The relationship between waterpipe smoking and body weight: Population-based findings from Syria

Kenneth D. Ward, Sang Nam Ahn, Fawaz Mzayek, Radwan Al Ali, Samer Rastam, Taghrid Asfar, Fouad Fouad, Wasim Maziak

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


Introduction: Cigarette smoking has well known effects on body weight, with current smokers weighing less than never-smokers, and cessation producing weight gain. Use of waterpipe (or "hookah") is increasing in many parts of the world but its effects on body weight are not known. Methods: We compared body mass index (BMI) among 2,536 adults (age ≥ 18 years old), who were never, former, current nondaily, or current daily waterpipe smokers, drawn from 2 representative, population-based household surveys of adults in Aleppo, Syria. Results: Overall, 84.1% (n = 2,134) never-smoked waterpipe, 4.6% (n = 116) were former smokers, 9.9% (n = 251) were current nondaily smokers, and 1.4% (n = 35) were current daily smokers. Mean BMI of the sample was 30.2 kg/m2 (SD = 6.3). Adjusted for cigarette smoking, number of chronic diseases, age, gender, income, and marital status, daily waterpipe users were 2.26 BMI units greater than never-smokers (beta = 2.26, 95% CI = 0.79-3.72), and had nearly threefold odds of being obese (odds ratio = 2.87, 95% CI = 1.06-7.76). Nondaily and former waterpipe users were similar to never-smokers in terms of BMI and obesity risk. Conclusion: Results indicate that daily waterpipe users, compared to never-users, have higher BMI, translating into 6 extra kilograms of weight on average, and are 3 times as likely to be obese.

Original languageEnglish (US)
Pages (from-to)34-40
Number of pages7
JournalNicotine and Tobacco Research
Issue number1
StatePublished - Jan 1 2015

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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