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, ali.albakri777@gmail.com

Saba Kassim, s.kassim@qmul.ac.uk

Mustafa al’Absi, malabsi@umn.edu

Ray Croucher, ray.e.croucher@gmail.com

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.

Questionnaire Questionnaire

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

Factors associated with WPTS dependency Factors associated with WPTS dependency

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

Thank you for listening Thank you for listening