Waterpipe use in adolescents in Northern Sweden: Association with mental well-being and risk and health behaviours

• Published in: Scandinavian Journal of Public Health
• Main Authors: Ramji, Rathi, Arnetz, Bengt B., Nilsson, Maria, Wiklund, Ywonne, Jamil, Hikmet, Maziak, Wasim, Arnetz, Judy
• Format: Article in Journal/Newspaper
• Language: English
• Published: SAGE Publications 2017
• Subjects: Public Health, Environmental and Occupational Health; General Medicine; Northern Sweden
• Online Access: http://dx.doi.org/10.1177/1403494817746534; http://journals.sagepub.com/doi/pdf/10.1177/1403494817746534; http://journals.sagepub.com/doi/full-xml/10.1177/1403494817746534

Aims: There is a lack of studies examining the association between waterpipe smoking and mental well-being among adolescents. This study sought to determine whether waterpipe smoking is associated with mental well-being and other risk and health behaviours in adolescents. Methods: A questionnaire was distributed to 1006 adolescents in grades 9–12 (with a response rate of >95%), containing questions on measures of stress, mental energy and sleep. In addition, the questionnaire assessed risk and health behaviours, including use of a waterpipe, cigarettes, e-cigarettes, snus, alcohol, narcotics, gambling and exercise. Logistic regression was used to assess factors associated with waterpipe use. Results: Thirty-seven per cent ( n=371) of the participants had used a waterpipe at some point. Waterpipe use was associated with lower mental energy (odds ratio [OR] = 0.90, 95% confidence interval [CI] 0.81–0.99), higher stress (OR = 1.10, 95% CI 1.02–1.20) and use of cigarettes (OR = 3.82, 95% CI 2.33–6.03), e-cigarettes (OR = 3.26, 95% CI 2.12–4.99), snus (OR = 2.29, 95% CI 2.12–4.99), alcohol (OR = 1.92, 95% CI 1.07–3.44) and narcotics (OR = 3.64, 95% CI 1.75–7.58). Waterpipe use was not significantly associated with gambling, exercise or sleep quality. Conclusions: Waterpipe use in adolescents is associated with worse mental well-being, as well as use of other nicotine products, alcohol and narcotics. Prospective studies are needed to delineate causal and temporal relationships further between waterpipe use and mental well-being and its relationship to other risky behaviours in order to design effective prevention programs.