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Knowledge, attitudes, harm perception, and practice related to waterpipe smoking in Lebanon

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Abstract

Waterpipe smoking (WPS) is one of the most emerging popular trends in Lebanon, with a prevalence of 36.9%, the highest among all Middle Eastern countries. Thus, the primary objective of the study was to examine the factors associated with knowledge, attitudes, and practice (KAP) related to WPS among a representative sample of waterpipe smokers. The secondary objective was to examine the effect of KAP on cumulative waterpipe dose and dependence. This cross-sectional study was carried out between May and December 2018 and enrolled a representative sample of 1550 waterpipe smokers from all Lebanese districts. The questionnaire used was specifically designed for this study. High knowledge score (Beta = 0.02, p = 0.002) were significantly associated with higher waterpipe harm perception score. In addition, high knowledge score (Beta = 0.32, p = 0.007) were significantly associated with higher attitude score toward smoking ban. Higher waterpipe harm perception score (Beta = − 1.30, p < 0.001), higher attitude (Beta = − 0.21, p < 0.001), and higher knowledge score (Beta = − 0.11, p < 0.001) were significantly associated with lower waterpipe dependence. In addition, higher waterpipe dependence (Beta = 2.02, p < 0.001) was significantly associated with higher cumulative waterpipe smoking, while higher waterpipe harm perception score (Beta = − 1.96, p = 0.009) and higher knowledge score (Beta = 0.27, p < 0.001) were significantly associated with lower cumulative waterpipe smoking. Our main finding was that better knowledge and perception of the harmful effects of waterpipe were related to a better attitude toward smoking bans and a lower waterpipe smoking. Therefore, health care providers and policymakers should join efforts to make awareness campaigns across Lebanon and develop adequate interventions to curb the use of waterpipe among the population.

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Acknowledgments

This study acknowledges all participants who helped in this study.

Author information

Authors and Affiliations

  1. Research Department, Psychiatric Hospital of the Cross, P.O. Box 60096, Jall-Eddib, Lebanon

    Chadia Haddad

  2. INSERM, U1094, Tropical Neuroepidemiology, Limoges, France

    Chadia Haddad

  3. Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, University of Limoges, UMR 1094, GEIST, 87000, Limoges, France

    Chadia Haddad

  4. CH Esquirol, Department of Psychiatry, 87025, Limoges, France

    Chadia Haddad

  5. INSPECT-LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon

    Nathalie Lahoud, Marwan Akel, Hala Sacre, Souheil Hallit & Pascale Salameh

  6. Faculty of Pharmacy, Lebanese University, Beirut, Lebanon

    Nathalie Lahoud & Pascale Salameh

  7. CERIPH, Center for Research in Public Health, Pharmacoepidemiology Surveillance Unit, Faculty of Public Health, Lebanese University, Fanar, Beirut, Lebanon

    Nathalie Lahoud

  8. School of Pharmacy, Lebanese International University, Beirut, Lebanon

    Nathalie Lahoud & Marwan Akel

  9. Drug Information Center, Order of Pharmacists of Lebanon, Beirut, Lebanon

    Hala Sacre

  10. Laboratory of Pharmacology, Clinical Pharmacy and Quality Control of Drugs, Faculty of Pharmacy, Pôle Technologie-Santé (PTS), Faculty of Pharmacy, Saint-Joseph University, Beirut, 1107 2180, Lebanon

    Aline Hajj

  11. Faculty of Pharmacy, Saint-Joseph University, Beirut, 1107 2180, Lebanon

    Aline Hajj

  12. Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon

    Souheil Hallit

  13. Building 560, Street 8, Biakout, Lebanon

    Souheil Hallit

  14. Faculty of Medicine, Lebanese University, Beirut, Lebanon

    Pascale Salameh

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  1. Chadia Haddad
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  7. Pascale Salameh
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Correspondence to Chadia Haddad or Souheil Hallit.

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Haddad, C., Lahoud, N., Akel, M. et al. Knowledge, attitudes, harm perception, and practice related to waterpipe smoking in Lebanon. Environ Sci Pollut Res 27, 17854–17863 (2020). https://doi.org/10.1007/s11356-020-08295-1

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