This study aims to investigate the relationship between waterpipe smoking, polycythaemia and cardiac risk factors, including blood pressure and obesity.

Cross-sectional Study conducted in 2022.

An-Najah National University (ANNU) in the West Bank, Palestine.

A total of 954 university students participated in the study.

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.

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

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.