Non-traditional tobacco smoking: An emerging risk in the West Bank among male Palestinians

Abstract

INTRODUCTION Non-traditional tobacco products, such as waterpipes and e-cigarettes, are perceived to be less harmful than cigarettes. The north of the West Bank has become the site for growing tobacco production and consumption. This study aimed to estimate the current prevalence of nontraditional tobacco smoking (waterpipes and e-cigarettes) and associated risk factors among men in the West Bank. METHODS In a cross-sectional study, a self-administered questionnaire was distributed among males aged ≥16 years in 2022 from the largest three governorates in the north of the West Bank (n=1241). Body mass index and waist circumferences were measured. RESULTS The final number of participants was 1204, aged 16-58 years; 58.9% were singles, 69.4% were young adults, 22.1% were adolescents, 67.5% were cigarette smokers (53.9% heavy smokers), 35.3% were waterpipe smokers, and 15% e-cigarette smokers. Adjusted logistic regression results revealed that risk factors associated with waterpipe smoking were e-cigarette smoking (AOR=3.29; 95% CI: 2.30-4.70), energy drink intake (AOR=1.62; 95% CI: 1.24-2.13), young adult age (AOR=2.15; 95% CI: 1.15-4.03), being a student without work (AOR=1.95; 95% CI: 1.09-3.50) or a working student (AOR=2.73; 95% CI: 1.32-5.65), and less likely to be associated with cigarette smoking (AOR=0.23; 95% CI: 0.18- 0.31). In addition, an increased likelihood of central obesity was associated with waterpipe smoking (AOR=2.15; 95% CI: 1.15-4.03) and decreased with coffee intake (AOR=0.44; 95% CI: 0.27-0.87). CONCLUSIONS Non-traditional tobacco smoking is an emerging hazard among male Palestinians, with waterpipe smoking linked to increased central obesity. Further research is needed to investigate the health consequences of this trend in the West Bank.