Waterpipe smoking, internet addiction and depression: A public health problem trio?

Abstract

Waterpipe smoking and Internet addiction may result in a new public health problem globally. This study aimed to explore waterpipe use among a large group of adolescents and its association with Internet use, mental health, primarily depression and their demographic characteristics. Using a stratified random sampling method, 2054 tertiary school students aged 14-18years were recruited in 2019. Demographical information and use of tobacco products (eg, waterpipe) were explored and compared with severity of Internet addiction and mental status. A total of 288 (14.0%) adolescents had ever used waterpipe. Multivariate logistic regression analyses suggested that being male (OR=2.55 and 95% CI=1.98-3.30; P=.0001), being depressed (OR=1.62 and 95% CI=1.24-2.11) and excessive Internet use (OR=1.94 and 95% CI=1.50-2.52; P=.0001) were significantly associated with waterpipe use. Family income and parents' educational status showed no relationship with waterpipe smoking. We suggest that adolescents who are depressed and who use the Internet excessively are at an increased risk for waterpipe use, independent of income and parenteral education.