Shisha, pain detection threshold (Pdt), pain tolerance threshold (Ptt), Lebanon.


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Shisha smoking is a common method of tobacco smoking in the Mediterranean Region with prevalence ranging between 20% and 70%. Actually, shisha smoking is becoming increasingly popular method of tobacco smoking worldwide. Pain is a subjective experience influenced by genetic, developmental, familial, psychological, social and cultural variables. An increase in pain tolerance threshold (Ptt) ,which is defined as the highest intensity of painful stimulation that a tested subject is able to tolerate, was noticed with cigarette smoking. However, the relation between shisha smoking and pain detection threshold (Pdt), defined as the lowest intensity of a painful stimulus at which the subject perceives pain and pain tolerance threshold (Ptt) has not been studied. The purpose of this study was to determine the association between Pdt and Ptt in shisha smokers in Lebanon. A total of 400 participants from different areas in Lebanon were recruited of which 216 were non-smokers and 184 were shisha-smokers. The sphygmomanometer cuff technique was used to detect Pdt and Ptt. As a result, the mean age of these participants was 27.46 years (standard deviation=11.79). Shisha-smoker male participants represented 53.7% while female shisha-smokers presented 40.8%. Pdt and Ptt were significantly greater in shisha smokers than in non-smokers with P = 0.001 and P < 0.001 respectively. The mean number of heads of shisha smoked was 2.64 heads (standard deviation = 4.70). Both Pdt and Ptt are significantly increased in shisha smokers who smokes more heads of shisha per day with a p value of 0.031 and 0.002 respectively. However, in shisha smokers, the mean number of shisha smoking years was 2.68years (standard deviation = 5.22). Only Ptt significantly increased (P = 0.007) with more smoking years Moreover, Pdt and Ptt were both significantly higher (P < 0.001) in males than in females. One may conclude that shisha smokers have higher tolerance thresholds for pain than non-smokers.



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