title: Factors related to frequency of narghile (waterpipe) use: the first insights on tobacco dependence in narghile users.
abstract: OBJECTIVE
  To evaluate factors related to level of narghile (waterpipe) use as a first step towards modeling tobacco dependence among narghile users.
  
  
  METHODS
  Cross sectional survey done in 2003 using interviewer-administered anonymous questionnaires.
  
  
  METHODS
  Cafes/restaurants serving narghiles in Aleppo, Syria.
  
  
  METHODS
  Narghile smokers (161 men and 107 women; mean age, 30.1 +/- 10.2, 161; age range, 18-68 years; response rate, 95.3%) randomly selected from the 17 cafes/restaurants sampled.
  
  
  METHODS
  Frequency of narghile use (daily, weekly, monthly) was assessed as a function of several factors potentially indicative of dependence, including situational characteristics (where, when, and with whom smoking occurs; seasonality of use, and sharing of narghile), attitudes, and experience with quitting narghile use, escalation of use over time, future intentions regarding use, perception of being "hooked" on narghile, and cognitions/behaviors engaged in to support use (carrying one's own narghile; think of narghile when it is not available; considering narghile for selection of cafes/restaurants).
  
  
  RESULTS
  Frequency of narghile use was strongly correlated with participant's subjective judgment of how hooked they are on narghile (coefficient, 0.5). Predictors of narghile use frequency according to multinomial logistic regression were: male gender, smoking mainly alone versus with others; smoking mainly at home versus outside; smoking more frequently since initiation, being hooked on narghile, carrying narghile, and considering it for cafe/restaurant choice.
  
  
  CONCLUSIONS
  Our data reveal two main domains of a tobacco dependence syndrome likely to be relevant to narghile; the first reflects the effects of nicotine contained in narghile tobacco, and is not very different from what is seen with other tobacco products, and the second is unique to narghile and is related mainly to its social dimension, with more intensive smokers showing an increasingly individual pattern of narghile smoking.
authors.affiliation: Syrian Center for Tobacco Studies, P.O. Box 16542, Aleppo, Syria. maziak@net.sy
authors.forename: W
authors.initials: W
authors.lastname: Maziak
authors.forename: K D
authors.initials: KD
authors.lastname: Ward
authors.forename: T
authors.initials: T
authors.lastname: Eissenberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000008:administration & dosage; D016017:Odds Ratio; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology*; D018709:Statistics, Nonparametric; D014029:Tobacco Use Disorder / Q000453:epidemiology* / Q000523:psychology*
chemical_list: D009538:Nicotine