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      Attitude of University Students towards Waterpipe Smoking: Study in Iran

      research-article
      , MD 1 , 2 , , MD 3
      Addiction & Health
      Kerman University of Medical Sciences
      Tobacco, Attitude, Drugs, Student

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          Abstract

          Background

          Tobacco is consumed in various forms, and there has been an increasing trend worldwide in the use of waterpipe. This study aimed to assess the university students’ attitudes towards waterpipe.

          Methods

          This was a cross-sectional study; 1130 students randomly were selected from universities of Kerman, Iran. They were provided with a researcher-made questionnaire after obtaining the informed consent. The anonymous questionnaires were completed with ensuring about information confidentiality. In addition to the underlying questions, the questionnaires consisted of 10 attitude survey questions. Higher scores indicated more positive attitudes.

          Findings

          The obtained results indicated a significant difference of attitude of the students who were current or occasional smokers of waterpipe in comparison with the students who never smoked it towards addictiveness, social acceptance or rejection and its harmfulness; so that their attitudes were more positive (P < 0.05). Mean ± SD of attitude score of the students who never consumed waterpipe before, those who had the history of consuming it at least once and those who were current smokers were 1.40 ± 0.40, 1.50 ± 0.41 and 1.70 ± 0.43, respectively (P < 0.001).

          Conclusion

          Waterpipe smoking was associated with false beliefs and positive attitudes among the students; therefore, the necessity of education and attitude changing is required in this regard.

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          Most cited references10

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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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            Waterpipe tobacco and cigarette smoking: direct comparison of toxicant exposure.

            Waterpipe (hookah, shisha) tobacco smoking has spread worldwide. Many waterpipe smokers believe that, relative to cigarettes, waterpipes are associated with lower smoke toxicant levels and fewer health risks. For physicians to address these beliefs credibly, waterpipe use and cigarette smoking must be compared directly. The purpose of this study is to provide the first controlled, direct laboratory comparison of the toxicant exposure associated with waterpipe tobacco and cigarette smoking. Participants (N=31; M=21.4 years, SD=2.3) reporting monthly waterpipe use (M=5.2 uses/month, SD=4.0) and weekly cigarette smoking (M=9.9 cigarettes/day, SD=6.4) completed a crossover study in which they each smoked a waterpipe for a maximum of 45 minutes, or a single cigarette. Outcome measures included expired-air carbon monoxide (CO) 5 minutes after session's end, and blood carboxyhemoglobin (COHb), plasma nicotine, heart rate, and puff topography. Data were collected in 2008-2009 and analyzed in 2009. On average, CO increased by 23.9 ppm for waterpipe use (SD=19.8) and 2.7 ppm for cigarette smoking (SD=1.8), while peak waterpipe COHb levels (M=3.9%, SD=2.5) were three times those observed for cigarette smoking (M=1.3%, SD=0.5; p's<0.001). Peak nicotine levels did not differ (waterpipe M=10.2 ng/mL, SD=7.0; cigarette M=10.6 ng/mL, SD=7.7). Significant heart rate increases relative to pre-smoking were observed at 5, 10, 15, 20, 25, and 35 minutes during the cigarette session and at 5-minute intervals during the waterpipe session (p's<0.001). Mean total puff volume was 48.6 L for waterpipe use as compared to 1.0 L for cigarette smoking (p<0.001). Relative to cigarette smoking, waterpipe use is associated with greater CO, similar nicotine, and dramatically more smoke exposure. Physicians should consider advising their patients that waterpipe tobacco smoking exposes them to some of the same toxicants as cigarette smoking and therefore the two tobacco-smoking methods likely share some of the same health risks.
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              Beliefs and attitudes related to narghile (waterpipe) smoking among university students in Syria.

              To assess the beliefs and attitudes related to narghile (waterpipe) smoking that are likely to contribute to its increased popularity among young people in Syria. In 2003, a cross-sectional survey was administered to university students in Aleppo, using an interviewer-administered questionnaire. Overall, 587 students participated in the study (278 males, 309 females; mean age, 21.8 +/- 2.1; response rate 98.8%). The most common positive perceptions of narghile were related to its smell and taste. Negative perceptions of narghile included the smoke produced, the pollution, and perceived adverse health effects. Students believed the popularity of narghile to be part of a rising regional trend in its use, due to its being an appealing way to spend leisure time socializing with friends. More students (49.7%) believed narghile to be more harmful to health than cigarettes, compared with 30% who believed the opposite. Respiratory disease was the most commonly cited health effect of narghile smoking. Family attitudes regarding tobacco use by younger members were more permissive about narghile compared with cigarettes, and, surprisingly, were more permissive about females smoking narghile than males doing so. The rise in narghile smoking as a trendy social habit appears to be occurring despite considerable appreciation of its potential health risks. Permissiveness of adult family members towards narghile use by young female members, especially in the presence of a strong taboo against female cigarette smoking may contribute to the continuous spread of narghile smoking among women in Syria.
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                Author and article information

                Journal
                Addict Health
                Addict Health
                AH
                Addiction & Health
                Kerman University of Medical Sciences
                2008-4633
                2008-8469
                Winter-Spring 2011
                : 3
                : 1-2
                : 9-14
                Affiliations
                [1 ]Assistant Professor, Department of Psychiatry, Kerman University of Medical Sciences, Kerman, Iran.
                [2 ]Senior Researcher, Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran.
                [3 ]Professor, Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran.
                Author notes
                Correspondence to: Nouzar Nakhaee MD, Email: nakhaeen@ 123456yahoo.com
                Article
                AH-03-009
                3905517
                24494111
                a9976e77-628d-4e66-b977-7093603af5b8
                © 2011 Kerman University of Medical Sciences

                This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.

                History
                : 19 December 2010
                : 27 February 2011
                Categories
                Original Article

                tobacco,attitude,drugs,student
                tobacco, attitude, drugs, student

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