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Azab M, Khabour OF, Alzoubi KH, Anabtawi MM, Quttina M, Khader Y, Eissenberg T. Exposure of pregnant women to waterpipe and cigarette smoke. Nicotine Tob Res 2013; 15:231-7. [PMID: 22573726 PMCID: PMC3524068 DOI: 10.1093/ntr/nts119] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2012] [Accepted: 03/27/2012] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Throughout the Eastern Mediterranean region, tobacco is used primarily in 2 forms: cigarette smoking and waterpipe smoking. Despite the fact that tobacco use is considered as a global public health threat, waterpipe smoking is reported to be growing in popularity, particularly among women. The objectives of this study are to determine the prevalence and patterns of cigarette, waterpipe, and passive smoking among pregnant women in Jordan, and to assess their perception of harmful effects of cigarette and waterpipe smoking. METHODS A total of 500 pregnant women were randomly recruited from maternity clinics in North and Middle of Jordan and surveyed regarding exposure to waterpipe tobacco and cigarette smoking. RESULTS The results showed that 7.9% of women were current cigarette smokers and 8.7% were current waterpipe smokers. About 82.4% of all women reported that they are exposed to cigarette smoke and 32.8% reported that they are exposed to waterpipe smoke. The most common place where women are exposed to cigarette and waterpipe smoke was their house (50.4% and 48.7%, respectively) followed by public places (31.4% and 21.4%, respectively). In addition, the husband was the main source for exposure to cigarette and waterpipe smoke (48.5% and 42.7%, respectively). Approximately, 74% of women believed that cigarette smoking is addictive, whereas only 55.1% reported that waterpipe smoking leads to addiction. CONCLUSIONS Exposure of pregnant women to tobacco smoke is a public health problem in Jordan that requires immediate action.
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Affiliation(s)
- Mohammed Azab
- Department of Community Medicine and Pathology, Faculty of Medicine, The Hashemite University, Zarqa, Jordan. a
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