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Prevalence, Knowledge, Attitude, and Predictors of Waterpipe Smoking among School Adolescents in Saudi Arabia. Glob Health Epidemiol Genom 2022; 2022:1902829. [PMID: 36263374 PMCID: PMC9553653 DOI: 10.1155/2022/1902829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 09/03/2022] [Indexed: 11/24/2022] Open
Abstract
This cross-sectional study was designed to investigate the prevalence, knowledge, attitude, and predictors of waterpipe (WP) smoking among intermediate and secondary school adolescents in the Kingdom of Saudi Arabia (KSA). A self-administered anonymous questionnaire was used to collect data on demography, WP smoking status and patterns, the Arabic version of the Global Youth Tobacco Survey tool, and instruments to assess knowledge and attitude towards WP smoking. The Patient Health Questionnaire (PHQ-9) was also used. Descriptive and inferential statistical techniques were used. Modeling of WP smoking behavior was conducted using logistic regression. A total of 639 male students participated in this study. The prevalence of current WP and cigarette smokers were 17.7% and 14.6%, respectively. Out of the total population, 47.8% of students have the misconception that WP smoking is less harmful than cigarettes. A significant association (P < 0.05) of some demographic factors (age, school stage, residence, and parents' educational level) on WP smoking status was observed. Pleasure, socializing, and happiness represented the primary motives for initiating WP smoking. The majority of students had misconceptions about WP's health effects. More than 50% believed that smoking WP could ease anxiety, cause less harm, and has less addictive properties compared to cigarettes. Modeling suggested that the most significant predictors of WP smoking were cigarette smoking, depression, and the attitude index. Current findings warrant further research and official health programs to promote educational initiatives regarding WP smoking.
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Al-Natour A, Gillespie GL, Alzoubi F. "We cannot stop smoking": Female university students' experiences and perceptions. Appl Nurs Res 2021; 61:151477. [PMID: 34544576 DOI: 10.1016/j.apnr.2021.151477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 07/08/2021] [Accepted: 07/17/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND While findings are available about smoking in young females, there is a dearth of research reporting this problem among Jordanian females, particularly university students. Also, there is lack of studies that describe the daily experience and the causative factors for smoking among female university students. PURPOSE The purpose of this study is to describe the experience of smoking as perceived by female Jordanian university students. In addition, this study aimed to describe the predisposing factors for initiating smoking and feelings toward that experience. METHOD A descriptive qualitative study was employed. A purposive sample of 12 female Jordanian university students who smoke cigarettes were asked to participate in this study. A semi-structured, face-to-face interviews were conducted. RESULTS Five themes of the study included: (1) living and enjoying smoking with other females, (2) hazardous effect of smoking, (3) our culture stigmatizing female smoking, (4) why we don't stop smoking, and (5) strategies to combat smoking among females. CONCLUSION Female university students disclosed peer pressure and stress as intensifying factors for smoking. Also they were unable to quit smoking because they were attached and addicted to smoking cigarettes. STUDY IMPLICATIONS The findings of our study have several implications for nursing education, policymaking, and practice. An important target would be to motivate university students who are smokers to attempt smoking cessation leveraging cultural leaders as role models. Policy makers also should revise policies related to importing and taxation of cigarettes is essential. In addition, policy makers should enforce legislation for smoking fee areas and prevention of smoking in closed areas.
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Affiliation(s)
- Ahlam Al-Natour
- Community and Mental Health Nursing, College of Nursing, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan.
| | - Gordon Lee Gillespie
- University of Cincinnati College of Nursing, P.O. Box 210038, Cincinnati, OH 45221-0038, United States of America.
| | - Fatmeh Alzoubi
- Community and Mental Health Nursing Department, College of Nursing, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan.
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Perspectives of Frontline Professionals on Palestinian Children Living with Sibling and Parental Drug Use in the UNRWA Camps, Jordan. Int J Ment Health Addict 2020. [DOI: 10.1007/s11469-020-00293-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Waterpipe Nicotine Dependence and Depressive Symptoms among Adolescent Waterpipe and Dual Users. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2020; 2020:2364571. [PMID: 33204280 PMCID: PMC7665911 DOI: 10.1155/2020/2364571] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 10/13/2020] [Accepted: 10/23/2020] [Indexed: 12/29/2022]
Abstract
Background Waterpipe nicotine dependence and its association with depressive symptoms and dual usage among adolescents are currently not examined in the literature. Adolescents are a vulnerable population that is susceptible to depression and initiation of tobacco use. We aim, in this novel study, to assess the association between depressive symptoms and waterpipe nicotine dependence among adolescents in Jordan, evaluate the association between waterpipe smoking status (waterpipe smoker vs. dual user) and waterpipe nicotine dependence, and assess the internal validity of the Waterpipe Nicotine Dependence Scale (WNDS). Method A cross-sectional study among adolescents of grade 9th to 12th in Jordan was conducted through multistage cluster random sampling. The self-reported Arabic Youth Tobacco Use Composite Measure Questionnaire (YTUCM) was used to collect the surveys that include demographic information, smoking status, and the WNDS to assess waterpipe nicotine dependence and depressive symptoms. Multiple linear regression and the t-test were used to analyze the data. Findings. One thousand three hundred and three surveys were collected, of which 1082 were included in the study (443 males and 639 females). 64.9% of the sample were nontobacco users, while 20.1% were waterpipe- (WTP-) only smokers, 11.4% were dual users, and 3.7% were cigarettes-only users. After adjusting for weights, 66.6% were nonsmokers, 19.2% were WTP-only smokers, 10.2% were dual users, and 3.9% were cigarettes-only smokers. Using multiple linear regression, depressive symptoms were significantly associated with WTP nicotine dependence (β 0.618), upon adjusting for confounders. Furthermore, dual users were associated with higher WTP nicotine dependence (β 12.034) compared to WTP-only smokers after adjusting for confounders. Cronbach's alpha for the WNDS was 0.955. Conclusions Our study shows that there is a statistically significant association between depressive symptoms and WTP nicotine dependence and higher dependence among dual users compared to WTP-only smokers. The WNDS can be a useful tool to assess WTP nicotine dependence with high internal consistency. However, a longitudinal study is needed to further understand the association and temporality between the depressive symptoms and WTP nicotine dependence. Additionally, research is needed to shorten the WNDS while maintaining high internal consistency and assess the external validity of the WNDS and the short- and long-term consequences of dual usage.
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Kheirallah KA, Cobb CO, Alsulaiman JW, Alzoubi A, Hoetger C, Kliewer W, Mzayek F. Trauma exposure, mental health and tobacco use among vulnerable Syrian refugee youth in Jordan. J Public Health (Oxf) 2020; 42:e343-e351. [PMID: 31742341 DOI: 10.1093/pubmed/fdz128] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 08/15/2019] [Accepted: 09/10/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Little is known about tobacco use among youth exposed to armed conflicts, or the influence of trauma on tobacco use in this context. This study examined patterns of smoking by tobacco product and gender among Syrian refugee youth living in host communities in Jordan and assessed the associations of post-traumatic stress disorder (PTSD) and depression symptoms, trauma exposure and social support with current smoking status in boys and girls. METHODS Syrian refugee students (mean [standard deviation] age = 14.9 [1.33] years) were identified through the public school system. Data were collected using an online Arabic questionnaire that included questions about demographics, trauma exposure, current smoking (cigarette and waterpipe), PTSD, depression and perceived social support. Logistic regression was used to assess the adjusted effects of independent variables on current smoking status. RESULTS One in 7 boys and one in 14 girls were current smokers, with boys reporting greater tobacco use than girls. Among boys, current smokers reported significantly higher family member loss and lower perceived family social support than nonsmokers; among girls, current smokers also reported significantly higher family member loss as well as greater PTSD symptoms and lower perceived significant other/special person social support. CONCLUSIONS Tobacco use is established among this vulnerable group. The findings highlight the potential role of psychosocial support for tobacco prevention and cessation strategies.
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Affiliation(s)
- Khalid A Kheirallah
- Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, P.O. Box 3030, Irbid 21110, Jordan
| | - Caroline O Cobb
- Department of Psychology, Virginia Commonwealth University, P.O. Box 842018, Richmond, VA 23284-2018, USA
| | - Jomana W Alsulaiman
- Department of Pediatrics, Faculty of Medicine, Yarmouk University, Irbid 21110, Jordan
| | - Abdallah Alzoubi
- Department of Pharmacology, Faculty of Medicine, Jordan University of Science and Technology, P.O. Box 3030, Irbid 21110, Jordan
| | - Cosima Hoetger
- Department of Psychology, Virginia Commonwealth University, P.O. Box 842018, Richmond, VA 23284-2018, USA
| | - Wendy Kliewer
- Department of Psychology, Virginia Commonwealth University, P.O. Box 842018, Richmond, VA 23284-2018, USA
| | - Fawaz Mzayek
- Division of Epidemiology, Biostatistics, and Environmental Health, University of Memphis School of Public Health, Memphis, TN 38152, USA
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Alzyoud S, Massoud F. Waterpipe and cigarette tobacco smoking and depressive symptoms among public school students in central Jordan. JOURNAL OF HEALTH RESEARCH 2020. [DOI: 10.1108/jhr-09-2019-0209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PurposeTobacco is the most widely used substance in the world that has been linked to several psychological problems. Few studies have assessed the relationship between dual (waterpipe and cigarette) tobacco smoking. This study aims to examine the relationship between dual tobacco use and symptoms of depression amongst its users.Design/methodology/approachA cross-sectional study using a random sample of school students was conducted to assess youth tobacco smoking in the central region of Jordan. A self-reported questionnaire including biographical information, smoking status and experience of depression symptoms was used with a sample of 9th to 12th-grade students. χ2 and regression test were used to analyze the data.FindingsThe final sample comprised 576 school students, of whom 60% were males. The age range was between 16 and 18 years (mean = 15.84 years, SD ± 0.97). 30% of the participants were dual tobacco smokers. A significant difference was found between males and females, with males being more likely to be dual tobacco smokers compared to females. Two depressive symptoms (“feeling sad” and “having crying spells”) had a significant likelihood amongst the youth who were dual smokers.Originality/valueTo the best of the authors' knowledge, this is the first study that aims to report the relationship between dual tobacco smoking and depressive symptoms. Prevention programs are crucial for raising awareness of the harmful effects of dual tobacco smoking and smoking cessation amongst the youth
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Salivary Microbiome and Cigarette Smoking: A First of Its Kind Investigation in Jordan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010256. [PMID: 31905907 PMCID: PMC6982339 DOI: 10.3390/ijerph17010256] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 12/20/2019] [Accepted: 12/22/2019] [Indexed: 12/28/2022]
Abstract
There is accumulating evidence in the biomedical literature suggesting the role of smoking in increasing the risk of oral diseases including some oral cancers. Smoking alters microbial attributes of the oral cavity by decreasing the commensal microbial population and increasing the pathogenic microbes. This study aims to investigate the shift in the salivary microbiota between smokers and non-smokers in Jordan. Our methods relied on high-throughput next-generation sequencing (NGS) experiments for V3-V4 hypervariable regions of the 16S rRNA gene, followed by comprehensive bioinformatics analysis including advanced multidimensional data visualization methods and statistical analysis approaches. Six genera—Streptococcus, Prevotella, Vellionella, Rothia, Neisseria, and Haemophilus—predominated the salivary microbiota of all samples with different percentages suggesting the possibility for the salivary microbiome to restored after quitting smoking. Three genera—Streptococcus, Prevotella, and Veillonella—showed significantly elevated levels among smokers at the expense of Neisseria in non-smokers. In conclusion, smoking has a definite impact on shifting the salivary microbiota in smokers. We can suggest that there is microbial signature at the genera level that can be used to classify smokers and non-smokers by Linear Discriminant Analysis Effect Size (LEfSe) based on the salivary abundance of genera. Proteomics and metabolomics studies are highly recommended to fully understand the effect of bacterial endotoxin release and xenobiotic metabolism on the bacterial interrelationships in the salivary microbiome and how they affect the growth of each other in the saliva of smokers.
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Lawal FB, Fagbule OF. Knowledge of School-Going Adolescents About the Oral Effects of Tobacco Usage in Ibadan, Southwest Nigeria. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2019; 40:337-343. [PMID: 31865853 DOI: 10.1177/0272684x19896730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The individual knowledge of the effects of tobacco usage on health plays an important role in its uptake. Tobacco consumption usually starts during adolescence, and lack of knowledge about the oral problems of tobacco usage probably plays a role in it. AIM To determine the knowledge of adolescents about the effect of tobacco usage on oral health. METHODS A cross-sectional study was conducted among 1,465 adolescents aged 12 to 20 years who attended senior secondary schools in a major city in Nigeria. Data were obtained through a semistructured questionnaire. Data obtained were analyzed with SPSS. RESULTS The mean age of respondents was 15.2 (±1.4) years. Only 40 (2.7%) of them used tobacco at the time of study and 992 (67.7%) said that tobacco usage has effect(s) on oral health. The main effects mentioned were mouth odor: 338 (34.1%); teeth discoloration: 297 (29.9%); tooth decay: 138 (13.9%); damage to teeth: 72 (7.3%); lip discoloration: 39 (3.9%); and oral cancer: 11 (1.1%). It was found that female respondents (72.1%, odds ratio = 1.4, confidence interval = 1.1-1.7, p = .005); those aged 12 to 15 years (73.6%, odds ratio = 2.0, confidence interval = 1.6-2.5, p < .001); and children of skilled workers (73.4%, odds ratio = 1.9, confidence interval = 1.2-3.0, p = .008) were more likely to mention that tobacco has adverse effect(s) on oral health. CONCLUSION Although two thirds of the students knew that tobacco usage has effects on oral health, there were gross inadequacies in the knowledge and misconceptions about those effects.
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Affiliation(s)
- Folake B Lawal
- Department of Periodontology and Community Dentistry, University of Ibadan College of Medicine, Nigeria
- Department of Periodontology and Community Dentistry, University College Hospital, Ibadan, Nigeria
| | - Omotayo F Fagbule
- Department of Periodontology and Community Dentistry, University College Hospital, Ibadan, Nigeria
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Evaluating the Impact of the Synar Program: Tobacco Access and Use among Youth in Mississippi, the South, and the U.S. Healthcare (Basel) 2019; 8:healthcare8010004. [PMID: 31877899 PMCID: PMC7151214 DOI: 10.3390/healthcare8010004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 12/11/2019] [Accepted: 12/17/2019] [Indexed: 11/17/2022] Open
Abstract
(1) Background: This study examines the impact of Synar policy adoption on youth commercial access to tobacco products in Mississippi, the South, and the remaining U.S. The principal focus on youth commercial access is complemented by analyses of Synar's impact on minors' non-commercial access to tobacco and tobacco use patterns. Mississippi has been especially aggressive in implementing Synar, as evidenced by its unusually low retailer violation rates (RVRs). Synar, a mandatory, enforceable regulation meant to limit youth's retail access to tobacco, was implemented nationwide in 1997. This study is governed by a combination of conceptual insights from a diffusion of health innovation perspective and structuration theory. (2) Methods: Repeated cross-sectional data from 1995 to 2011 from the CDC Youth Risk Behavior Survey are analyzed using a pre/post-implementation, quasi-experimental analytic strategy. Tobacco access and use in the pre-Synar era (1995-1997) are compared with two post-Synar periods (1999-2005 and 2007-2011), thereby highlighting diffusion effects related to this policy innovation within Mississippi, the South, and the remaining U.S. (3) Results: Analyses of temporal trends reveal that Mississippi and other study regions effectively restricted commercial access to tobacco. Positive outcomes associated with Synar adoption were observed several years after initial implementation, thus supporting a diffusion of innovation perspective. However, results also reveal that Mississippi youth were more inclined than their counterparts elsewhere to gain access to tobacco through non-commercial means after Synar implementation, and that declines in tobacco use among Mississippi youth were less robust than those observed elsewhere. Such variegated effects are in line with expectations linked to structuration theory. (4) Conclusions: Synar policy implementation has been generally effective at deterring youth access to tobacco and, in many cases, has yielded declines in tobacco use. However, there is no evidence that especially aggressive retailer compliance checks in Mississippi have yielded distinctive benefits for youth in this state.
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The Use of Psychoactive Substances in a Conflict Area in the West Bank: Drug Use Risk Factors and Practices in Palestinian Refugee Camps. Int J Ment Health Addict 2019. [DOI: 10.1007/s11469-019-00183-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
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Damiri BR, Salahat IA, Aghbar MH. Pattern of substance use among schoolchildren in Palestine: a cross-sectional study. EGYPTIAN JOURNAL OF FORENSIC SCIENCES 2018. [DOI: 10.1186/s41935-018-0090-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Al-Zboon E. Evaluation of Substance Abuse Education at Schools for Students with Disabilities: A Preventative Approach. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2018. [DOI: 10.1080/1067828x.2018.1431991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Alomari MA, Al-sheyab NA. Dual tobacco smoking is the new trend among adolescents: Update from the Irbid-TRY. JOURNAL OF SUBSTANCE USE 2017. [DOI: 10.1080/14659891.2017.1348559] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Mahmoud A. Alomari
- Division of Physical Therapy, Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Nihaya A. Al-sheyab
- Faculty of Nursing, Maternal and Child Health Department, Jordan University of Science and Technology, Irbid, Jordan
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Affiliation(s)
- Lama H Nazer
- Lama H Nazer, PharmD, BCPS, is with the Department of Pharmacy, King Hussein Cancer Center, Amman, Jordan
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Al-Zboon E, Al-Dababneh K. Substance abuse at Jordanian universities: Perspectives of pre-service special education teachers. JOURNAL OF SUBSTANCE USE 2017. [DOI: 10.1080/14659891.2016.1271031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Eman Al-Zboon
- Department of Special Education, Queen Rania Faculty for Childhood, Hashemite University, Zarqa, Jordan
| | - Kholoud Al-Dababneh
- Department of Special Education, Queen Rania Faculty for Childhood, Hashemite University, Zarqa, Jordan
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Al-sheyab NA, Alomari MA, Shah S, Gallagher R. “Class smoke-free” pledge impacts on nicotine dependence in male adolescents: A cluster randomized controlled trial. JOURNAL OF SUBSTANCE USE 2016. [DOI: 10.3109/14659891.2015.1112848] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Veeranki SP, Alzyoud S, Dierking L, Kheriallah K, Mzayek F, Pbert L, Ward KD. Associations of Adolescents' Cigarette, Waterpipe, and Dual Tobacco Use With Parental Tobacco Use. Nicotine Tob Res 2015; 18:879-84. [PMID: 26438651 DOI: 10.1093/ntr/ntv224] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 09/25/2015] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Previous studies have demonstrated the influence of parental (both mother and father) cigarette smoking on adolescents' cigarette smoking. Little is known, however, about how parental tobacco use is related to waterpipe and dual waterpipe/cigarette use, which is increasing dramatically in the Arab countries. METHODS Study data (n = 34 788, N = 6 109 572) were obtained from nationally representative Global Youth Tobacco Surveys in 17 Arab countries. Study outcome was adolescents' tobacco use categorized into none, cigarette smoking only, waterpipe smoking (WPS) only, and dual use. Primary exposure included parental tobacco use categorized into 10 groups-maternal (mother) cigarette smoking only, maternal WPS only, maternal dual use, paternal (father) cigarette smoking only, paternal WPS only, paternal dual use, parental (both mother and father) cigarette smoking only, parental WPS only, parental dual use, and none. Weighted multinomial regression models were conducted to assess the relationships. RESULTS Adolescents reported smoking WPS only (5.7%), cigarettes only (2.9%), and dual use (3.5%). Compared to adolescent with no exposure to parental tobacco use, adolescent exposure to parental dual use was associated with significant increase in WPS only (OR = 6.08, 95% CI = 2.38-15.51) and dual use (OR = 3.86, 95% CI = 1.43-10.43). Effect modification of the relationship by adolescents' sex was observed. CONCLUSIONS This is the first study to examine adolescent cigarette, waterpipe, and dual use with parental tobacco use. Study findings may help development of cessation interventions targeting parental tobacco use to prevent the rising waterpipe and dual use strain of the global tobacco epidemic. IMPLICATIONS (1) Influence of parents' cigarette smoking on adolescents' smoking has been demonstrated in earlier studies, however, little is known about how tobacco use behaviors of mother and father influences an adolescent's cigarette, waterpipe and dual cigarette/waterpipe use. (2) Associations of parental (both mother and father) tobacco use with adolescents' tobacco use differed significantly if the adolescent is a waterpipe smoker or dual user compared to an adolescent cigarette smoker. (3) Adolescents' exposed to their mothers' WPS or dual use were more likely to be a waterpipe smoker or dual user. High likelihood of adolescents' cigarette, waterpipe and dual use is found in homes where parental tobacco use is rampant with both parents smoking either cigarette, waterpipe or both.
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Affiliation(s)
- Sreenivas P Veeranki
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX;
| | - Sukaina Alzyoud
- Department of Community and Mental Health, Faculty of Nursing, Hashemite University, Zarqa, Jordan
| | - Leah Dierking
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX
| | - Khalid Kheriallah
- Deparment of Public Health, Jordan University of Science and Technology, Irbed, Jordan
| | - Fawaz Mzayek
- Division of Epidemiology, Biostatistics and Environmental Health, School of Public Health, University of Memphis, Memphis, TN
| | - Lori Pbert
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA
| | - Kenneth D Ward
- Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, TN; Syrian Center for Tobacco Studies, Aleppo, Syria
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Alzyoud S, Veeranki SP, Kheirallah KA, Shotar AM, Pbert L. Validation of the Waterpipe Tolerance Questionnaire Among Jordanian School-Going Adolescent Waterpipe Users. Glob J Health Sci 2015; 8:198-208. [PMID: 26383198 PMCID: PMC4804001 DOI: 10.5539/gjhs.v8n2p198] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 03/17/2015] [Indexed: 11/20/2022] Open
Abstract
Introduction: Waterpipe use among adolescents has been increasing progressively. Yet no studies were reported to assess the validity and reliability of nicotine dependence scale. The current study aims to assess the validity and reliability of an Arabic version of the modified Waterpipe Tolerance Questionnaire WTQ among school-going adolescent waterpipe users. Methods: In a cross-sectional study conducted in Jordan, information on waterpipe use among 333 school-going adolescents aged 11-18 years was obtained using the Arabic version of the WTQ. An exploratory factor analysis and correlation matrices were conducted to assess validity and reliability of the WTQ. Results: The WTQ had a 0.73 alpha of internal consistency indicating moderate level of reliability. The scale showed multidimensionality with items loading on two factors, namely waterpipe consumption and morning smoking. Conclusion: This study report nicotine dependence level among school-going adolescents who identify themselves as waterpipe users using the WTQ.
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Jawad M, Lee JT, Millett C. Waterpipe Tobacco Smoking Prevalence and Correlates in 25 Eastern Mediterranean and Eastern European Countries: Cross-Sectional Analysis of the Global Youth Tobacco Survey. Nicotine Tob Res 2015; 18:395-402. [PMID: 25957438 DOI: 10.1093/ntr/ntv101] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 05/01/2015] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Waterpipe tobacco smoking is highly prevalent among young people in some settings. There is an absence of nationally representative prevalence studies of waterpipe tobacco use and dual use with other tobacco products in young people. METHODS We conducted a secondary analysis of the Global Youth Tobacco Survey, a nationally representative cross-sectional study of students aged 13-15 years. Of 180 participating countries, 25 included optional waterpipe tobacco smoking questions: 15 Eastern Mediterranean and 10 Eastern European countries. We calculated the prevalence of current (past 30-day) waterpipe tobacco use, including dual waterpipe and other tobacco use, and used logistic regression models to identify sociodemographic correlates of waterpipe tobacco smoking. Individual country results were combined in a random effects meta-analysis. RESULTS Waterpipe tobacco smoking prevalence was highest in Lebanon (36.9%), the West Bank (32.7%) and parts of Eastern Europe (Latvia 22.7%, the Czech Republic 22.1%, Estonia 21.9%). These countries also recorded greater than 10% prevalence of dual waterpipe and cigarette use. In a meta-analysis, higher odds of waterpipe tobacco smoking were found among males (Adjusted odds ratio [AOR] = 1.37, 95% confidence interval [CI] = 1.18% to 1.59%), cigarette users (AOR = 6.95, 95% CI = 5.74% to 8.42%), those whose parents (AOR = 1.54, 95% CI = 1.31% to 1.82%) or peers smoked (AOR = 3.53, 95% CI = 2.97% to 4.20%) and those whose parents had higher educational attainment (Father, AOR = 1.47, 95% CI = 1.14% to 1.89%; Mother, AOR = 1.62, 95% CI = 1.07% to 2.46%). We report on regional- and country income-level differences. CONCLUSIONS Waterpipe tobacco smoking, including dual waterpipe and cigarette use, is alarmingly high in several Eastern Mediterranean and Eastern European countries. Ongoing waterpipe tobacco smoking surveillance is warranted.
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Affiliation(s)
- Mohammed Jawad
- Department of Primary Care and Public Health, Imperial College London, Hammersmith, United Kingdom
| | - John Tayu Lee
- Department of Primary Care and Public Health, Imperial College London, Hammersmith, United Kingdom
| | - Christopher Millett
- Department of Primary Care and Public Health, Imperial College London, Hammersmith, United Kingdom
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Aboaziza E, Eissenberg T. Waterpipe tobacco smoking: what is the evidence that it supports nicotine/tobacco dependence? Tob Control 2015; 24 Suppl 1:i44-i53. [PMID: 25492935 PMCID: PMC4345797 DOI: 10.1136/tobaccocontrol-2014-051910] [Citation(s) in RCA: 129] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 11/20/2014] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Waterpipe tobacco smoking (WTS) involves passing tobacco smoke through water prior to inhalation, and has spread worldwide. This spread becomes a public health concern if it is associated with tobacco-caused disease and if WTS supports tobacco/nicotine dependence. A growing literature demonstrates that WTS is associated with disability, disease and death. This narrative review examines if WTS supports nicotine/tobacco dependence, and is intended to help guide tobacco control efforts worldwide. DATA SOURCES PUBMED search using: (("waterpipe" or "narghile" or "arghile" or "shisha" or "goza" or "narkeela" or "hookah" or "hubble bubble")) AND ("dependence" or "addiction"). STUDY SELECTION Excluded were articles not in English, without original data, and that were not topic-related. Thirty-two articles were included with others identified by inspecting reference lists and other sources. DATA SYNTHESIS WTS and the delivery of the dependence-producing drug nicotine were examined, and then the extent to which the articles addressed WTS-induced nicotine/dependence explicitly, as well as implicitly with reference to criteria for dependence outlined by the WHO. CONCLUSIONS WTS supports nicotine/tobacco dependence because it is associated with nicotine delivery, and because some smokers experience withdrawal when they abstain from waterpipe, alter their behaviour in order to access a waterpipe and have difficulty quitting, even when motivated to do so. There is a strong need to support research investigating measurement of WTS-induced tobacco dependence, to inform the public of the risks of WTS, which include dependence, disability, disease and death, and to include WTS in the same public health policies that address tobacco cigarettes.
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Affiliation(s)
- Eiman Aboaziza
- Center for Clinical and Translational Research and Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Thomas Eissenberg
- Department of Psychology, Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
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Al-Sheyab N, Kheirallah KA, Mangnall LJT, Gallagher R. Agreement between exhaled breath carbon monoxide threshold levels and self-reported cigarette smoking in a sample of male adolescents in Jordan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:841-54. [PMID: 25599375 PMCID: PMC4306896 DOI: 10.3390/ijerph120100841] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2014] [Accepted: 01/13/2015] [Indexed: 12/13/2022]
Abstract
This study aimed to measure the percent agreement between Exhaled Breath Carbon Monoxide (eBCO) measure using a piCO+ smokerlyzer® and self-reported cigarette smoking status and to determine the optimal thresholds for definite identification of cigarette smokers of male school students in Jordan. A descriptive, cross sectional, study of a random sample of male adolescents in grades 7 and 8 from four public high schools in Irbid, completed an adaptation of a standardized Arabic-language tobacco smoking questionnaire and an eBCO measure. Sensitivity and specificity of the eBCO were calculated against self-reported cigarette smoking. Participants (n = 439) had a mean age of 12.5 years (SD = 0.50) and 174 (39.9%) reported being an ever smoker of whom 59 (33.9%) reported being a recent (30-day) smoker. The optimal eBCO cut-off point for recent smoking was 4.5 ppm with a sensitivity of 84.7% and specificity of 65.5%. Overall, eBCO can accurately identify recent smokers and distinguish them from non-smokers. The eBCO use enables healthcare professionals and researchers to assess efficacy of smoking cessation and prevention programs without necessarily relying on self-report. Further research is indicated to validate our findings and should be expanded to include females, detailed characteristics of cigarette and waterpipe smoking.
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Affiliation(s)
- Nihaya Al-Sheyab
- Faculty of Nursing, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan.
| | - Khalid A Kheirallah
- Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan.
| | - Linda J Thomson Mangnall
- Charles Perkins Centre, Faculty of Nursing and Midwifery, the University of Sydney, Sydney 2007, Australia.
| | - Robyn Gallagher
- Faculty of Health, University of Technology, Sydney 2007, Australia.
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