title: Assessment of tobacco dependence in waterpipe smokers in Egypt.
abstract: METHODS
  Waterpipe smoking is increasing worldwide. Nevertheless, little is known about nicotine dependence in tobacco smokers who use waterpipes.
  
  
  OBJECTIVE
  To assess evidence of dependence among non-cigarette smoking waterpipe smokers in Egypt.
  
  
  METHODS
  A total of 154 male exclusive  current waterpipe smokers were enrolled for the present study. We adapted the Fagerström test for nicotine dependence and the Reasons for Smoking (RFS) scales and related these to smoking behavior.
  
  
  RESULTS
  The mean age of the subjects was 47 ± 14 years, the mean age at smoking  initiation was 22 ± 9 years, and average daily consumption was 4 ± 8 hagars (tobacco units). The time to the first smoke of the day (P < 0.001), smoking even when ill (P = 0.003), time to tobacco craving (P < 0.001), and hating to give up the first  smoke of the day (P = 0.033) were each significantly associated with the number of hagars smoked per day. The RFS subscales of addictive smoking, smoking to relieve negative affect, and smoking for stimulation were also associated with these variables.
  
  
  CONCLUSIONS
  The overall findings  suggest that waterpipe smokers exhibit many of the same features of nicotine dependency attributed to cigarette smokers.
authors.affiliation: Department of Community, Environmental and Occupational Health, Ain Shams University, Cairo, Egypt. rahman_rehab@hotmail.com
authors.forename: R A
authors.initials: RA
authors.lastname: Auf
authors.forename: G N
authors.initials: GN
authors.lastname: Radwan
authors.forename: C A
authors.initials: CA
authors.lastname: Loffredo
authors.forename: M
authors.initials: M
authors.lastname: El Setouhy
authors.forename: E
authors.initials: E
authors.lastname: Israel
authors.forename: M K
authors.initials: MK
authors.lastname: Mohamed
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016739:Behavior, Addictive / Q000453:epidemiology* / Q000523:psychology; D004534:Egypt / Q000453:epidemiology; D005374:Filtration / Q000295:instrumentation; D006184:Habits; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D019570:Inhalation Exposure; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D014029:Tobacco Use Disorder / Q000453:epidemiology* / Q000523:psychology; D014867:Water; D055815:Young Adult; D014026:Nicotiana
chemical_list: D014867:Water