Gender differences in waterpipe tobacco smoking among
university students in four Eastern Mediterranean countries

Hamadeh, Randah R; Lee, Juhan; Abu-Rmeileh, Niveen M E; Darawad, Muhammad W.; Mostafa, Aya; Kheirallah, Khalid A.; Yusufali, Afzalhussein; Thomas, Justin; Salama, Mohamed; Nakkash, Rima; Salloum, Ramzi G.

doi:10.18332/tid/129266

Cited by 21 publications

(16 citation statements)

References 30 publications

(52 reference statements)

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“…When Jordanian pregnant women were asked about tobacco use addiction, the majority reported cigarettes as being addictive, whereas only 55.1% believed waterpipe to be addictive [ 28 ]. The misconception that waterpipe use is a healthy behavior, along with its social acceptability and lack of implemented anti-tobacco policies, were suggested to bridge the gap in waterpipe use between boys and girls and to fuel waterpipe use among girls around 2013 [ 20 , 44 , 50 , 51 ].…”

Section: Discussionmentioning

confidence: 99%

Trends of maternal waterpipe, cigarettes, and dual tobacco smoking in Jordan. A decade of lost opportunities

2021

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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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Section: Discussionmentioning

confidence: 99%

Trends of maternal waterpipe, cigarettes, and dual tobacco smoking in Jordan. A decade of lost opportunities

2021

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“…The relative popularity among men can be related to the perception of smoking, in general, and waterpipe smoking, in particular, as a traditional masculine behavior (11). Among women university students, although the rates are lower than those observed in Eastern Mediterranean countries (30), they are still quite high (for example, 20% were current users (11) and 35% were ever users ( 12)).…”

Section: Discussionmentioning

confidence: 99%

Waterpipe Smoking Among Youth and Socioeconomic Status: A Cross-Sectional Study of Students in Public Versus Private Universities

Caner

Özcebe

2021

Preprint

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Background Waterpipe smoking has become a global public health problem as its popularity increased over time, especially among youth. This study aims to examine waterpipe smoking patterns of university students in Ankara, Turkey, and compare the patterns in public and private universities, which have different economic and social environments. Students in these two types of universities differ, on average, in socioeconomic background and access to financial resources. Methods The survey was conducted among public (n=2685) and private (n=2485) university students via an online questionnaire. Logistic regressions (on the full sample and on the sample that excludes students who initiate before age 18) were used to test the association between ever using waterpipe and respondent characteristics such as age, gender, university type, living arrangements, and source of income. Descriptive statistics on consumption pattern (age at first use, use within last month, location of use, availability of waterpipe venues, whether it is usually shared, reasons for use, and harm perceptions) were also generated. Moreover, never, ever, and current user prevalence rates by age at first use were estimated for waterpipe and cigarettes. Results69% of students in private and 59% of students in public universities (p<0.001) were ever smokers of waterpipe. Being older, male, private university student, living alone or having roommate(s), as well as financial resources such as having access to a car, having income from work or family were associated with ever using waterpipe. Although more than half (68-70%) of ever users tried waterpipe before age 18, risk continued in university and 41-46% of those who tried before 18 were current users in university. For women who had abstained from waterpipe until university age, the risk of waterpipe use was higher in private than in public universities. ConclusionsWaterpipe smoking has increased and is highly common among university students. Students with higher socioeconomic status are at higher risk. There is an urgent need to implement the new creative interventions based on the WHO Framework Convention on Tobacco Control to prevent the young people from waterpipe smoking after 18 years old.

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“…A systematic review of waterpipe smoking prevalence among university students in Arab countries showed that males had significantly higher rates than females in most of the countries, the highest rates for males being in Egypt, Jordan and Palestine 6 . Several studies showed further gender differences among university students in Arab countries with relation to prevalence 4 , to perception of harm 7 , WTS initiation and smoking behavior 8 , females showing higher levels of perceived harm and lower levels of heavy smoking behaviors.…”

Section: Introductionmentioning

confidence: 99%

Association of health warning labels and motivation to quit waterpipe tobacco smoking among university students in the Eastern Mediterranean Region

Farran¹,

Khawam²,

Nakkash³

et al. 2021

Tob. Prev. Cessation

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INTRODUCTION This study aimed to determine associations between health warning label content and motivation to quit waterpipe smoking by gender and smoking location. METHODS Convenience samples of university students in three Eastern Mediterranean countries -Egypt (n=442), Jordan (n=535) and Palestine (n=487) -completed an online survey assessing health warning labels. Multinomial logit regression models were conducted to determine the association between different variables, particularly gender and smoking location, with motivation to quit. RESULTS In Palestine, female smokers were more motivated to quit waterpipe smoking when seeing textual warning labels related to children (T2) and pregnancy (T6) [T2: 1.8 (95% CI: 1.1-2.8), T6: 2.7 (95% CI: 1.6-4.3)] compared to males. Similar results were found in Jordan [T2: 1.6 (95% CI: 1.0-2.6), T6: 1.8 (95% CI: 1.1-3.0)]. As for the smoking location, home-only smokers in Palestine were more likely to quit in response to the following warnings: waterpipe smoking is addictive T1: 2.3 (95% CI: 1.4-3.7), harmful for children T2: 2.3 (95% CI: 1.4-4.1), harmful for the baby during pregnancy T6: 2.4 (95% CI: 1.3-4.3), and to believe that quitting reduces the health risks T9: 1.8 (95% CI: 1.0-3.1). These results were not found in Jordan nor Egypt. Smokers reported that the most noticeable location of a HWL on a waterpipe device is the mouthpiece. CONCLUSIONS A better understanding of motivation to quit and its association with various warnings and smoking location could guide countries on which warnings to require in legislation and where best to require them particularly in relation to location.

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Gender differences in waterpipe tobacco smoking among university students in four Eastern Mediterranean countries

Cited by 21 publications

References 30 publications

Trends of maternal waterpipe, cigarettes, and dual tobacco smoking in Jordan. A decade of lost opportunities

Trends of maternal waterpipe, cigarettes, and dual tobacco smoking in Jordan. A decade of lost opportunities

Waterpipe Smoking Among Youth and Socioeconomic Status: A Cross-Sectional Study of Students in Public Versus Private Universities

Association of health warning labels and motivation to quit waterpipe tobacco smoking among university students in the Eastern Mediterranean Region

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