Waterpipe Tobacco Smoking Prevalence and Associated Factors in the Southeast of Iran

Document Type : Original Article(s)

Authors

1 Assistant Professor, HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran

2 Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran

3 PhD Student, Cancer Research Center, Institute of Cancer, Tehran University of Medical Sciences, Tehran, Iran

4 Assistant Professor, Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran

Abstract

Background: Waterpipe smoking is a growing public health threat worldwide. The aim of this study was to assess waterpipe smoking prevalence and its associated factors among Iranian adults.Methods: This cross-sectional study was conducted in Kerman, Iran, recruiting 1090 adult participants using multistage sampling in 2016. A self-reported researcher-designed questionnaire was used. The socio-demographic characteristics and waterpipe smoking behaviors such as pattern, duration, and the most common place of waterpipe use, the type of tobacco, and the concurrent use of alcohol and substances were assessed. Data analyses were performed using chi-square, independent t-test, and multiple logistic regression.Findings: The prevalence of ever, current and daily waterpipe smoking were 43.8%, 28.8%, and 7.2%, respectively. Men initiated to use waterpipe in more early ages than women (P < 0.001). Café or restaurant (34.4%) and friends' house (36.8%) were the most frequent places for waterpipe using by men and women, respectively. Men used waterpipe 2.8 times more frequently than women. Waterpipe smoking was 4.9 times more likely in the 18-24 years age range compared to the 45 years or older. Waterpipe use was 2.4 times greater in the unemployed than in housewives. People with a university education were 1.4 and 1.7 times more likely to use waterpipe compared to people with high school diploma and illiterates, respectively.Conclusion: The present study revealed that men, high level of education, younger age and unemployment were associated with waterpipe smoking. Therefore, we need to design and implement more effective interventions, especially for vulnerable target groups.

Keywords


  1. Scurry WC Jr, Stack BC Jr. Role of metalloproteins in the clinical management of head and neck squamous cell carcinoma. Head Neck 2007; 29(12): 1144-55.
  2. Rautelin HI, Oksanen AM, Veijola LI, Sipponen PI, Tervahartiala TI, Sorsa TA, et al. Enhanced systemic matrix metalloproteinase response in Helicobacter pylori gastritis. Ann Med 2009; 41(3): 208-15.
  3. Nagase H, Woessner JF Jr. Matrix metalloproteinases. J Biol Chem 1999; 274(31): 21491-4.
  4. Fink K, Boratynski J. The role of metalloproteinases in modification of extracellular matrix in invasive tumor growth, metastasis and angiogenesis. Postepy Hig Med Dosw (Online) 2012; 66: 609-28.
  5. Stamenkovic I. Extracellular matrix remodelling: The role of matrix metalloproteinases. J Pathol 2003; 200(4): 448-64.
  6. Egeblad M, Werb Z. New functions for the matrix metalloproteinases in cancer progression. Nat Rev Cancer 2002; 2(3): 161-74.
  7. Torii A, Kodera Y, Uesaka K, Hirai T, Yasui K, Morimoto T, et al. Matrix metalloproteinase 9 in human plasma has 96% specificity and 56% sensitivity for gastric cancer screening. Int J Clin Oncol 1996; 1(1): 39-43.
  8. Nakamura T, Ebihara I, Shimada N, Koide H. Effect of cigarette smoking on plasma metalloproteinase-9 concentration. Clin Chim Acta 1998; 276(2): 173-7.
  9. Lim S, Roche N, Oliver BG, Mattos W, Barnes PJ, Chung KF. Balance of matrix metalloprotease-9 and tissue inhibitor of metalloprotease-1 from alveolar macrophages in cigarette smokers. Regulation by interleukin-10. Am J Respir Crit Care Med 2000; 162(4 Pt 1): 1355-60.
  10. Xu M, Scott JE, Liu KZ, Bishop HR, Renaud DE, Palmer RM, et al. The influence of nicotine on granulocytic differentiation-inhibition of the oxidative burst and bacterial killing and increased matrix metalloproteinase-9 release. BMC Cell Biol 2008; 9: 19.
  11. Khademi H, Malekzadeh R, Pourshams A, Jafari E, Salahi R, Semnani S, et al. Opium use and mortality in Golestan Cohort Study: Prospective cohort study of 50,000 adults in Iran. BMJ 2012; 344: e2502.
  12. Masjedi MR, Naghan PA, Taslimi S, Yousefifard M, Ebrahimi SM, Khosravi A, et al. Opium could be considered an independent risk factor for lung cancer: A case-control study. Respiration 2013; 85(2): 112-8.
  13. Naghibzadeh Tahami A, Khanjani N, Yazdi Feyzabadi V, Varzandeh M, Haghdoost AA. Opium as a risk factor for upper gastrointestinal cancers: A population-based case-control study in Iran. Arch Iran Med 2014; 17(1): 2-6.
  14. Rodrigo JP, Dominguez F, Suarez V, Canel M, Secades P, Chiara MD. Focal adhesion kinase and E-cadherin as markers for nodal metastasis in laryngeal cancer. Arch Otolaryngol Head Neck Surg 2007; 133(2): 145-50.
  15. Schneider GB, Kurago Z, Zaharias R, Gruman LM, Schaller MD, Hendrix MJ. Elevated focal adhesion kinase expression facilitates oral tumor cell invasion. Cancer 2002; 95(12): 2508-15.
  16. Field JK, Spandidos DA, Malliri A, Gosney JR, Yiagnisis M, Stell PM. Elevated P53 expression correlates with a history of heavy smoking in squamous cell carcinoma of the head and neck. Br J Cancer 1991; 64(3): 573-7.
  17. Christopoulos TA, Papageorgakopoulou N, Theocharis DA, Mastronikolis NS, Papadas TA, Vynios DH. Hyaluronidase and CD44 hyaluronan receptor expression in squamous cell laryngeal carcinoma. Biochim Biophys Acta 2006; 1760(7): 1039-45.
  18. Hashimoto T, Uchida K, Okayama N, Imate Y, Suehiro Y, Hamanaka Y, et al. Association of matrix metalloproteinase (MMP)-1 promoter polymorphism with head and neck squamous cell carcinoma. Cancer Lett 2004; 211(1): 19-24.