waterpipe tobacco dependence in uk male adult residents: a cross sectional study ali al-bakri,...
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Waterpipe Tobacco Dependence In Waterpipe Tobacco Dependence In UK Male Adult Residents: UK Male Adult Residents: A Cross Sectional StudyA Cross Sectional Study
Ali Al-Bakri, [email protected]
Saba Kassim, [email protected]
Mustafa al’Absi, [email protected]
Ray Croucher, [email protected]
IntroductionIntroduction
Waterpipe tobacco smoking (WPTS) is getting popular in Europe (1)
WPTS has common and unique dependency aspects (2)
WPTS dependency can not be measured in traditional cigarette dependency tools (2,3)
WPTS dependence amongst UK adults WPT smokers has not been assessed
Few studies which lack validation and standardization
(4)
AimsAims
To assess, estimate and identify factors associated with waterpipe tobacco dependence syndrome amongst UK male adult resident waterpipe smokers
To evaluate the psychometric properties of the Lebanon Waterpipe Dependence Scale (LWDS-11), in measuring WPTS dependence amongst UK male adult resident WPT smokers
Methodology Methodology
Cross sectional survey
7 shisha premises participated in central London
Random time table,180 participants in 4 weeks
Data were collected via face to face interview
QMUL Research Ethics Committee approved the study
Data analysis: descriptive, chi square, uni and multivariate
and psychometric analysis.
Results Results
Sample Background Sample Background
Socio-demographic factors N (%)
Age (Mean/SD 29.46/±9.41 years) 180 (100)
EthnicityArab
Asian
White
Black
106 (58.89)
27 (15.00)
26 (14.44)
21 (11.67)
Level of educationAbove completed secondary education
Completed secondary education
Below completed secondary education
97 (53.89)
55 (30.56)
28 (15.55)
Sample background Sample background (continued)
Aspects of WPTS N (%)
Historic WPTS pattern
Age/Yrs of WPTS initiation
Smoked WPTS daily in the past
Mean 21.28 (SD ±8.1)
94 (52.2)
Current WPTS pattern
With others Alone
Smoked flavored tobacco
Did not Mix the water in the WP tank with other substances
Duration
140 (77.8) 38 (21.1)
154 (85.6)
176 (97.8)
Median (range) 1 (0.15-10) hours
Level of WPTS Dependence in the sample Level of WPTS Dependence in the sample
• The mean/SD LWDS-11 score is 10.05±5.68
• 47% of participants were more likely WPTS dependent
Psychometric assessment of Psychometric assessment of LWDS-11 LWDS-11
The Cronbach’s alpha coefficient =0.74
Two domains were identified
physiological dependence
positive and negative reinforcement
Explanatory Variables Adjusted OR (95%CI) P-value
EthnicityWhiteArabAsianBlack
12.63 (1.05-6.62)*1.71 (0.56-5.28)1.79 (0.58-5.48)
0.0400.3500.309
Education LevelHigh Intermediatelow
11.40 (0.80-2.45)1.26 (0.76-2.09)
0.2360.370
Daily WPTS in the pastNoYes
12.13 (1.30-3.49)* 0.003
Last WPTS variables
Duration
WPTS with others
WPTS alone
1.15 (1.00-1.32)*
11.31 (0.80-2.15)
0.044
0.285
Model of factors associated with WPTS Dependency Model of factors associated with WPTS Dependency
DiscussionDiscussion
Of the participant 47% were WPT dependents confirming previous studies (5)
Two domain of WPT dependence emerged , contradicting other studies (3)
The association of being from Arab ethnicity and being daily WPT dependence in past with current WPT dependence confirmed current literature (6,7,8,9,10)
Future researchFuture research
Investigating the WPTS dependency among female population
Conducting LWDS-11 in different population
to improve validity
Biomarker validation of WPTS dependency
ConclusionConclusion
level of WPTS dependence was significant in this sample and was associated with socio-behavioural factors
The LWDS-11 was found useful in assessing WPTS dependency
Future research to address gaps identified
ReferencesReferences
1- MAZIAK, W. 2011. The global epidemic of waterpipe smoking. Addict Behav, 36, 1-5
2- MAZIAK, W., WARD, K. D. & EISSENBERG, T. 2004e. Factors related to frequency of narghile (waterpipe) use: the first insights on tobacco dependence in narghile users. Drug Alcohol Depend, 76, 101-6.
3-SALAMEH, P., WAKED, M. & AOUN, Z. 2008. Waterpipe smoking: construction and validation of the Lebanon Waterpipe Dependence Scale (LWDS-11). Nicotine Tob Res, 10, 149-58.
4- Akl EA, Aleem S, Gunukula SK, Honeine R, Abou Jaoude P, Irani J. Survey instruments used in clinical and epidemiological research on waterpipe tobacco smoking: a systematic review. BMC Public Health. 2010;10:415
5-SALAMEH, P., KHAYAT, G. & WAKED, M. 2012. Lower prevalence of cigarette and waterpipe smoking, but a higher risk of waterpipe dependence in Lebanese adult women than in men. Women Health, 52, 135-50.
6- GREKIN, E. R. & AYNA, D. 2008. Argileh use among college students in the United States: an emerging trend. J Stud Alcohol Drugs, 69, 472-5.
7- JAMIL, H., TEMPLIN, T., FAKHOURI, M., RICE, V. H., KHOURI, R., FAKHOURI, H., AL-OMRAN, H., AL-FAUORI, I. & BAKER, O. 2009. Comparison of personal characteristics, tobacco use, and health states in Chaldean, Arab American, and non-Middle Eastern White adults. J Immigr Minor Health, 11, 310-7.
8-JORDAN, H. M. & DELNEVO, C. D. 2010. Emerging tobacco products: hookah use among New Jersey youth. Prev Med, 51, 394-6.
9-Maziak, W., Rastam, S., Shihadeh, A. L., Bazzi, A., Ibrahim, I., Zaatari, G. S., . . . Eissenberg, T. (2011). Nicotine exposure in daily waterpipe smokers and its relation to puff topography. Addictive Behavior, 36(4), 397-399. doi: S0306-4603(10)00334-5 10.1016/j.addbeh.2010.11.013.
10- Neergaard, J., Singh, P., Job, J., & Montgomery, S. (2007). Waterpipe smoking and nicotine exposure: a review of the current evidence. Nicotine and Tobacco Research, 9(10), 987-994. doi: 783052859 10.1080/14622200701591591.
AcknowledgmenAcknowledgment t
Special thanks for the BSTP for funding my participation
The contribution of the owners of the shisha premises in the study is appreciated