Adding to the growing body of evidence that water pipe tobacco smoking supports nicotine/tobacco dependence will be important (Hammal, Mock, Ward, Eissenberg, & Maziak, 2008; Salameh, Waked, & Aoun, 2008). One potentially counterintuitive selleck compound observation was that��compared with those who believe the addictive potential to be similar between cigarettes and water pipe��those believing water pipe to be more addictive than cigarettes were more likely to be water pipe smokers (Figure 2). This observation may reflect the personal experience of water pipe tobacco smokers who have indeed found it to be addictive. Qualitative investigations may be valuable to investigate this issue. Although the demographics of our sample approximate those of our target population in terms of key variables, such as age, gender, and income, we did not collect demographic data on nonparticipants.

Thus, our sampling strategy limits the external generalizability of this study. Future studies should assess populations representative of the nation as a whole in order to include the nonuniversity population. Additionally, because of the cross-sectional nature of our data, we cannot infer causality. For example, although those who believe water pipe tobacco smoking to be nonharmful may subsequently begin using a water pipe, the nature of our data could also support alternative interpretations, such as the idea that once people begin to smoke tobacco using a water pipe they hear from friends with whom they smoke that the water pipe is not harmful.

Despite these limitations, this study offers a first look at national data related to water pipe smoking in Jordanian university students and suggests that ever use and use at least monthly are very high (~60% and 40%, respectively)��and even higher than cigarettes. It further suggests that use is widespread across a spectrum of sociodemographic variables but does seem to be concentrated among men and the upper middle income bracket. Surveillance, further research, and educational interventions emphasizing the harm and addictiveness of water pipe tobacco smoking may be highly valuable in Jordan. Funding This work was supported by the National Institutes of Health (R03-TW008371 to OK and MA; R03-TW008371, R01-CA120142, and R01-DA024876 to TE; and K07-”type”:”entrez-nucleotide”,”attrs”:”text”:”CA114315″,”term_id”:”34967622″CA114315 to BP) and the Deanship of Research at Jordan University of Science and Technology (129/2008 to OK and MA).

Declaration of Interests None declared. Acknowledgments The authors thank Dr. Amjad AlNasser for his help with initial data processing and Cilengitide Ms. Enas Jaradat for her help with data collection.
During abstinence, smokers experience deficits in cognition and sensorimotor processing that may contribute to relapse (Hughes, 2007; Jacobsen et al., 2005; Mendrek et al.