Poly-Tobacco Use among Young Adult Waterpipe Smokers

Insights from University Students in Three Eastern Mediterranean Countries

Bibliographic Data

ID21645784
AuthorsMuhammad W Darawad (0000-0003-3314-7933, School of Nursing, The University of Jordan, Amman, Jordan, corresponding author), Mary Rezk‐Hanna (0000-0001-9926-5276, University of California, Los Angeles), Mary Rezk-Hanna (University of California, Los Angeles), Mahmoud Al‐Hussami (0000-0002-4947-8887, University of Jordan), Juhan Lee (0000-0003-0860-3327, University of Florida), Aya Mostafa (0000-0002-2803-2608, Ain Shams University), Niveen M E Abu-Rmeileh (0000-0003-0831-9692, Birzeit University), Niveen Abu-Rmeileh (Birzeit University), Khalid Kheirallah (0000-0003-4504-4472, Department of Public Health-Medical School, Jordan University of Science & Technology, Irbid, Jordan), Mohamed Salama (0009-0000-9950-3342, Mansoura University), Mohammed Salama (Mansoura University), Rima Nakkash (0000-0001-8800-5591, American University of Beirut), Zyad T Saleh (0000-0002-1107-0413, University of Jordan), Zeyad Saleh (School of Nursing, The University of Jordan, Amman, Jordan), Ramzi G Salloum (0000-0002-8139-2418, University of Florida), Ramzi Salloum (University of Florida)
Year2020
Volume55
Issue13
Pages2099-2108
Publication date2020-03-03
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueSubstance Use & Misuse (JOURNAL)
Journal identifiersISSN: 1082-6084 • E-ISSN: 1532-2491
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1080/10826084.2020.1790010
PMID32666880
OpenAlexW3042233308
LanguageEN
Citations received1
References cited39

Introduction There is a tendency of waterpipe smokers to advance their practice toward concurrent use (poly-tobacco use) of other tobacco products and nicotine delivery systems. This study investigated poly-tobacco use among waterpipe smokers, and its effect on their quit intention.Methods Descriptive cross-sectional design was utilized to recruit a convenience sample of university students who used waterpipe in three East Mediterranean countries. Using an internet-based survey, data were collected regarding participants’ demographics, use of alternative tobacco products and nicotine delivery systems, and waterpipe quitting profile. Results: A total of 2290 students agreed to participate, among which 1116 (45.3%) reported using at least one tobacco product beside waterpipe. Poly-tobacco use was highest (61.1%) in Egypt, followed by Jordan (45.1%) and Palestine (33.1%). Across countries, cigarettes were the most common product (45.2%, n = 924) followed by cigar (18.6%, n = 374) and e-shisha (17.5%, n = 353). Conversely, the least reported product was smokeless tobacco (7.5%, n = 151) preceded by regular pipe (9.5%, n = 193). Participants who were males (OR = 2.83, 95% CI: 2.18–3.65), older (22–29 years) (OR = 1.15, 95% CI: 1.09–1.22), unemployed (OR = 1.58, 95% CI: 1.22–2.04), and those who initiated waterpipe at a younger age (OR = 0.87, 95% CI: 0.87–0.91) had higher odds of being poly-smokers. Poly-tobacco users were significantly more resistant to quit waterpipe. Conclusion: This study demonstrates poly-tobacco use as a rising phenomenon among waterpipe smokers and highlights the necessity for initiating advanced interventions to help waterpipe poly-tobacco users quit this dangerous type of addiction. Various country-specific programs are needed considering the various products used by the users

Cross-sectional study · Demographics · Environmental health · Nicotine · Palestine · Population · Smokeless tobacco · Tobacco product · Tobacco use · Air Quality and Health Impacts · Demography · Medicine · School Health and Nursing Education · Smoking Behavior and Cessation · Internal Medicine