Cigarette and waterpipe smoking among Lebanese adolescents, a cross-sectional study, 2003-2004.

Waterpipe or "argileh" is a form of smoking other than cigarettes that is currently spreading among people of all ages. The objective of the present study was to assess tobacco smoking practices (waterpipe and/or cigarette) among public and private adolescent school students in Beirut, Lebanon. A sample of 2,443 students selected from 10 private and 3 public schools with intermediate/secondary classes filled out a self-administered anonymous questionnaire that inquired about sociodemographic characteristics, and behavior about tobacco smoking. Binary analysis was performed as well as three regression models for the relationship between exclusive cigarettes smoking, exclusive waterpipe smoking and both cigarettes and waterpipe as the dependent variables and gender, type of school, and class as the independent variables. The current prevalence of cigarettes smoking was 11.4%, and that of waterpipe smoking was 29.6%. Gender was significantly associated with cigarettes (OR=3.2, 95% CI 1.8-5.6) but not waterpipe smoking. Public school students were, respectively, 3.2 (95% CI 1.8-5.6) and 1.7 (95% CI 1.4-2.1) times more likely to be exclusive cigarettes smokers, and exclusive waterpipe smokers. Class was not significantly associated with exclusive cigarette smoking; however, students attending secondary classes were 1.3 (95% CI 1.1-1.6) times more likely to be exclusive waterpipe smokers. The reasons behind the high prevalence of both types of smoking are presented and discussed. The present study calls for school-based prevention programs and other types of interventions such as tax increases, and age-restrictions on tobacco sales. More aggressive interventions to disseminate education and awareness among parents and students altogether are warranted.

Cigarette and nargileh smoking practices among school students in Beirut, Lebanon.

OBJECTIVES: To determine the prevalence and predictors of smoking nargileh and/or cigarettes among school students in Greater Beirut, Lebanon. METHODS: A proportionate random sample of 2443 students from 13 public and private schools was selected and asked to complete self-administered anonymous questionnaires. RESULTS: The prevalence of smoking cigarettes only, nargileh only, and both was 2.5%, 25.6%, and 6.3%, respectively. Stepwise regression analyses revealed that the predictors of smoking for either type are different, whereby nargileh smoking is more culturally accepted than cigarette smoking. CONCLUSIONS: Design interventions to increase awareness towards the hazards of the misconceived harmless effects of nargileh smoking.

Exposure of pre-school children to passive cigarette and narghile smoke in Beirut.

BACKGROUND: Narghile is a resurging smoking device. However, little research has been done to assess passive smoking exposure. The objective of the present study is to evaluate the exposure of pre-school age children in Beirut to parental passive smoking from cigarette and/or narghile. METHODS: Data were collected from 1057 pre-school age children attending 16 day cares and 7 nursery schools in the city of Beirut. RESULTS: The overall prevalence of parental smoking (cigarette and/or narghile) was 53.3%. Ten per cent of respondents reported smoking only narghile. Fathers were significantly more likely than mothers to smoke cigarettes. However, there was no significant difference between fathers and mothers with respect to smoking narghile only. Education was a significant predictor for smoking cigarettes but not for smoking narghile. CONCLUSION: Narghile smoking appears to follow different gender and social patterns than cigarette smoking. Further research is needed to establish the determinants of narghile smoking, in order to develop adequate prevention policies.

Argileh smoking among university students: a new tobacco epidemic.

The recent global increase in argileh use represents the modern renaissance of an old public health threat and a new tobacco epidemic. This study examined argileh smoking knowledge and attitudes in a sample of university students in Beirut as determinants of argileh smoking. Data were collected cross-sectionally through self-administered questionnaires from 416 students at the American University of Beirut through stratified cluster sampling. The proportion of ever-smokers in this study was 43%, compared with the 30% reported 4 years ago. A total of 28.3% of the surveyed students were current argileh smokers, and the average initiation age was 16 years. Compared with argileh smokers, significantly greater proportions of nonsmokers had positive attitudes about argileh banning and more accurate knowledge about argileh. Argileh smoking among Lebanese young is on the rise. Students demonstrated partial knowledge and moderate to favorable attitudes concerning argileh smoking. Possible public health interventions are discussed in light of the social and cultural context of argileh use to neutralize this emerging global public health threat.

Exposure of children to environmental tobacco smoke (ETS) and its association with respiratory ailments.

OBJECTIVES: To assess the impact of domestic passive smoking (cigarettes or narghile) on the development of respiratory ailments among children ages 10-15 years. METHODS: Students were recruited from five private schools in Beirut, and information on demographic, in-home smoking, and students' respiratory tract illnesses (cough, wheezing, runny nose, or nasal congestion) were collected from each participant. RESULTS: Of 625 students surveyed, 438 (70.1%) had at least one individual smoking at home. Compared with the nonexposed group, the odds ratio of having respiratory illness for children exposed to narghile or cigarette smoke were 2.3 (95% Confidence Interval [CI] 1.1-5.1) and 3.2 (95% CI 1.9-5.4), respectively. CONCLUSIONS: In addition to the well-established effect of smoking, domestic passive smoking of the misconceived "innocuous" habitual smoking device, narghile, is associated with significant respiratory health ailments.