TY - JOUR T1 - Waterpipe smoking in Lebanese women: A lower prevalence but a higher risk of dependence JF - European Respiratory Journal JO - Eur Respir J VL - 38 IS - Suppl 55 SP - p4213 AU - Salameh, Pascale AU - Khayat, Georges AU - Waked, Mirna Y1 - 2011/09/01 UR - http://erj.ersjournals.com/content/38/Suppl_55/p4213.abstract N2 - Introduction: Waterpipe smoking has gained in popularity among Lebanese women. Our objective was to evaluate whether nicotine dependence is higher in smoking women compared with men.Methods: Data were taken from a cross-sectional study on Lebanese residents aged 40 years and above. After an oral informed consent, subjects answered a questionnaire, including smoking history, cigarette and waterpipe dependence using validated dependence questionnaires (Fagerström for cigarettes and LWDS-11 for waterpipe).Results: 1066 males and 1134 females were interviewed; respectively, 58.7% and 42.9% of them had ever smoked cigarettes, while 6.9% versus 6.7% had ever smoked waterpipe (p&lt;0.001). Similar results were found for actual and previous smokers. However, when looking at dependence, patterns differed between genders: 57.5% vs 49.1% in cigarette smokers (p=0.041), 35.9% vs 51.6% in waterpipe smokers (p=0.076), and 67.9% vs 43.6% in mixed smokers. These results were confirmed by dependence dose-effect relationship (p=0.05 for trend) and multivariate analysis (ORa=2.28). The main components of waterpipe dependence in women were positive and negative reinforcement (p&lt;0.05), but not nicotine dependence or psychological craving. In female waterpipe smokers, a higher prevalence of respiratory disease and symptoms were found.Discussion and conclusion: Since tobacco dependence seems highly associated with tobacco related diseases, waterpipe smoking women could be at a higher risk of disease; they should be considered as real smokers, and receive particular attention during tobacco related health education and in smoking cessation treatments. ER -