{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T02:50:04Z","timestamp":1780455004945,"version":"3.54.1"},"reference-count":50,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T00:00:00Z","timestamp":1760918400000},"content-version":"unspecified","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,9,30]]},"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aims to investigate the relationship between waterpipe smoking, polycythaemia and cardiac risk factors, including blood pressure and obesity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional Study conducted in 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>An-Najah National University (ANNU) in the West Bank, Palestine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 954 university students participated in the study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>A questionnaire used to assess smoking behaviours and other substance practices and patterns. Anthropometric and clinical measurements were measured and recorded, and complete blood counts (CBC) were obtained using an automated haematology analyser. Descriptive statistics were used to characterise the sample. Logistic regression models were applied to assess associations between smoking and polycythaemia. Also, there is a link between polycythaemia and high systolic and diastolic blood pressure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Out of 954 participants, 60% were females, 18.5% smoked cigarettes (57.1% daily), 31.1% smoked waterpipes (20.5% daily), 6.5% smoked e-cigarettes (18.2% daily), 18.8% had polycythaemia and 17.6% were obese. After adjusting for gender, obesity and other confounders, waterpipe smoking was associated with polycythaemia (OR=1.70, p=0.023), male gender (OR=87.89, p&lt;0.001) and obesity (OR=3.82, p=0.014). Polycythaemia was associated with higher systolic blood pressure (OR=2.00, p=0.016) and higher diastolic blood pressure (OR=1.98, p=0.007).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The study findings indicated significant associations between high blood pressure and polycythaemia, tobacco smoking, obesity and male gender. These findings underscore the importance of addressing tobacco hazards and their potential impact on cardiometabolic health, particularly among young adults.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-093985","type":"journal-article","created":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T08:00:16Z","timestamp":1761033616000},"page":"e093985","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Association between waterpipe smoking, polycythaemia and cardiac risk factors among Palestinian university students: a cross-sectional study"],"prefix":"10.1136","volume":"15","author":[{"given":"Taima","family":"Younis","sequence":"first","affiliation":[{"name":"Department of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine, State of"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2289-0457","authenticated-orcid":false,"given":"Haya","family":"Hodali","sequence":"additional","affiliation":[{"name":"Department of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine, State of"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7863-2129","authenticated-orcid":false,"given":"Motaz","family":"Saifi","sequence":"additional","affiliation":[{"name":"Department of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine, State of"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sima","family":"Gharabeh","sequence":"additional","affiliation":[{"name":"An-najah National University Faculty of Medicine and Health Sciences, Nablus, Palestine, State of"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8242-391X","authenticated-orcid":false,"given":"Basma","family":"Damiri","sequence":"additional","affiliation":[{"name":"Drugs and Toxicology, An-najah National University Faculty of Medicine and Health Sciences, Nablus, Palestinian Territory, Occupied"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,10,20]]},"reference":[{"key":"2025120415072355000_15.10.e093985.1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/91.16.1365"},{"key":"2025120415072355000_15.10.e093985.2","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2020.02.47"},{"key":"2025120415072355000_15.10.e093985.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-7125(16)30356-X"},{"key":"2025120415072355000_15.10.e093985.4","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1016\/j.sjbs.2019.11.009","article-title":"Association between cigarette & shisha smoking and the severity of polycythemia: A cross sectional study","volume":"27","author":"AlQahtany","year":"2020","journal-title":"Saudi J Biol Sci"},{"key":"2025120415072355000_15.10.e093985.5","unstructured":"sciences AA-S journal of biological . 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