title: The relationship between waterpipe smoking and body weight: population-based findings from Syria.
abstract: BACKGROUND
  Cigarette smoking has well known effects on body weight, with current smokers weighing less than never-smokers, and cessation producing weight gain. Use of waterpipe (or "hookah") is increasing in many parts of the world but its effects on body weight are not known.
  
  
  METHODS
  We compared body mass index (BMI) among 2,536 adults (age ≥ 18 years old), who were never, former, current nondaily, or current daily waterpipe smokers, drawn from 2 representative, population-based household surveys of adults in Aleppo, Syria.
  
  
  RESULTS
  Overall, 84.1% (n = 2,134) never-smoked waterpipe, 4.6% (n = 116) were former smokers, 9.9% (n = 251) were current nondaily smokers, and 1.4% (n = 35) were current daily smokers. Mean BMI of the sample was 30.2 kg/m(2) (SD = 6.3). Adjusted for cigarette smoking, number of chronic diseases, age, gender, income, and marital status, daily waterpipe users were 2.26 BMI units greater than never-smokers (beta = 2.26, 95% CI = 0.79-3.72), and had nearly threefold odds of being obese (odds ratio = 2.87, 95% CI = 1.06-7.76). Nondaily and former waterpipe users were similar to never-smokers in terms of BMI and obesity risk.
  
  
  CONCLUSIONS
  Results indicate that daily waterpipe users, compared to never-users, have higher BMI, translating into 6 extra kilograms of weight on average, and are 3 times as likely to be obese.
authors.affiliation: School of Public Health, University of Memphis, Memphis, TN; Syrian Center for Tobacco Studies, Aleppo, Syria; kdward@memphis.edu.
authors.forename: Kenneth D
authors.initials: KD
authors.lastname: Ward
authors.affiliation: School of Public Health, University of Memphis, Memphis, TN;
authors.forename: SangNam
authors.initials: S
authors.lastname: Ahn
authors.affiliation: School of Public Health, University of Memphis, Memphis, TN; Syrian Center for Tobacco Studies, Aleppo, Syria;
authors.forename: Fawaz
authors.initials: F
authors.lastname: Mzayek
authors.affiliation: Syrian Center for Tobacco Studies, Aleppo, Syria;
authors.forename: Radwan
authors.initials: R
authors.lastname: Al Ali
authors.affiliation: Syrian Center for Tobacco Studies, Aleppo, Syria;
authors.forename: Samer
authors.initials: S
authors.lastname: Rastam
authors.affiliation: Syrian Center for Tobacco Studies, Aleppo, Syria; University of Miami Miller School of Medicine, Miami, FL;
authors.forename: Taghrid
authors.initials: T
authors.lastname: Asfar
authors.affiliation: Syrian Center for Tobacco Studies, Aleppo, Syria; American University of Beirut, Beirut, Lebanon;
authors.forename: Fouad
authors.initials: F
authors.lastname: Fouad
authors.affiliation: Syrian Center for Tobacco Studies, Aleppo, Syria; Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL.
authors.forename: Wasim
authors.initials: W
authors.lastname: Maziak
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D001835:Body Weight; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000503:physiopathology*; D016017:Odds Ratio; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology*; D013593:Syria / Q000453:epidemiology; D015430:Weight Gain
references.citation: Asian Pac J Cancer Prev. 2009 Jan-Mar;10(1):3-16
references.pmid: 19469617
references.citation: Int J Obes Relat Metab Disord. 2004 Aug;28(8):1091-6
references.pmid: 15197410
references.citation: Eur J Clin Nutr. 2010 Jan;64(1):16-22
references.pmid: 19654593
references.citation: N Engl J Med. 1991 Mar 14;324(11):739-45
references.pmid: 1997840
references.citation: NIDA Res Monogr. 1989;95:469-70
references.pmid: 2701319
references.citation: JAMA. 2013 Apr 24;309(16):1681-2
references.pmid: 23613067
references.citation: BMC Public Health. 2005 Feb 25;5:19
references.pmid: 15733316
references.citation: Prev Chronic Dis. 2009 Jan;6(1):A14
references.pmid: 19080020
references.citation: Public Health Nutr. 2012 Nov;15(11):2131-9
references.pmid: 22314203
references.citation: Tob Control. 2006 Jun;15 Suppl 1:i24-9
references.pmid: 16723671
references.citation: Am J Clin Nutr. 2008 Apr;87(4):801-9
references.pmid: 18400700
references.citation: Pharmacol Biochem Behav. 2005 Jan;80(1):173-9
references.pmid: 15652393
references.citation: J Clin Epidemiol. 2008 Jul;61(7):646-53
references.pmid: 18359190
references.citation: Diabetes Metab. 2008 Sep;34(4 Pt 1):307-14
references.pmid: 18468932
references.citation: Prev Control. 2006 Jun;2(2):85-94
references.pmid: 18040524
references.citation: Nicotine Tob Res. 2007 Dec;9(12):1339-46
references.pmid: 18058352
references.citation: Am J Epidemiol. 2003 Apr 15;157(8):701-11
references.pmid: 12697574
references.citation: Am J Public Health. 1987 Apr;77(4):439-44
references.pmid: 3493709
references.citation: Ann Epidemiol. 2007 Sep;17(9):713-20
references.pmid: 17553700
references.citation: BMJ. 2012 Jul 10;345:e4439
references.pmid: 22782848
references.citation: Neth Heart J. 2014 Mar;22(3):91-9
references.pmid: 24307377
references.citation: Obesity (Silver Spring). 2007 May;15(5):1311-8
references.pmid: 17495208
references.citation: Prev Med. 2006 May;42(5):348-53
references.pmid: 16504277
references.citation: J Diabetes. 2010 Jun;2(2):85-91
references.pmid: 20923489
references.citation: Int J Epidemiol. 1998 Dec;27(6):984-8
references.pmid: 10024192
references.citation: BMC Public Health. 2011 Apr 19;11:244
references.pmid: 21504559
references.citation: Tob Control. 2004 Dec;13(4):327-33
references.pmid: 15564614
references.citation: J Consult Clin Psychol. 1998 Dec;66(6):987-93
references.pmid: 9874912
references.citation: Soc Sci Med. 2013 Dec;98:125-34
references.pmid: 24331890
references.citation: J Consult Clin Psychol. 1997 Apr;65(2):286-91
references.pmid: 9086692
references.citation: J Obes. 2013;2013:291546
references.pmid: 24073332
references.citation: Int J Epidemiol. 2010 Jun;39(3):834-57
references.pmid: 20207606
references.citation: Epidemiol Rev. 2007;29:115-28
references.pmid: 17494056
references.citation: Am J Health Behav. 2010 May-Jun;34(3):275-85
references.pmid: 20001185
references.citation: J Epidemiol Community Health. 1989 Sep;43(3):228-33
references.pmid: 2607300
references.citation: Am J Prev Med. 2000 Apr;18(3):215-8
references.pmid: 10722987
references.citation: Psychol Bull. 1989 Sep;106(2):204-30
references.pmid: 2678202
references.citation: Addiction. 2011 Jan;106(1):188-96
references.pmid: 20925685
references.citation: Public Health. 2005 May;119(5):400-4
references.pmid: 15780328
references.citation: Nicotine Tob Res. 2007 Oct;9(10):987-94
references.pmid: 17943617
references.citation: Health Serv Res. 2006 Dec;41(6):2255-66
references.pmid: 17116119
references.citation: J Ambul Care Manage. 2005 Apr-Jun;28(2):102-10
references.pmid: 15923944
references.citation: Int J Tuberc Lung Dis. 2002 Mar;6(3):183-91
references.pmid: 11934135
references.citation: PLoS One. 2012;7(7):e39734
references.pmid: 22848361
references.citation: N Engl J Med. 1995 Nov 2;333(18):1165-70
references.pmid: 7565970
references.citation: Am J Health Behav. 2008 Jan-Feb;32(1):93-110
references.pmid: 18021037
references.citation: Drug Alcohol Depend. 2004 Oct 5;76(1):101-6
references.pmid: 15380294
references.citation: Int J Obes (Lond). 2005 Oct;29(10):1289-94
references.pmid: 15997244
references.citation: BMC Public Health. 2013 May 25;13:507
references.pmid: 23705638
references.citation: J Epidemiol Community Health. 1997 Jun;51(3):252-60
references.pmid: 9229053
references.citation: Int J Public Health. 2011 Dec;56(6):653-62
references.pmid: 21814848
references.citation: BMC Public Health. 2004 Aug 04;4:32
references.pmid: 15294023