title: Prevalence, social acceptance, and awareness of waterpipe smoking among dental university students: a cross sectional survey conducted in Jordan.
abstract: BACKGROUND
  Waterpipe tobacco smoking is increasing in popularity especially among young adults. This spread could be related to limited knowledge of the negative health effects of waterpipe smoking. In this study, prevalence, social acceptance, and awareness of waterpipe smoking were examined among dental university students.
  
  
  METHODS
  This is a cross-sectional survey study, where a self-administered questionnaire was completed by a sample of dental university students in Jordan.
  
  
  RESULTS
  Students (n=547) reported current tobacco use of 54.3% for males versus 11.1% for females (P<0.005). Among current smokers, 3.5% used only cigarettes (22.0% males, 2.3% females), 12.6% used only waterpipe (36.6% males, 88.6% females), and 6.9% used both (41.5% males, 9.1% females). Approximately, 70% of males and 42.5% of females who used waterpipe reported smoking mostly at a café. Nearly half of the females reported that they smoke at home in the presence of parents. Among participants, 33.3% of males and 62.5% of females reported indifferent parents' reaction regarding their waterpipe smoking. Approximately one third of students agreed with the statement that waterpipe smoking is less harmful to oral health than cigarette smoking. About 50-70% of students agreed that waterpipe smoking causes halitosis, delays wound healing time, is associated with dental implant failure, and increases the risk of dental decay.
  
  
  CONCLUSIONS
  In this sample, waterpipe tobacco smoking was more common than cigarette smoking among dental students, especially females. This could be an implication of social acceptance of waterpipe leading to its predominance, and thus, the gradual replacement of cigarette smoking with waterpipe smoking. Additionally, dental students' awareness about the harms of waterpipe is not optimal, and steps are needed to ensure providing such knowledge to students.
authors.affiliation: Department of Applied Dental Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan. saobeidat@just.edu.jo.
authors.forename: Suhair R
authors.initials: SR
authors.lastname: Obeidat
authors.forename: Omar F
authors.initials: OF
authors.lastname: Khabour
authors.forename: Karem H
authors.initials: KH
authors.lastname: Alzoubi
authors.forename: Arwa M
authors.initials: AM
authors.lastname: Mahasneh
authors.forename: Abdel Raheem M
authors.initials: AR
authors.lastname: Bibars
authors.forename: Yousef S
authors.initials: YS
authors.lastname: Khader
authors.forename: Amani
authors.initials: A
authors.lastname: Alsa'di
mesh_terms: D003430:Cross-Sectional Studies; D003710:Demography; D003813:Dentistry / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007597:Jordan / Q000453:epidemiology; D008297:Male; D009909:Oral Health; D015995:Prevalence; D012929:Psychological Distance; D012907:Smoking / Q000453:epidemiology*; D013337:Students, Medical / Q000706:statistics & numerical data*; D014495:Universities / Q000706:statistics & numerical data*; D055815:Young Adult; D014026:Nicotiana