Vol. 17, No. 6, 2008
Issue release date: October 2008
Open Access Gateway
Med Princ Pract 2008;17:435–439
(DOI:10.1159/000151563)
Original Paper
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Prevalence of Waterpipe Smoking among Rural Pregnant Women in Southern Iran

Mirahmadizadeh A.a · Nakhaee N.b
aDepartment of Epidemiology, Shiraz University of Medical Sciences, Shiraz, bKerman Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran
email Corresponding Author


 goto top of outline Key Words

  • Pregnancy
  • Waterpipe
  • Low birth weight
  • Risk factor
  • Iran

 goto top of outline Abstract

Objective: To estimate the prevalence of waterpipe smoking among rural pregnant women in Southern Iran and to identify the impact of maternal waterpipe smoking on baby’s birth weight. Subjects and Methods: A population-based survey was conducted in rural areas of Southern Iran in 2004 using existing health records and interviewing all mothers during the 10 days after delivery. Maternal exclusion criteria included cigarette smoking during pregnancy, a history or occurrence of epilepsy, diabetes and hypertension (gestational and/or essential) during pregnancy, factors that have been proved to have detrimental effects on birth weight. Results: Of the 2,808 mothers interviewed, 224 (8%) were waterpipe smokers of which 90 (3.2%) and 134 (4.8%) were occasional (smoking less than once per day) and daily (at least once per day) smokers, respectively. Six hundred and seventy-four (24%) were passively exposed to waterpipe smoke during pregnancy and 322 (11.5%) were exposed to second-hand cigarette smoke. Mothers who started smoking during the first trimester had lower birth weight babies (3,215 ± 612 g) compared to those who started smoking during the second or third trimesters (3,447 ± 550 g, p = 0.04). Conclusion: Waterpipe smoking during pregnancy is prevalent in Southern Iran and appears to be a risk factor for low birth weight babies.

Copyright © 2008 S. Karger AG, Basel


 goto top of outline References
  1. World Health Organization (Tobacco Free Initiative): Advisory Note. Waterpipe Tobacco Smoking: Health Effects, Research Needs and Recommended Actions by Regulators 2005. http://www.who.int/tobacco/global_interaction/tobreg/en/ (retrieved 1 July 2005).
  2. Knishkowy B, Amitai Y: Water-pipe (narghile) smoking: an emerging health risk behavior. Pediatrics 2005;116:e113–e119.
  3. Radwan GN, Mohamed MK, El-Setouhy M, Israel E: Review on waterpipe smoking. J Egypt Soc Parasitol 2003;33(3 suppl):1051–1071.
  4. Chaouachi K: A critique of the WHO TobReg’s ‘Advisory Note’ report entitled: ‘Waterpipe tobacco smoking: health effects, research needs and recommended actions by regulators’. J Negat Results Biomed 2006;5:17.
  5. Nuwayhid IA, Yamout B, Azar G, Kambris MA: Narghile (hubble-bubble) smoking, low birth weight, and other pregnancy outcomes. Am J Epidemiol 1998;148:375–383.
  6. Maziak W, Ward KD, Afifi Soweid RA, Eissenberg T: Standardizing questionnaire items for the assessment of waterpipe tobacco use in epidemiological studies. Public Health 2005;119:400–404.
  7. Bachir R, Chaaya M: Maternal smoking: determinants and associated morbidity in two areas in Lebanon. Matern Child Health J 2008;12:298–307.
  8. Tamim H, Yunis KA, Chemaitelly H, Alameh M, Nassar AH: Effect of narghile and cigarette smoking on newborn birthweight. BJOG 2008;115:91–97.
  9. Kirchengast S, Hartmann B: Nicotine consumption before and during pregnancy affects not only newborn size but also birth modus. J Biosoc Sci 2003;35:175–188.
  10. Kallen K: The impact of maternal smoking during pregnancy on delivery outcome. Eur J Public Health 2001;11:329–333.
  11. Majdzadeh SR, Zamani G, Kazemi SH: Barresie keifie avamele geraayeshe mardome hormozgan be estemaale Qalyan va raah haaye monasebe mobareze ba an (Qualitative survey on the factors affecting tendency to hookah in Hormozgan province and appropriate campaign methods against it). Hakim 2001;5:183–187.
  12. Shadpour K: Primary health care networks in the Islamic Republic of Iran. East Mediterr Health J 2000;6:822–825.
  13. World Health Organization: Guidelines for Controlling and Monitoring the Tobacco Epidemic. Geneva, WHO, 1998.
  14. Kramer MS: Determinants of low birth weight: methodological assessment and meta-analysis. Bull World Health Organ 1987;65:663–737.
  15. Shihadeh A: Investigation of mainstream smoke aerosol of the arghileh waterpipe. Food Chem Toxicol 2003;41:134–152.
  16. Shihadeh A, Saleh R: Polycyclic aromatic hydrocarbons, carbon monoxide, ‘tar’, and nicotine in the mainstream smoke aerosol of the narghile waterpipe. Food Chem Toxicol 2005;43:655–661.
  17. Maziak W, Ward KD, Afifi Soweid RA, Eissenberg T: Tobacco smoking using a waterpipe: a re-emerging strain in a global epidemic. Tob Control 2004;13:327–333.
  18. Mohammad K, Noorbala AA, Madjdzadeh R, Karimloo M: Ravande taghirate shoyoe estemale dokhaniat dar iran (1370–1378) bar asase do tarhe mellie salamat va bimari (Trend of smoking prevalence in Iran from 1991 to 1999 based on two National Health Surveys). Hakim 2000;4:290–297.
  19. Golshan M, Estekib, Dadvand P: Prevalence of chronic bronchitis and chronic respiratory symptoms in adults over the age of 35 years in Isfahan, Iran in 1998. Respirology 2001;6:231–235.
  20. Ahmadi J, Khalili H, Jooybar R, Namazi N, Mohammadagaei P: Prevalence of cigarette smoking in Iran. Psychol Rep 2001;89:339–341.
  21. Asfar T, Ward KD, Eissenberg T, Maziak W: Comparison of patterns of use, beliefs, and attitudes related to waterpipe between beginning and established smokers. BMC Public Health 2005;5:19.
  22. Wardlaw T, Blanc A, Zupan J, Ahman E: Low Birth Weight Country, Regional and Global Estimates. Geneva, The United Nations Children’s Fund and World Health Organization, 2004.
  23. Bernstein IM, Mongeon JA, Badger GJ, Solomon L, Heli SH, Higgins ST: Maternal smoking and its association with birth weight. Obstet Gynecol 2005;106:986–991.
  24. Desjardins E, Hardwick D: How many visits by health professionals are needed to make a difference in low birth weight? A dose-response study of the Toronto Healthiest Babies Possible Program. Can J Public Health 1999;90:224–228.

 goto top of outline Author Contacts

Nouzar Nakhaee
Kerman Neuroscience Research Center
Kerman University of Medical Sciences
Kerman (Iran)
Tel. +98 341 322 4613, Fax +98 341 211 1010, E-Mail nakhaeen@yahoo.com


 goto top of outline Article Information

Received: September 26, 2007
Revised: January 7, 2008
Published online: October 03, 2008
Number of Print Pages : 5
Number of Figures : 0, Number of Tables : 2, Number of References : 24


 goto top of outline Publication Details

Medical Principles and Practice (International Journal of the Kuwait University Health Sciences Centre)

Vol. 17, No. 6, Year 2008 (Cover Date: October 2008)

Journal Editor: Owunwanne A. (Kuwait)
ISSN: 1011–7571 (Print), eISSN: 1423–0151 (Online)

For additional information: http://www.karger.com/MPP


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