Bahelah Raed, DiFranza Joseph R, Ward Kenneth D, Eissenberg Thomas, Fouad Fouad M, Taleb Ziyad Ben, Jaber Rana, Maziak Wasim
Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA; Faculty of Medicine and Health Sciences, Aden University, Yemen.
Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, MA, USA.
Addict Behav. 2017 Nov;74:127-133. doi: 10.1016/j.addbeh.2017.06.003. Epub 2017 Jun 7.
Waterpipe typically is smoked intermittently over long smoking sessions. Waterpipe is addictive and its users show symptoms of nicotine dependence (ND). This study examined the risk of developing ND symptoms across waterpipe use patterns among Lebanese youth.
Waterpipe use patterns (length of smoking session, smoking a whole waterpipe without sharing, past-30day use frequency, number of waterpipes smoked) were assessed. Symptoms of ND were assessed using the 10-item Hooked on Nicotine Checklist (HONC; endorsement of ≥1 symptom) and the 6 criteria of the International Classification of Diseases-10th revision (ICD-10 ND; presence of ≥3 criteria during 12months).
Both the proportion of participants endorsing ND symptoms and the average number of endorsed ND symptoms increased with increasing waterpipe use frequency, number of waterpipes smoked, and length of smoking session. The risk of endorsing≥1 HONC symptom increased with increasing number of waterpipes smoked in the past 30-days (≥10 vs. <4 waterpipes; Hazard ratio (HR)=2.05, 95% CI: 1.52-2.58, p=0.007), and session length (>60min vs. <30min; HR=2.87, 95% CI: 2.83-2.91, p=0.001). The risk of attaining ICD-10 ND increased with increasing number of waterpipes used in the past 30-days (≥10 vs. <4 waterpipes; HR=2.56, 95% CI: 1.89-3.22, p=0.006), and smoking every day/almost every day vs. less than once weekly (HR=2.86, 95% CI: 2.12-3.60, p=0.007).
Increasing use frequency, number of waterpipes smoked, and longer smoking sessions were associated with higher risk of ND. The length of smoking session emerged as a novel indicator of ND among waterpipe smokers.
水烟通常在较长的吸烟时段中间歇性吸食。水烟会上瘾，其使用者表现出尼古丁依赖（ND）症状。本研究调查了黎巴嫩青年中不同水烟使用模式下出现尼古丁依赖症状的风险。
评估水烟使用模式（吸烟时段长度、不与他人共用吸食整支水烟、过去30天的使用频率、吸食水烟的数量）。使用10项尼古丁成瘾清单（HONC；认可≥1种症状）和国际疾病分类第10版（ICD - 10 ND；12个月内出现≥3条标准）评估尼古丁依赖症状。
认可尼古丁依赖症状的参与者比例和认可的尼古丁依赖症状平均数量均随着水烟使用频率、吸食水烟数量和吸烟时段长度的增加而增加。过去30天内吸食水烟数量增加（≥10支与<4支；风险比（HR）=2.05，95%置信区间：1.52 - 2.58，p = 0.007）以及吸烟时段长度增加（>60分钟与<30分钟；HR = 2.87，95%置信区间：2.83 - 2.91，p = 0.001），认可≥1种HONC症状的风险增加。过去30天内使用水烟数量增加（≥10支与<4支；HR = 2.56，95%置信区间：1.89 - 3.22，p = 0.006）以及每天/几乎每天吸烟与每周少于一次吸烟相比（HR = 2.86，95%置信区间：2.12 - 3.60，p = 0.007），达到ICD - 10尼古丁依赖的风险增加。
使用频率增加、吸食水烟数量增加和吸烟时段延长与尼古丁依赖的较高风险相关。吸烟时段长度成为水烟吸食者中尼古丁依赖的一个新指标。
