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      Prevalence, Predictors, and Characteristics of Waterpipe Smoking Among Jazan University Students in Saudi Arabia: A Cross-Sectional Study

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          Abstract

          Background:

          Waterpipe smoking (WPS), also called shisha, has considerable short and long-term effects on human health. WPS has become increasingly popular among the youth in Jazan society. Hence, this study is aimed to assess the prevalence, predictors, and characteristics (knowledge and attitude) of WPS among male and female students at Jazan University.

          Methods and materials:

          A descriptive, cross-sectional study was conducted among 405 students. Data were collected using a self-administered validated questionnaire. The prevalence and predictors of WPS and the association between important socio-demographic factors (sex, type of college, parents smoking, home mate smoking and close friend smoking) were studied.

          Results:

          The prevalence of WPS among students was high, approximately 34.0%. The prevalence rate was significantly higher in males (42.5%, n = 74) than in females (27.0%, n = 57) (p = 0.001). The main predictors of WPS were: being male (OR = 1.99, 95% CI [1.30, 3.06], p = 0.001), believing that shisha smoking is less harmful & addictive than cigarettes (OR = 3.84, 95% CI [1.88, 7.83], p < 0.001 and 3.80, 95% CI [2.0, 7.11], p < 0.001, respectively), and having a close friend who smokes (OR = 6.85, 95% CI [3.84, 12.22], p < 0.001).

          Conclusions:

          WPS prevalence among Jazan University students was high, and the most influential factors were being male, having smoker housemates and friends, and having incorrect thoughts and beliefs.

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          Most cited references19

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          The effects of waterpipe tobacco smoking on health outcomes: a systematic review.

          There is a need for a comprehensive and critical review of the literature to inform scientific debates about the public health effects of waterpipe smoking. The objective of this study was therefore to systematically review the medical literature for the effects of waterpipe tobacco smoking on health outcomes. We conducted a systematic review using the Cochrane Collaboration methodology for conducting systematic reviews. We rated the quality of evidence for each outcome using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. Twenty-four studies were eligible for this review. Based on the available evidence, waterpipe tobacco smoking was significantly associated with lung cancer [odds ratio (OR) = 2.12; 95% confidence interval (CI) 1.32-3.42], respiratory illness (OR = 2.3; 95% CI 1.1-5.1), low birth-weight (OR = 2.12; 95% CI 1.08-4.18) and periodontal disease (OR = 3-5). It was not significantly associated with bladder cancer (OR = 0.8; 95% CI 0.2-4.0), nasopharyngeal cancer (OR = 0.49; 95% CI 0.20-1.23), oesophageal cancer (OR = 1.85; 95% CI 0.95-3.58), oral dysplasia (OR = 8.33; 95% CI 0.78-9.47) or infertility (OR = 2.5; 95% CI 1.0-6.3) but the CIs did not exclude important associations. Smoking waterpipe in groups was not significantly associated with hepatitis C infection (OR = 0.98; 95% CI 0.80-1.21). The quality of evidence for the different outcomes varied from very low to low. Waterpipe tobacco smoking is possibly associated with a number of deleterious health outcomes. There is a need for high-quality studies to identify and quantify with confidence all the health effects of this form of smoking.
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            Toxicant content, physical properties and biological activity of waterpipe tobacco smoke and its tobacco-free alternatives

            Objectives Waterpipe smoking using sweetened, flavoured tobacco products has become a widespread global phenomenon. In this paper, we review chemical, physical and biological properties of waterpipe smoke. Data sources Peer-reviewed publications indexed in major databases between 1991 and 2014. Search keywords included a combination of: waterpipe, narghile, hookah, shisha along with names of chemical compounds and classes of compounds, in addition to terms commonly used in cellular biology and aerosol sizing. Study selection The search was limited to articles published in English which reported novel data on waterpipe tobacco smoke (WTS) toxicant content, biological activity or particle size and which met various criteria for analytical rigour including: method specificity and selectivity, precision, accuracy and recovery, linearity, range, and stability. Data extraction Multiple researchers reviewed the reports and collectively agreed on which data were pertinent for inclusion. Data synthesis Waterpipe smoke contains significant concentrations of toxicants thought to cause dependence, heart disease, lung disease and cancer in cigarette smokers, and includes 27 known or suspected carcinogens. Waterpipe smoke is a respirable aerosol that induces cellular responses associated with pulmonary and arterial diseases. Except nicotine, smoke generated using tobacco-free preparations marketed for ‘health conscious’ users contains the same or greater doses of toxicants, with the same cellular effects as conventional products. Toxicant yield data from the analytical laboratory are consistent with studies of exposure biomarkers in waterpipe users. Conclusions A sufficient evidence base exists to support public health interventions that highlight the fact that WTS presents a serious inhalation hazard.
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              Water pipe (shisha) smoking among male students of medical colleges in the eastern region of Saudi Arabia

              BACKGROUND AND OBJECTIVES: Shisha smoking, one of the commonest methods of smoking tobacco among Arabs, increases the risk of cardiovascular and respiratory diseases. The objective of this study was to determine the prevalence of shisha smoking among male students of three colleges and to identify factors associated with shisha smoking. METHODS: This cross-sectional study included 500 male students of three colleges (medicine, applied medical sciences and dentistry). Data were collected from 371 students using a self-administered questionnaire. RESULTS: The overall prevalence of shisha smoking was 12.6% (8.6% shisha only and 4.0% both shisha and cigarettes). Thirty students (63.8%) started shisha smoking at ages of 16 to 18 years. Seven students (15%) smoked shisha daily. Cafés or restaurants were the favorite places for smoking (70.2% of students). There was a high prevalence of shisha smoking among students whose mothers had a secondary (19.1%) and higher (53.3%) education. CONCLUSIONS: There was a high prevalence of shisha smoking among university students. The majority of students started shisha smoking at a young age. Public health measures, including the banning of smoking in public places are recommended.
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                Author and article information

                Contributors
                Journal
                Ann Glob Health
                Ann Glob Health
                2214-9996
                Annals of Global Health
                Ubiquity Press
                2214-9996
                29 July 2020
                2020
                : 86
                : 1
                : 87
                Affiliations
                [1 ]Jazan University, SA
                Author notes
                Corresponding author: Sarah Salih ( sarahoda@ 123456yahoo.com )
                Article
                10.5334/aogh.2912
                7394196
                32775218
                c367f28d-a36e-4a81-a5ed-5a18282c64b3
                Copyright: © 2020 The Author(s)

                This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See http://creativecommons.org/licenses/by/4.0/.

                History
                Funding
                The study was completely self-funded by the researchers.
                Categories
                Original Research

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