Waterpipe Use Predicts Progression to Regular Cigarette Smoking Among Danish Youth

Abstract

Waterpipe smoking among Danish, Swedish, and German youth is increasing dramatically, indicating the emergence of a new health threat. This study assessed the association between waterpipe smoking and progression to regular cigarette smoking among Danish continuation school students during 2004–2005. All participants (N = 762) had smoked cigarettes on a nonregular basis at baseline. Among boys, waterpipe smoking frequency was predictive of being a regular cigarette smoker at follow-up eight months later. Further research should examine waterpipe smoking as a potential predictor of cigarette smoking. The study's limitations are noted.

RÉSUMÉ

L’usage de la pipe à eau est associé à la progression vers une consommation régulière de cigarettes parmis les jeunes Danois

L’usage de la pipe à eau parmis les jeunes Danois, Suedois et Allemands a augmenté dramatiquement, indiquant l’émergence d’une nouvelle menace pour la santé. Cette étude évalue l’association entre l’usage de la pipe à eau et la progression vers une consommation régulière de cigarettes parmis les lycéens Danois en internat. Tous les participants choisis comme reference (N = 762) avaient déjà fumé de manière non régulière dans le passé. Pour les garçons, la frequence à laquelle la pipe à eau était utilisée était prédictive de leurs progressions vers une consommation régulière de cigarettes cette derniere etant déterminée au cours d’un suivi huit mois après.

Des recherches supplémentaires devraient examiner l’usage de la pipe à eau en tant qu’indicateur potentiel de la consommation future de cigarettes. Les limitations de cette étude sont indiquées.

RESUMEN

Uso del narguile se asocia con la progresión al fumar cigarrillos regularmente entre los jóvenes daneses

El fenómeno de fumar el narguile está subiendo dramáticamente entre los jóvenes daneses, suecos y alemanes, lo cual indica la aparición de una nueva amenaza hacia la salud. Este estudio investiga la relación entre fumar de narguile y el aumento del consumo regular del cigarrillo entre los estudiantes de educación secundaria de Dinamarca. Todos los participantes de la investigación (N = 762) habían fumado cigarrillos de manera no regular.

Tras un seguimento de 8 meses se demostró que el uso del narguile entre los chicos predice un consumo regular de cigarrillos.

Futuras investigaciones deberán examinar el uso del narguile como potencial pronosticador del consumo de cigarrillos. Las limitaciones de la investigación están señaladas.

Keywords :

• waterpipe smoking
• cigarette progression
• addiction
• youth

THE AUTHORS

Poul D. Jensen, M.A., is a project manager, Adolescents & Smoking, at the Department of Prevention and Documentation, Danish Cancer Society. His work focuses on the development and evaluation of smoking prevention programs and digital cessation methods for adolescents. Recent focus has involved the increase of waterpipe smoking trying to understand this new smoking behavior among youth with an anthropological approach and to document relevant health problems.

Rikke Cortes, M.Sc., has been a statistician in the Documentation group at the Department of Prevention & Documentation, Danish Cancer Society, and has assisted with data administration and statistical analysis in the department. Presently, she is working with quality control in a big Danish pharmaceutical company.

Gerda Engholm, M.Sc., is a senior statistician and the head of the Documentation group at the Department of Prevention and Documentation, Danish Cancer Society. The group is secretariat for NORDCAN (www.ancr.nu), a database with information about cancer incidence, mortality, and prevalence in the Nordic countries with data from start of the Nordic cancer registries to the latest available. The group also assists with data administration, data cleaning, and statistical analysis in the department. Register-based research linking register information from the Danish Cancer registry, Statistics Denmark, and other sources for longitudinal studies has been a focus point throughout her career.

Dr. Stef P. J. Kremers is an associate professor at the Department of Health Promotion, Faculty of Health, Medicine and Life sciences, Maastricht University, The Netherlands. His Ph.D. studies aimed at understanding the process of smoking initiation among adolescents. His current research focus is on the systematic development, implementation and evaluation of comprehensive health promotion programs, primarily aimed at the prevention of obesity.

Mette Gislum is a statistician in the Documentation group at the Department of Prevention and Documentation, Danish Cancer Society, and assists with data administration and statistical analysis in the department. Her latest big project has been the statistical analysis in a Nordic collaboration project of trends in cancer survival in the Nordic countries.

Notes

1 The reader is reminded that the concepts of “gateway” and ‘gateway drugs” are often noted in the literature without adequately helping the reader to understand their dimensions (linear, non-linear), their “demands”, the critical necessary conditions (endogenously as well as exogenously; from a micro to a macro level) which are necessary for them to operate (begin, continue, become anchored and integrate, change as de facto realities change, cease, etc.) or not to and whether their underpinnings are theory-driven, empirically-based, individual and/or systemic stake holder- bound, based upon “principles of faith” or what. This is necessary to clarify if the term is not to remain as yet another shibboleth in a field in which labels are offered with a sense of certainty for uncertain complex processes. Editor's note