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. 2013 Jul 2:10:12.
doi: 10.1186/1477-7517-10-12.

Motives, beliefs and attitudes towards waterpipe tobacco smoking: a systematic review

Elie A Akl  1 , Mohammed Jawad, Wai Yim Lam, Christopher N Co, Rawad Obeid, Jihad Irani
Affiliations

Motives, beliefs and attitudes towards waterpipe tobacco smoking: a systematic review

Elie A Akl et al. Harm Reduct J. .

Abstract

Background: In spite of the negative health effects of waterpipe tobacco smoking, its use is becoming more common. The objective of this study is to systematically review the medical literature for motives, beliefs and attitudes towards waterpipe tobacco smoking.

Methods: We electronically searched MEDLINE, EMBASE, and the ISI the Web of Science in January 2012. We included both quantitative and qualitative studies. We selected studies and abstracted data using standard systematic review methodology. We synthesized data qualitatively.

Results: We included 58 papers reporting on 56 studies. The main motives for waterpipe tobacco smoking were socializing, relaxation, pleasure and entertainment. Peer pressure, fashion, and curiosity were additional motives for university and school students while expression of cultural identity was an additional motive for people in the Middle East and for people of Middle Eastern descent in Western countries. Awareness of the potential health hazards of waterpipe smoking was common across settings. Most but not all studies found that the majority of people perceived waterpipe smoking as less harmful than cigarette smoking. Waterpipe smoking was generally socially acceptable and more acceptable than cigarette smoking in general. In Middle Eastern societies, it was particularly more acceptable for women's use compared to cigarette use. A majority perceived waterpipe smoking as less addictive than cigarette smoking. While users were confident in their ability to quit waterpipe smoking at any time, willingness to quit varied across settings.

Conclusions: Socializing, relaxation, pleasure and entertainment were the main motives for waterpipe use. While waterpipe users were aware of the health hazards of waterpipe smoking, they perceived it as less harmful, less addictive and more socially acceptable than cigarette smoking and were confident about their ability to quit.

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Figures

Figure 1
Figure 1
Waterpipe device. Annotates of the different parts of the waterpipe device.
Figure 2
Figure 2
Study flow diagram. Shows the flow of the studies in the process of screening and selection.
See this image and copyright information in PMC

References

    1. Chaouachi K. The medical consequences of narghile (hookah, shisha) use in the world. Rev Epidemiol Sante Publique. 2007;55(3):165–170. doi: 10.1016/j.respe.2006.12.008. - DOI - PubMed
    1. Shihadeh A, Saleh R. Polycyclic aromatic hydrocarbons, carbon monoxide, "tar", and nicotine in the mainstream smoke aerosol of the narghile water pipe. Food Chem Toxicol. 2005;43(5):655–661. doi: 10.1016/j.fct.2004.12.013. - DOI - PubMed
    1. Akl EA, Gaddam S, Gunukula SK, Honeine R, Abou Jaoude P, Irani J. The effects of waterpipe tobacco smoking on health outcomes: a systematic review. Int J Epidemiol. 2010. p. . [Epub ahead of print] - PubMed
    1. Akl EA, Aleem S, Gunukula SK, Honeine R, Abou Jaoude P, Irani J. Survey instruments used in clinical and epidemiological research on waterpipe tobacco smoking: a systematic review. BMC Public Health. 2010;10:415. doi: 10.1186/1471-2458-10-415. - DOI - PMC - PubMed
    1. Lim BL, Lim GH, Seow E. Case of carbon monoxide poisoning after smoking shisha. Int J Emerg Med. 2009;2(2):121–122. doi: 10.1007/s12245-009-0097-8. - DOI - PMC - PubMed

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