Keywords
Waterpipe and cigarette smoking; Waterpipe leads to cigarettes
Abstract
Introduction: The purpose of this study is to determine whether waterpipe use may contribute to the onset of cigarette use or if it may help current cigarette smokers reduce or quit cigarette smoking.
Method: This is a cross-sectional study of 622 current waterpipe smokers selected randomly from within 15 different randomly selected waterpipe lounges in Riyadh, Saudi Arabia. Using an iPad volunteers completed a self-administered survey regarding their smoking history, tobacco withdrawal symptoms, and demographics. Those who initially started smoking with waterpipe and those who initially started smoking with cigarettes were analyzed separately.
Results: Logistic regression showed that both the years of waterpipe use and withdrawal symptoms significantly predicted being a current cigarette smoker (waterpipe starters: years of waterpipe use: OR=1.18, C.I.=[1.07-1.30] withdrawal symptoms: OR=1.11, C.I.=[1.01-1.22] and cigarette starters: years of waterpipe use: OR=1.08, C.I.=[1.00-1.17] withdrawal symptoms: OR=1.15, C.I.=[1.03-1.27]. However, the likelihood of being a current cigarette smoker decreased as age and frequency of waterpipe use increased. Additionally, there was evidence that waterpipe withdrawal symptoms were predicted by frequency of waterpipe use.
Conclusions: Waterpipe use may be a potential gateway to cigarette use. However, among those who initially started smoking with cigarettes, older age and greater frequency of waterpipe may protect against cigarette use.
Implications: The study findings add additional evidence that smoking waterpipe may lead to initiate another smoking behavior, in a particular cigarette use, especially among young individuals. However, long history and greater use of waterpipe could be associated with less likelihood of being a current cigarette user. Health promotion and intervention programs must consider the mutual association between waterpipe and cigarette use among youth and young adults in order to develop effective health promotion programs.
Citation
Alanazi NH and Lee JW. Waterpipe Smoking: Gateway to or Escape from Cigarette Use among Current Waterpipe Users in Riyadh, Saudi Arabia. SM Addict Res Ther. 2017; 1(1): 1002s.