title: The determinants of intention to smoke waterpipe among adolescents in Lebanon: a national household survey.
abstract: BACKGROUND
  The phenomenon of waterpipe smoking (WPS) among adolescents has become eminent, and it is especially prevalent in Lebanon. Unlike cigarette smoking, WPS is parentally and socially acceptable. This study aims at examining the association between intention to smoke waterpipe in the next 6 months, and knowledge, attitudes and parental and social influences.
  
  
  METHODS
  This is a secondary data analysis from a national survey in 2007 on 1028 households. This study addresses 258 non-smoking adolescents and their parents. Consent was sought and the study was approved by the Institutional Review Board at the American University of Beirut. Face-to-face interviews were conducted. Descriptive analysis, crude and adjusted odds ratios (ORs) were generated.
  
  
  RESULTS
  At the bivariate level, late adolescence, mothers without university education, prior adolescents' WPS experiences, best friends' and parents' WPS habits and adolescents' and parents' lower attitude scores were associated with smoking intention. In the adjusted model, adolescents' beliefs about positive effects, best friends' similar habits and prior smoking remained significant (respective ORs [95% confidence interval ]: 1.81 [1.33-2.45], 2.51 [1.24-5.10], 4.91 [2.35-10.36]). Parents' perceived attitude against smoking was protective (OR: 0.57 [0.39-0.83]).
  
  
  CONCLUSIONS
  Adolescents' intention to smoke is highly influenced by parents' permissive attitudes and peer pressure. Interventions targeting these two groups and limiting access to smoking by adolescents should be instigated.
authors: Ludwig Maximilian Universität, München, Germany.
authors: Claudia
authors: C
authors: Schröder
authors: Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, PO Box 11-0236, Riad El Solh, Beirut 1107 2020, Lebanon.
authors: Monique
authors: M
authors: Chaaya
authors: Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, PO Box 11-0236, Riad El Solh, Beirut 1107 2020, Lebanon.
authors: Dahlia
authors: D
authors: Saab
authors: Weill Cornell Medical College, Doha, Qatar.
authors: Ziyad
authors: Z
authors: Mahfoud
mesh_terms: D000293:Adolescent; D000367:Age Factors; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033182:Intention; D007407:Interviews as Topic; D007861:Lebanon; D008297:Male; D010290:Parents / Q000523:psychology; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires
keywords: Lebanon; adolescence; attitudes; intention to smoke; parental influence; peer influence; tobacco; waterpipe smoking