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      Prevalence, Patterns and Correlates of Cigarette Smoking in Male Adolescents in Northern Jordan, and the Influence of Waterpipe Use and Asthma Diagnosis: A Descriptive Cross-Sectional Study

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          Abstract

          Our study investigates the prevalence, patterns and predictors of tobacco smoking among early adolescent males in Northern Jordan and whether asthma diagnosis affects smoking patterns. A descriptive cross sectional design was used. Males in grades 7 and 8 from four randomly selected high schools in the city of Irbid were enrolled. Data on waterpipe (WP) use and cigarette smoking patterns were obtained ( n = 815) using a survey in Arabic language. The overall prevalence of ever having smoked a cigarette was 35.6%, with 86.2% of this group smoking currently. Almost half of the sample reported WP use. The most common age in which adolescents started to experiment with cigarettes was 11–12 years old (49.1%), although 10 years was also common (25.3%). Significant predictors of male cigarette smoking were WP use (OR = 4.15, 95% CI = 2.99–5.76), asthma diagnosis (OR = 2.35, 95% CI = 1.46–3.78), grade 8 (OR = 1.52, 95% CI = 1.10–2.11), and having a sibling who smokes (OR = 2.23, 95% CI = 1.53–3.24). However, this cross-sectional study cannot establish causality, thus longitudinal studies are needed. Public health programs and school-based anti-tobacco smoking interventions that target children in early years at high schools are warranted to prevent the uptake of tobacco use among this vulnerable age group. High school students with asthma should be specifically targeted.

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          International Study of Asthma and Allergies in Childhood (ISAAC): rationale and methods.

          The aetiology of asthma and allergic disease remains poorly understood, despite considerable research. The International Study of Asthma and Allergies in Childhood (ISAAC), was founded to maximize the value of epidemiological research into asthma and allergic disease, by establishing a standardized methodology and facilitating international collaboration. Its specific aims are: 1) to describe the prevalence and severity of asthma, rhinitis and eczema in children living in different centres, and to make comparisons within and between countries; 2) to obtain baseline measures for assessment of future trends in the prevalence and severity of these diseases; and 3) to provide a framework for further aetiological research into genetic, lifestyle, environmental, and medical care factors affecting these diseases. The ISAAC design comprises three phases. Phase 1 uses core questionnaires designed to assess the prevalence and severity of asthma and allergic disease in defined populations. Phase 2 will investigate possible aetiological factors, particularly those suggested by the findings of Phase 1. Phase 3 will be a repetition of Phase 1 to assess trends in prevalence.
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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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              Reliability of the 1999 youth risk behavior survey questionnaire.

              To assess the test-retest reliability of the 1999 Youth Risk Behavior Survey (YRBS) questionnaire. A sample of 4,619 male and female high school students from white, black, Hispanic, and other racial/ethnic groups completed the YRBS questionnaire on two occasions approximately two weeks apart. The questionnaire assesses a broad range of health risk behaviors. This study used a protocol that maintained anonymity yet allowed matching of Time-1 and Time-2 responses. The authors computed a kappa statistic for the 72 items measuring health risk behaviors, and compared group prevalence estimates at the two testing occasions. Kappas ranged from 23.6% to 90.5%, with a mean of 60.7% and a median of 60.0%. Kappas did not differ by gender, grade, or race/ethnicity of the respondent. About one in five items (22.2%) had significantly different prevalence estimates at Time 1 vs. Time 2. Ten items, or 13.9%, had both kappas below 61% and significantly different Time-1 and Time-2 prevalence estimates. Overall, students appeared to report health risk behaviors reliably over time, but several items need to be examined further to determine whether they should be revised or deleted in future versions of the YRBS.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                01 September 2014
                September 2014
                : 11
                : 9
                : 9008-9023
                Affiliations
                [1 ]Faculty of Nursing, Jordan University of Science and Technology, Irbid 22110, P.O. Box 3030, Jordan
                [2 ]Faculty of Health, University of Technology, Sydney, Sydney 2007, Australia; E-Mails: Patrick.gallagher@ 123456uts.edu.au (P.G.); robyn.gallagher@ 123456uts.edu.au (R.G.)
                [3 ]Charles Perkins Centre and Faculty of Nursing and Midwifery, the University of Sydney, Sydney 2007, Australia
                [4 ]Faculty of Medical Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan; E-Mail: alomari@ 123456just.edu.jo
                [5 ]Faculty of Medicine, Western Clinical School, The University of Sydney, Sydney 2007, Australia; E-Mail: smita_shah@ 123456health.nsw.gov.au
                Author notes
                [†]

                These authors contributed equally to this work.

                [* ]Author to who correspondence should be addressed; E-Mail: nasheyab@ 123456just.edu.jo ; Tel.: +61-470-519-795; Fax: +1-111-111-112.
                Article
                ijerph-11-09008
                10.3390/ijerph110909008
                4199003
                25257355
                e47f50a5-b5b6-4965-8f8d-8ab4ed71e6af
                © 2014 by the authors; licensee MDPI, Basel, Switzerland.

                This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license ( http://creativecommons.org/licenses/by/3.0/).

                History
                : 14 July 2014
                : 15 August 2014
                : 26 August 2014
                Categories
                Article

                Public health
                adolescent,asthma,cigarette smoking,prevalence,water pipe,jordan
                Public health
                adolescent, asthma, cigarette smoking, prevalence, water pipe, jordan

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