Correlates of nicotine dependence among adolescent waterpipe smokers

Abstract

Introduction Waterpipe smoking is addictive and its use is increasing globally among youth, yet little is known about the factors associated with nicotine dependence (ND) among waterpipe smokers. We investigated the factors associated with ND symptoms among a sample of Lebanese adolescents who smoke a waterpipe. Methods We collected data on factors potentially associated with ND (individual, socio-demographic, environmental, smoking patterns) among 160 current (past 30 days) waterpipe smokers recruited from 8th and 9th school grades in Lebanon. We assessed the loss of autonomy over tobacco using the Hooked on Nicotine Checklist (HONC), ND using the International Classification of Diseases, 10th revision (ICD-10), and the number of ND symptoms endorsed. Results Depressive symptoms, lower self-esteem, and having at least one sibling who smokes a waterpipe were associated with the presence of ND symptoms, while enrollment in public schools, smoking a waterpipe ≥30 minutes per session, and believing that cigarette smoking is harmful to health were associated with endorsement of a higher number of ND symptoms. Smoking a whole waterpipe head without sharing and being in 9th grade in this study were associated with the presence and endorsement of a higher number of ND symptoms. Conclusions We identified specific social and psychological characteristics, waterpipe smoking patterns, and beliefs about harmful effects of smoking associated with the presence of ND among adolescent waterpipe smokers. Considering these factors when planning policies to prevent ND among waterpipe smokers is warranted.

Determinants of progression of nicotine dependence symptoms in adolescent waterpipe smokers

“…Six psychological factors were assessed: stress (Cronbach’s ‘α’=0.79), depressive symptoms (α=0.75), novelty seeking (α=0.76), impulsivity (α=0.81), self-esteem (α=0.79) and distractibility (α=0.63) 21. Baseline waterpipe use frequency (less than weekly, weekly but not daily, daily), number of waterpipes (ie, heads) smoked in the past 30 days, and the usual length of a smoking session (<30 min, 30–60 min, >60 min) were obtained.…”

“…A cut-off value of VIF ≤5 was applied to rule out multicollinearity 21. Accordingly, multicollinearity was not an issue in this analysis.…”

Waterpipe smoking patterns and symptoms of nicotine dependence: The Waterpipe Dependence in Lebanese Youth Study

“…Department of Health and Human Services 2014), and that less frequent use is less likely to be associated with ND among adolescents (O'Loughlin et al 2003). More details about the WDLY study can be found elsewhere (Bahelah et al 2016a). …”

“…Using interviewer-administered questionnaires, participants provided information about their tobacco use patterns and responded to measures of ND (Bahelah et al 2016a; DiFranza et al 2007). Interviewers met participants individually in private rooms on school premises and school personnel were not allowed during interviews to minimize social-desirability bias.…”

“…Using baseline data from the Waterpipe Dependence in Lebanese Youth (WDLY) study, we showed that smoking a whole waterpipe without sharing and the length of a smoking session were among the factors strongly associated with ND (Bahelah et al 2016a). Using a survival analysis, the current study aims to examine the risk of attaining the first ND symptom (as measured by Hooked on Nicotine Checklist “HONC”) and the full syndrome of ND (as measured by ICD-10 ND criteria) and how this risk differs by smoking patterns among adolescent waterpipe smokers.…”