Risk of Tobacco Smoking and Consumption of Energy Drinks on Obesity and Central Obesity Among Male University Students

Abstract

BackgroundObesity is one of the leading causes of morbidity and premature death. The prevalence of obesity and being overweight in young adulthood is increasing exponentially globally, including Palestine. Consumption of energy drinks (EDs) and tobacco smoking are highly prevalent among Palestinian young adults. Although different studies have demonstrated that the use of caffeine and tobacco products is highly prevalent among Palestinians, especially university students, the adverse effects of these products on obesity have not been thoroughly investigated. MethodologyMale students from An-Najah National University in the West Bank were recruited to fill out a selfadministrated questionnaire in this cross-sectional study conducted in 2021. Obesity was measured as total adiposity by calculating body mass index (BMI) and as central obesity by measuring waist circumference. To determine the association between obesity and ED consumption and tobacco smoking, we used adjusted multiple logistic regression models. Shapiro-Wilk's test was used to assess the normality of the data. ResultsA total of 396 students filled the questionnaire, with a response rate of 89.4%. The prevalence of obesity and central obesity was 42% and 35.75%, respectively. The prevalence of ED consumption, cigarette smoking, and waterpipe smoking was 59.6%, 39.6%, and 43.2%, respectively. ED consumers were more likely to be cigarette smokers (odds ratio (OR) = 3.827, P < 0.001), waterpipe smokers (OR = 4.578, P < 0.001), and chocolate consumers (OR = 3.524, P = 0.001). Central obesity was associated with waterpipe smoking (OR = 2.126, P = 0.044), increased age (OR = 1.367, P = 0.001), and increased BMI (OR = 1.927, P < 0.001). On the other hand, cigarette smoking increased the risk of being underweight (OR = 6.255, P = 0.012), and ED consumption decreased the risk of being obese (OR = 0.183, P = 0.017). ConclusionsWaterpipe smoking was a risk factor for increased central obesity, and ED consumption was associated with decreased; however, smoking was associated with the underweight BMI category. Given the undesirable health consequences of consuming the closely associated tobacco and EDs, stricter measures are needed to prevent access to these products.

Non-traditional tobacco smoking: An emerging risk in the West Bank among male Palestinians

“…These results highlight the importance of understanding the factors that can influence both consumption of energy drinks and waterpipe smoking among young adults in Palestine, specifically males. Further research in this area could help develop targeted interventions that address the unique challenges 15,17 .…”

“…The waist circumference, or central obesity, was measured to the nearest 1.0 cm using a non-elastic tape. These measurements were taken following World Health Organization recommendations 15 . Waist circumference was measured halfway between the thoracic cage's inferior edge and the iliac crest's superior border 23 .…”

“…A study conducted in 2021 revealed that cigarettes were the most commonly used by daily smokers (58.9%), followed by waterpipe (23.6%) and e-cigarettes (17.5%) 14 . Other studies revealed that waterpipe smoking was more common among males, younger age groups, those with a lower education level 12,13 and as an alternative to cigarettes smoking 15 . A recent study in 2023 described the epidemiology of e-cigarette smoking among Palestinians and indicated that e-cigarette smoking is prevalent among university students (13.3%) 16 , while the PCBS indicated that 4% of individuals aged ≥18 years in the West Bank were e-cigarette smokers 11 .…”

“…Moreover, waterpipe smoking was inversely associated with increased body mass index 17 . All previous research indicates that smoking is a growing problem among young Palestinians, particularly university students, and that waterpipe and e-cigarettes are emerging as significant hazards in the West Bank 15,[18][19][20] . However, most of these studies focused on university students.…”

Balancing Act: Exploring the Interplay Between Lifestyle Habits and Nutritional Status Among University Students. A Cross-Sectional Study

“…It is widely acknowledged that dietary habits change with the transition to university education. According to [14], the majority (> 83.6%) of Palestine university students consumed coffee, chocolate and black tea while 59.6% consumed energy drinks. Concerning frequency, daily intake of energy drinks, coffee, black tea, and chocolate was reported by 19.2%, 56.8%, 43.8% and 34% respectively.…”