Assessment of perceptions and attitudes linked to water pipe and cigarette smoking in Lebanon

Abstract

Introduction Tobacco use is currently responsible for the death of about six million people across the world each year. Cigarette smoking accounts for the majority of tobacco attributed morbidity and mortality, and water pipe (WP) is gaining in popularity especially among the young population. The emerging trend of WP use can be attributed to many factors and research suggests that it is associated with health and dependence problems. Descriptive studies show some misconceptions and wrong beliefs among its users. The objective of this study is to asses some perceptions and attitudes linked to water pipe and cigarette smoking and to describe some contexts and patterns of WP use among Lebanese adults. Method This is a cross-sectional study conducted in Mount-Lebanon and Beirut Directorates through face-to-face interview on a random sample of adult population aged from 18 to 83 years. Data was collected using a piloted questionnaire containing sociodemographic information and dependence scales (Lebanese Cigarette Dependence LCD scale and the Lebanese Waterpipe Dependence Scale LWDS). Statistical analysis was performed using SPSS software version 23. Results were considered significant at P Results The prevalence of cigarette smoking was 36.9% and that of WP was 22.6%, while 6.1% reported smoking both. LCD scale showed 69.4% of cigarette smokers at high dependence level while 65.8% were highly dependent on WP according to LWDS. The studied contexts and patterns of WP use were evaluated according to the level of dependence and showed that WP smoking is a socializing method since smoking WP with friends and at the cafe showed higher rates among low and high dependence subgroups. Concerning harm perception, 84.9% of the population reported no decrease in harm when switching from cigarette to WP. But when comparing the two methods of smoking, 52.1% of the total sample believes that smoking WP is less harmful than cigarettes while 62.9% of highly dependent cigarette smokers have a different point of view. Concerning smoking acceptability, 56.1% of the population agreed on banning smoking. While upon comparison between subgroups, the majority of cigarette and WP smokers disagreed. Regardless of the smoking status (nonsmoker, cigarette or WP smoker) or the dependence level, people believe that WP is a safer method of smoking and that it is helpful to facilitate socializing. The majority agreed on banning smoking for minors but smoking in cafes is still considered “sacred”. Conclusion Smoking rates are reaching alarming levels especially WP smoking trend despite governmental action against smoking. WP is gaining popularity because of many factors including misconceptions about harm perception, ease of availability and many other factors. The different study subgroups showed different attitudes and perceptions. The dependence level plays an important role in some of the aspects. So there is an urgent need for a comprehensive national program to educate people about the harm of smoking especially that of WP and to reactivate the governmental actions and implementing policies against smoking.