Top

BMC Public Health

Published in:

Open Access 01-12-2021 | Research article

Association between cumulative cigarette and Waterpipe smoking and symptoms of dependence in Lebanese adults

Authors: Diana Malaeb, Marwan Akel, Hala Sacre, Chadia Haddad, Sahar Obeid, Souheil Hallit, Pascale Salameh

Published in: BMC Public Health | Issue 1/2021

Abstract

Background

Waterpipe and cigarette smoking dependence are becoming increasingly prevalent forms of addiction globally. This study examined whether cumulative cigarette smoking and cumulative waterpipe smoking are associated with higher dependence on both cigarettes and waterpipe.

Methods

This cross-sectional study conducted between February and April 2020, enrolled 363 participants drawn from all Lebanese districts. The mean age was 29.51 years, 64.8% were females, and 124 (34.2%) exclusive cigarette smokers, 189 (52.1%) exclusive waterpipe smokers, and 50 (13.8%) dual smokers (waterpipe and cigarette). We used the Hooked on Nicotine Checklist (HONC) as an indicator of decreased autonomy towards nicotine, in addition to the Lebanon Waterpipe Dependence Scale-11 (LWDS11) and the Lebanese Cigarette Dependence scale (LCD). A stepwise linear regression was performed taking the HONC scores due to cigarette and waterpipe smoking, LCD and LWDS-11 scores as dependent variables.

Results

The results showed that in the total sample, higher cumulative cigarette smoking (B = 0.005 with a confidence interval of 0.004, 0.006) was significantly associated with higher HONC cigarette scores, whereas higher cumulative waterpipe smoking (B = -0.006 with a confidence interval of − 0.009, − 0.002) was significantly associated with lower HONC cigarette scores. Moreover, higher cumulative waterpipe smoking (B = 0.012 with a confidence interval of 0.009,0.015) was significantly associated with higher HONC waterpipe scores. The results showed that, in both sexes, higher cumulative cigarette smoking was associated with higher HONC cigarette scores and lower HONC waterpipe scores. Furthermore, higher cumulative waterpipe smoking was significantly associated with higher HONC waterpipe scores in both sexes.

Conclusion

Our study supports the fact that heavy nicotine consumption, related to both the increased frequency and smoking duration, can increase the risk of dependence. It raises the need for strategic plans to minimize and discourage the use of nicotine products in Lebanese community settings.

Available only for authorised users

Tobacco [Internet]. 2020 [cited 2021 Jun 8]. Available from: https://www.who.int/news-room/fact-sheets/detail/tobacco

Knishkowy B, Amitai Y. Water-pipe (narghile) smoking: an emerging health risk behavior. Pediatrics. 2005;116(1):e113–9. https://doi.org/10.1542/peds.2004-2173.CrossRefPubMed

Maziak W. The waterpipe: an emerging global risk for cancer. Cancer Epidemiol. 2013;37(1):1–4. https://doi.org/10.1016/j.canep.2012.10.013.CrossRefPubMed

Maziak W, Ward KD, Soweid RA, Eissenberg T. Tobacco smoking using a waterpipe: a re-emerging strain in a global epidemic. Tob Control. 2004;13(4):327–33. https://doi.org/10.1136/tc.2004.008169.CrossRefPubMedPubMedCentral

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. 2016;18(4):395–402. https://doi.org/10.1093/ntr/ntv101.CrossRefPubMed

Akiki Z, Saadeh D, Haddad C, Sacre H, Hallit S, Salameh P. Knowledge and attitudes toward cigarette and narghile smoking among previous smokers in Lebanon. Environ Sci Pollut Res Int. 2020;27(12):14100–7. https://doi.org/10.1007/s11356-020-07763-y.CrossRefPubMed

Haddad C, Lahoud N, Akel M, Sacre H, Hajj A, Hallit S, et al. Knowledge, attitudes, harm perception, and practice related to waterpipe smoking in Lebanon. Environ Sci Pollut Res Int. 2020;27(15):17854–63. https://doi.org/10.1007/s11356-020-08295-1.CrossRefPubMed

Waked M, Khayat G, Salameh P. Chronic obstructive pulmonary disease prevalence in Lebanon: a cross-sectional descriptive study. Clin Epidemiol. 2011;3:315–23. https://doi.org/10.2147/CLEP.S26350.CrossRefPubMedPubMedCentral

El-Shahawy O, Haddad L. Correlation between nicotine dependence and barriers to cessation between exclusive cigarette smokers and dual (water pipe) smokers among Arab Americans. Subst Abus Rehabil. 2015;6:25–32. https://doi.org/10.2147/SAR.S72360.CrossRef

10.

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. Environ Sci Pollut Res Int. 2020;27(3):3440–8. https://doi.org/10.1007/s11356-019-07247-8.CrossRefPubMed

11.

Nakkash RT, Khalil J, Afifi RA. The rise in narghile (shisha, hookah) waterpipe tobacco smoking: a qualitative study of perceptions of smokers and non smokers. BMC Public Health. 2011;11:315.CrossRef

12.

Qasim H, Alarabi AB, Alzoubi KH, Karim ZA, Alshbool FZ, Khasawneh FT. The effects of hookah/waterpipe smoking on general health and the cardiovascular system. Environ Health Prev Med. 2019;24(1):58. https://doi.org/10.1186/s12199-019-0811-y.CrossRefPubMedPubMedCentral

13.

Maziak W, Eissenberg T, Ward KD. Patterns of waterpipe use and dependence: implications for intervention development. Pharmacol Biochem Behav. 2005;80(1):173–9. https://doi.org/10.1016/j.pbb.2004.10.026.CrossRefPubMed

14.

Cobb CO, Khader Y, Nasim A, Eissenberg T. A multiyear survey of waterpipe and cigarette smoking on a US university campus. J Am Coll Heal. 2012;60(7):521–7. https://doi.org/10.1080/07448481.2012.692416.CrossRef

15.

Jawad M, Dogar O, Kanaan M, Ahluwalia J, Siddiqi K. Factors associated with dual use of waterpipe tobacco and cigarettes among adults in Pakistan. East Mediterr Health J. 2020;26(01):47–54. https://doi.org/10.26719/2020.26.1.47.CrossRefPubMed

16.

Kheirallah KA, Veeranki SP, Alzyoud S, Alzoubi A, Walker L, Khader Y, et al. Collision of waterpipe and cigarette smoking epidemics among youth in Arab countries. J Subst Abus. 2016;21(5):530–6.

17.

Jawad M, Roderick P. Integrating the impact of cigarette and waterpipe tobacco use among adolescents in the eastern Mediterranean region: a cross-sectional, population-level model of toxicant exposure. Tob Control. 2017;26(3):323–9. https://doi.org/10.1136/tobaccocontrol-2015-052777.CrossRefPubMed

18.

Wellman RJ, DiFranza JR, Savageau JA, Godiwala S, Friedman K, Hazelton J. Measuring adults' loss of autonomy over nicotine use: the hooked on nicotine checklist. Nicotine Tob Res. 2005;7(1):157–61. https://doi.org/10.1080/14622200412331328394.CrossRefPubMed

19.

DiFranza JR, Savageau JA, Fletcher K, Ockene JK, Rigotti NA, McNeill AD, Coleman M, Wood C. Measuring the loss of autonomy over nicotine use in adolescents: the DANDY (Development and Assessment of Nicotine Dependence in Youths) study. Arch Pediatr Adolesc Med. 2002;156(4):397–403. https://doi.org/10.1001/archpedi.156.4.397.

20.

Doubeni CA, Reed G, DiFranza JR. Early course of nicotine dependence in adolescent smokers. Pediatrics. 2010;125(6):1127–33. https://doi.org/10.1542/peds.2009-0238.CrossRefPubMed

21.

Guze SB. Diagnostic and statistical manual of mental disorders, (DSM-IV). Am J Psychiatr. 1995;152(8):1228. https://doi.org/10.1176/ajp.152.8.1228.CrossRef

22.

Zhan W, Dierker LC, Rose JS, Selya A, Mermelstein RJ. The natural course of nicotine dependence symptoms among adolescent smokers. Nicotine Tob Res. 2012;14(12):1445–52. https://doi.org/10.1093/ntr/nts031.CrossRefPubMedPubMedCentral

23.

Salameh P, Khayat G, Waked M. The Lebanese cigarette dependence (LCD) score: a comprehensive tool for cigarette dependence assessment. International journal of behavioral medicine. 2014;21(2):385–93. https://doi.org/10.1007/s12529-012-9288-4.CrossRefPubMed

24.

Salameh P, Waked M, Aoun Z. Waterpipe smoking: construction and validation of the Lebanon Waterpipe dependence scale (LWDS-11). Nicotine Tob Res. 2008;10(1):149–58. https://doi.org/10.1080/14622200701767753.CrossRefPubMed

25.

Hallit S, Obeid S, Sacre H, Akel M, Khoury A, Salameh P. Adaptation of the Young Adults' Cigarette Dependence (YACD) Scale for the development and validation of the Adolescent Cigarette Dependence Scale (ACDS). Environ Sci Pollut Res Int. 2021;28(22):28407–14. https://doi.org/10.1007/s11356-021-12667-6.

26.

Heatherton TF, Kozlowski LT, Frecker RC, Fagerström KO. The Fagerström test for nicotine dependence: a revision of the Fagerström tolerance questionnaire. Br J Addict. 1991;86(9):1119–27. https://doi.org/10.1111/j.1360-0443.1991.tb01879.x.CrossRefPubMed

27.

Baker TB, Breslau N, Covey L, Shiffman S. DSM criteria for tobacco use disorder and tobacco withdrawal: a critique and proposed revisions for DSM-5. Addiction. 2012;107(2):263–75. https://doi.org/10.1111/j.1360-0443.2011.03657.x.CrossRefPubMedPubMedCentral

28.

George D: SPSS for windows step by step: A simple study guide and reference, 17.0 update, 10/e: Pearson Education India; 2011.

29.

Mishra P, Pandey CM, Singh U, Gupta A, Sahu C, Keshri A. Descriptive statistics and normality tests for statistical data. Ann Card Anaesth. 2019;22(1):67–72. https://doi.org/10.4103/aca.ACA_157_18.CrossRefPubMedPubMedCentral

30.

Prokhorov AV, Hudmon KS, de Moor CA, Kelder SH, Conroy JL, Ordway N. Nicotine dependence, withdrawal symptoms, and adolescents' readiness to quit smoking. Nicotine Tob Res. 2001;3(2):151–5. https://doi.org/10.1080/14622200110043068.CrossRefPubMed

31.

Ursprung WW, DiFranza JR. The loss of autonomy over smoking in relation to lifetime cigarette consumption. Addict Behav. 2010;35(1):14–8. https://doi.org/10.1016/j.addbeh.2009.08.001.CrossRefPubMed

32.

Hessami Z, Masjedi MR, Mortaz E, Heydari G, Kazempour-Dizaji M, Sharifi H, et al. Evaluation of dual tobacco smoking (water pipe and cigarettes) and associated factors in adults in Tehran. Tanaffos. 2016;15(3):180–6.PubMedPubMedCentral

33.

Smith-Simone S, Maziak W, Ward KD, Eissenberg T. Waterpipe tobacco smoking: knowledge, attitudes, beliefs, and behavior in two U.S. samples. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco. 2008;10(2):393–8. https://doi.org/10.1080/14622200701825023.CrossRef

34.

Jiménez MC, Trullén AP, Aranda ER, Tundidor RM, Ibáñez MR, Labarga IH. A version of DSM-IV criteria adapted for adolescents and applied to young smokers. Arch Bronconeumol. 2003;39(7):303–9.CrossRef

35.

John U, Meyer C, Hapke U, Rumpf H-J. Nicotine dependence and lifetime amount of smoking in a population sample. The European Journal of Public Health. 2004;14(2):182–5. https://doi.org/10.1093/eurpub/14.2.182.CrossRefPubMed

36.

Kandel D, Schaffran C, Griesler P, Samuolis J, Davies M, Galanti R. On the measurement of nicotine dependence in adolescence: comparisons of the mFTQ and a DSM-IV–based scale. J Pediatr Psychol. 2005;30(4):319–32. https://doi.org/10.1093/jpepsy/jsi027.CrossRefPubMed

37.

Selya AS, Dierker LC, Rose JS, Hedeker D, Tan X, Li R, et al. Time-varying effects of smoking quantity and nicotine dependence on adolescent smoking regularity. Drug Alcohol Depend. 2013;128(3):230–7. https://doi.org/10.1016/j.drugalcdep.2012.08.026.CrossRefPubMed

38.

Garcia-Rodriguez O, Blanco C, Wall MM, Wang S, Jin CJ, Kendler KS. Toward a comprehensive developmental model of smoking initiation and nicotine dependence. Drug Alcohol Depend. 2014;144:160–9. https://doi.org/10.1016/j.drugalcdep.2014.09.002.CrossRefPubMedPubMedCentral

39.

Eissenberg T, Shihadeh A. Waterpipe tobacco and cigarette smoking: direct comparison of toxicant exposure. Am J Prev Med. 2009;37(6):518–23. https://doi.org/10.1016/j.amepre.2009.07.014.CrossRefPubMedPubMedCentral

40.

Shihadeh A. Investigation of mainstream smoke aerosol of the argileh water pipe. Food Chem Toxicol. 2003;41(1):143–52. https://doi.org/10.1016/S0278-6915(02)00220-X.CrossRefPubMed

41.

Albisser S, Schmidlin J, Schindler C, Tamm M, Stolz D. Water pipe smoking and its association with cigarette and cannabis use in young adults in Switzerland. Respiration. 2013;86(3):210–5. https://doi.org/10.1159/000342894.CrossRefPubMed

42.

Piper ME, Baker TB, Benowitz NL, Kobinsky KH, Jorenby DE. Dual users compared to smokers: demographics, dependence, and biomarkers. Nicotine Tob Res. 2019;21(9):1279–84. https://doi.org/10.1093/ntr/nty231.CrossRefPubMed

43.

Afifi R, Saravanan M, El Salibi N, Nakkash R, Rady A, Sherman S, et al. Evidence from the Lebanon global school-based student health survey on midwakh tobacco smoking in school students: a harbinger of the next global tobacco pandemic? East Mediterr Health J. 2020;26(1):116–21. https://doi.org/10.26719/2020.26.1.116.CrossRefPubMed

44.

Edwards AL: The social desirability variable in personality assessment and research. Dryden Press 1957.

Title: Association between cumulative cigarette and Waterpipe smoking and symptoms of dependence in Lebanese adults
Authors: Diana Malaeb
Marwan Akel
Hala Sacre
Chadia Haddad
Sahar Obeid
Souheil Hallit
Pascale Salameh
Publication date: 01-12-2021
Publisher: BioMed Central
Published in: BMC Public Health / Issue 1/2021
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-021-11626-7

2024 ASCO Annual Meeting

Springer Medicine

Association between cumulative cigarette and Waterpipe smoking and symptoms of dependence in Lebanese adults

Abstract

Background

Methods

Results

Conclusion

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2021

Social gradient in health-related quality of life among urban middle-age residents in Limassol, Cyprus: research article

Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) participant’s profile regarding self-rated health: a multiple correspondence analysis

Correction to: Questionnaire choice affects the prevalence of recommended physical activity: an online survey comparing four measuring instruments within the same sample

An analytical study on the awareness and practice relating toxoplasmosis among pregnant women in Casablanca, Morocco

Early public adherence with and support for stay-at-home COVID-19 mitigation strategies despite adverse life impact: a transnational cross-sectional survey study in the United States and Australia

Community-based organizations’ perspectives on improving health and social service integration