Characterizing the Development and Trajectories of Nicotine Dependence Among a Cohort of Adolescent Waterpipe and Cigarette Smokers

Abstract

Nicotine dependence (ND) is the fundamental reason that people persist in using tobacco products, which kill more than eight million people every year globally. So far, ND research has primarily focused on cigarettes, yet for many youths worldwide, tobacco use, and addiction is maintained by means other than the cigarette including waterpipe (WP) smoking (a.k.a. hookah). It is important to better understand the WP-associated ND trajectories given its unique use features that can influence ND development such as its time-consuming preparation and consumption, intermittent use, and strong sensory and social cues. Hence, using data from 8 waves (2015-2020) of the Waterpipe Dependence in Lebanese Youth (WDLY) study, this pioneer research compared the development of ND symptoms and their predictors among adolescent current (past 30 days) WP (n=283) and cigarette (n=146) smokers. Also, we identified ND trajectories from early to late adolescence in current WP smokers and examine baseline correlates by each identified trajectory. We evaluated the initial ND symptoms using the Hooked on Nicotine Checklist (HONC) and the full syndrome of ND using the International Classification of Diseases-10th revision (ICD-10 ND).