Dual tobacco smoking is the new trend among adolescents: Update from the Irbid-TRY

The current study evaluated the prevalence and contributing factors to smoking styles, particularly cigarette (Cg) and waterpipe (Wp), and dual (combined Cg and Wp) smoking, in adolescents. Tobacco consumption pattern and style, and demographic and socioeconomic characteristics were obtained from all participants. A total of 2,407 adolescents participated, of which 57.6% consumed tobacco. The prevalence of dual was 30%, which was greater than Wp only (21.1%) and Cg only (6.7%). Additionally, male adolescents are more likely to smoke Cg only (OR = 2.15; 95%CI: 1.3/3.4; p = 0.001), Wp only (OR = 1.3; 95%CI: 1/1.8; p = 0.05), and dual (OR = 2.95; 95%CI: 2.2/3.9; p = 0.001). Adolescents in grade 10 were more likely to be dual smokers as compared to grades 7 (OR = 0.5; 95%CI: 0.3/0.7; p = 0.001) and 8 (OR = 0.5; 95%CI: 0.3/0.7; p = 0.001). The study indicates that gender and grade can predict smoking status with dual is most prevalent in older boys. The data also show that dual smoking exceeds combined Cg-only and Wp-only smoking. Compared with previous studies, we are witnessing an increase in dual consumption, while Wp only and Cg only are decreasing, suggesting a shift in adolescent smoking-style selections. Therefore, studies and cessation programs for adolescents, especially for dual smoking among older boys, are warranted. Additionally, studies are needed to examine the health effects of dual smoking among adolescents.