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Free Content Assessment of tobacco dependence in waterpipe smokers in Egypt

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SETTING: Waterpipe smoking is increasing worldwide. Nevertheless, little is known about nicotine dependence in tobacco smokers who use waterpipes.

OBJECTIVE: To assess evidence of dependence among non-cigarette smoking waterpipe smokers in Egypt.

METHODS: A total of 154 male exclusive current waterpipe smokers were enrolled for the present study. We adapted the Fagerström test for nicotine dependence and the Reasons for Smoking (RFS) scales and related these to smoking behavior.

RESULTS: The mean age of the subjects was 47 ± 14 years, the mean age at smoking initiation was 22 ± 9 years, and average daily consumption was 4 ± 8 hagars (tobacco units). The time to the first smoke of the day (P < 0.001), smoking even when ill (P = 0.003), time to tobacco craving (P < 0.001), and hating to give up the first smoke of the day (P = 0.033) were each significantly associated with the number of hagars smoked per day. The RFS subscales of addictive smoking, smoking to relieve negative affect, and smoking for stimulation were also associated with these variables.

CONCLUSION: The overall findings suggest that waterpipe smokers exhibit many of the same features of nicotine dependency attributed to cigarette smokers.
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Keywords: Egypt; FTND; RFS; nicotine dependence; waterpipe smoking

Document Type: Research Article

Affiliations: 1: Department of Community, Environmental and Occupational Health, Ain Shams University, Cairo, Egypt 2: Department of Public Health, Cairo University, Cairo, Egypt; and International Union Against Tuberculosis and Lung Disease, Union Middle East, Cairo, Egypt 3: Department of Oncology, Lombardi Cancer Center, Georgetown University, Washington DC, USA 4: Department of Epidemiology and Preventive Medicine, School of Medicine, University of Maryland, Baltimore, Maryland, USA 5: Department of Community, Environmental and Occupational Health, Ain Shams University, Cairo, Egypt; deceased

Publication date: 01 January 2012

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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