Water pipe tobacco smoking among university students in Jordan

Abstract

Introduction: Although water pipe tobacco smoking is common in Lebanon and Syria, prevalence in neighboring Jordan is uncertain. The purposes of this study were (a) to assess the prevalence of water pipe tobacco smoking among university students in Jordan and (b) to determine associations between sociodemographic variables and water pipe tobacco smoking in this population.

Methods: A trained interviewer administered a questionnaire among randomly selected students at four prominent universities in Jordan. The questionnaire assessed sociodemographic data, personal history of water pipe tobacco use, and attitudes regarding water pipe tobacco smoking. We used logistic regression to determine independent associations between sociodemographic and attitudinal factors and each of two dependent variables: ever use of water pipe and use at least monthly.

Results: Of the 548 participants, 51.8% were male and mean age was 21.7 years. More than half (61.1%) had ever smoked tobacco from a water pipe, and use at least monthly was reported by 42.7%. Multivariable analyses controlling for all relevant factors demonstrated significant associations between ever use and only two sociodemographic factors: (a) gender (for women compared with men, odds ratio [OR] = 0.11, 95% CI = 0.07-0.17) and (b) income (for those earning 500-999 Jordanian dinar (JD) monthly vs. <250 JD monthly, OR = 2.37, 95% CI = 1.31-4.31). There were also significant associations between perception of harm and addictiveness and each outcome.

Discussion: Water pipe tobacco smoking is highly prevalent in Jordan. Although use is associated with male gender and upper middle income levels, use is widespread across other sociodemographic variables. Continued surveillance and educational interventions emphasizing the harm and addictiveness of water pipe tobacco smoking may be valuable in Jordan.

Figure 1.

Association between use of water pipe to smoke tobacco and beliefs regarding harm. Bars indicate the percentage of individuals in each harm belief category who have smoked tobacco from a water pipe ever (left side) and at least monthly (right side). Chi-squared tests demonstrate p = .09 for ever use and p < .001 for use at least monthly.

Figure 2.

Association between use of water pipe to smoke tobacco and beliefs regarding addictiveness. Bars indicate the percentage of individuals in each addiction belief category who have smoked tobacco from a water pipe ever (left side) and at least monthly (right side). Chi-squared tests demonstrate p < .001 for both outcomes (ever use and use at least monthly).