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2014 ; 142
(ä): 307-13
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Determinants of waterpipe smoking initiation among school children in Irbid,
Jordan: a 4-year longitudinal analysis
#MMPMID25060962
McKelvey K
; Attonito J
; Madhivanan P
; Jaber R
; Yi Q
; Mzayek F
; Maziak W
Drug Alcohol Depend
2014[Sep]; 142
(ä): 307-13
PMID25060962
show ga
OBJECTIVE: Guided by the Attitude-Social influence-self Efficacy (ASE) theory,
this study identified predictors of waterpipe (WP) smoking initiation in a WP
naïve cohort of Jordanian school children. METHODS: A school-based cohort of all
7th grade students (N=1781) in 19 of 60 schools in Irbid, Jordan, was followed
from 2008 to 2011. Generalized linear mixed modeling was used to examine
predictors of WP initiation among WP-naïve students (N=1243). RESULTS: During the
3-year study, WP initiation was documented in 39% of boys and 28% of girls. Prior
cigarette smoking (boys: odds ratio 7.41; 95% confidence interval 4.05-12.92 and
girls: 8.48; 4.34-16.56) and low WP refusal self-efficacy (boys: 26.67;
13.80-51.53 and girls: 11.49; 6.42-20.55) were strongly predictive of initiating
WP. Boys were also more likely to initiate WP smoking if they had siblings (2.30;
1.14-4.64) or teachers (2.07; 1.12-3.84) who smoked and girls if they had friends
(2.96; 1.59-5.54) who smoked. CONCLUSION: There is a sizeable incidence of WP
initiation among students of both sexes. These findings will help in designing
culturally responsive prevention interventions against WP smoking.
Gender-specific factors, refusal skills, and cigarette smoking need to be
important components of such initiatives.