Linda Weglicki

Comparison of cigarette and water-pipe smoking by Arab and non-Arab-American youth.

BACKGROUND Water-pipe smoking is a rapidly growing form of tobacco use worldwide. Building on an earlier report of experimentation with cigarette and water-pipe smoking in a U.S. community sample of Arab-American youth aged 14-18 years, this article examines water-pipe smoking in more detail (e.g., smoking history, belief in harmfulness compared to cigarettes, family members in home who smoke water pipes) and compares the water-pipe-smoking behaviors of Arab-American youth with non-Arab-American youth in the same community. METHODS A convenience sample of 1872 Arab-American and non-Arab-American high school students from the Midwest completed a 24-item tobacco survey. Data were collected in 2004-2005 and analyzed in 2007-2008. RESULTS Arab-American youth reported lower percentages of ever cigarette smoking (20% vs 39%); current cigarette smoking (7% vs 22%); and regular cigarette smoking (3% vs 15%) than non-Arab-American youth. In contrast, Arab-American youth reported significantly higher percentages of ever water-pipe smoking (38% vs 21%) and current water-pipe smoking (17% vs 11%) than non-Arab-American youth. Seventy-seven percent perceived water-pipe smoking to be as harmful as or more harmful than cigarette smoking. Logistic regression showed that youth were 11.0 times more likely to be currently smoking cigarettes if they currently smoked water pipes. Youth were also 11.0 times more likely to be current water-pipe smokers if they currently smoked cigarettes. If one or more family members smoked water pipes in the home, youth were 6.3 times more likely to be current water-pipe smokers. The effects of ethnicity were reduced as a result of the explanatory value of family smoking. CONCLUSIONS Further research is needed to determine the percentages, patterns, and health risks of water-pipe smoking and its relationship to cigarette smoking among all youth. Additionally, youth tobacco prevention/cessation programs need to focus attention on water-pipe smoking in order to further dispel the myth that water-pipe smoking is a safe alternative to cigarette smoking.

Predictors of Arab American Adolescent Tobacco Use

This study examined personal, psychosocial, sociocultural, and environmental predictors in tobacco use for 1,671 Arab American adolescents. Cigarette smoking in the past 30 days was 6.9%. This increased from 1% at age 14 to 14% at age 18. Twenty-nine percent of the youths reported having ever smoked cigarettes. Experimentation with narghile was 27%; it increased from 23% at 14 years to 40% at 18 years. All trends were significant (p < .001). Logistic regression analyses found 11 predictors for having smoked a cigarette in the past 30 days and 9 and 7 predictors, respectively, for having ever smoked a cigarette or the narghile. Tobacco use by friends and family members was the strongest predictor of cigarette and narghile smoking. Narghile use supported cigarette smoking.

Intervention Effects on Tobacco Use in Arab and Non-Arab American Adolescents

A quasi-experimental design was used to test a modified Project Towards No Tobacco (TNT) use program on cigarette smoking in 380 Arab American and 236 non-Arab American 9th graders in the Midwest. Tenth grade Non-Arab American students given the intervention as 9th graders were 23% less likely to experiment (Odds Ratio=1.31, 95% CI: 1.05, 1.64) or to have smoked cigarettes in the past 30 days (Odd Ratio=1.43 times, 95% CI: 1.03, 2.01) compared to Arab American youth. Arab American students reported greater experimentation with water pipe smoking than cigarettes (38% vs. 22%), and more current (16% vs. 6%) and regular (7% vs. 3%) use of water pipes than cigarettes, respectively. The intervention designed to focus on cigarette smoking had non-significant effects on water pipe smoking. These findings provide support for a school-based intervention revised to focus on prevention as well as cessation and to be culturally consistent. They also call for further research and intervention tailoring to address the problem of water pipe smoking in a growing Arab American adolescent population.

eHealthSmart®: Designing personalized e-technology to reduce health disparities on urban adult populations

This interdisciplinary study (information science, nursing, business, engineering, and gerontology) focuses on the design and development of personalized eHealthSmart®, an information system specific to smoking cessation, health diet, and exercise. In designing and developing eHealthSmart® we adopted theoretical frameworks of Kolb Learning-Style Inventory and Davis Technology Acceptance Model. The system was built using ColdFusion scripting language, MySQL database, running at the Linux platform. It is clear from our pilot test that urban older adults have access, are comfortable, and willing to participate in educational programs that use personalized eHealth programs.