Waterpipe dependence in university students and effect of normative beliefs: a cross-sectional study

Objectives The objective of this study was to measure the correlates, including normative beliefs, associated with waterpipe (WP) and cigarette smoking prevalence and dependence. Setting A cross-sectional study was carried out using a proportionate cluster sample of Lebanese students in 17 public and private universities. Participants Of the 4900 distributed questionnaires, 3384 (69.1%) were returned to the field worker. All available students during break times were approached, with no exclusion criteria. Primary and secondary outcome measures sociodemographic variables, detailed active and passive smoking, in addition to items of the tobacco dependence scales were all evaluated. Results Correlates to WP smoking were studying in a private university (adjusted OR, aOR=1.50 (1.26 to 1.79); p 1; p Conclusions In conclusion, WP smoking and dependence are influenced by parents’ and friends’ opinions, and idols’ smoking status. Future research is necessary to further improve our understanding of motives for WP smoking and dependence.