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. 2018 Jan-Apr;25(1):13-19.
doi: 10.4103/jfcm.JFCM_3_17.

Factors contributing to the upsurge of water-pipe tobacco smoking among Saudi females in selected Jeddah cafés and restaurants: A mixed method study

Ola A Abdulrashid  1 , Omar Balbaid  2 , Adel Ibrahim  3 , Hassan B U Shah  3
Affiliations

Factors contributing to the upsurge of water-pipe tobacco smoking among Saudi females in selected Jeddah cafés and restaurants: A mixed method study

Ola A Abdulrashid et al. J Family Community Med. 2018 Jan-Apr.

Abstract

Background: Despite clear evidence indicating the health hazards of water tobacco smoking (WTS), there is a remarkable increase in the frequency of WTS in the Middle East and the Gulf region, particularly among young girls and women. The objective of this survey was to examine the prevalence of and the reasons for addiction to WTS and study in depth the factors contributing to the increased frequency of WTS among Saudi females.

Materials and methods: This study was conducted in different cafés and restaurants in Jeddah using a mixed method approach. A quantitative approach was carried out by a cross-sectional design, in which adult WTS Saudi females (n = 332) were selected from ten cafés. In addition, a qualitative approach was pursued involving five focus group discussions and three in-depth interviews of heavy smokers. Frequencies and percentages were calculated for the categorical variables, and Chi-square test and regression analysis were performed to establish association. Key themes were identified and built upon for the qualitative part.

Results: The mean age of female water-pipe (WP) smokers was 32.5 ± 11.9 years. Addicted to WTS were 39.6% of the women. Significant predictors of smokers' addiction to WTS according to regression analysis (p < 0.05) were increased frequency of WTS, perception that it improved mood, and insistence on carrying one's own WP to restaurants and cafés. Smoking frequency increased in pleasant weather (p = 0.025) and better mood (p = 0.033). This study showed that students and working women were more addicted to WTS (p < 0.001). Those who smoked daily preferred to smoke at home especially when alone (p < 0.001), while the preferred place for those who smoked weekly was restaurants in the company of their friends (p < 0.001). Most of the participants in this study believed that WTS was less harmful and less addictive than cigarette smoking. The only driving force to quit WTS was the effects on their beauty/skin.

Conclusion: WTS is a public health problem, especially among young girls. Peer pressure, view that it is a fashion symbol, carrying one's own WP and wrong belief that WP was less harmful, improved mood, and effect of the weather are main factors leading to unintentional dependency on WTS. The only driving force to stop WTS is the effect it has on beauty/skin. It is important to understand the reasons behind the upsurge of WTS in this group for appropriate policy for intervention for its prevention and cessation.

Keywords: Female smokers; hokkah; hooking; mo’assel; water tobacco smoking.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Frequency distribution of Water tobacco smoking by age
Figure 2
Figure 2
Water tobacco smoking (a) frequency and marital status (b) frequency and occupation
See this image and copyright information in PMC

References

    1. WHO Report on the Global Tobacco Epidemic: Warning about the Dangers of Tobacco. Global Tobacco Epidemic. 3rd ed. World Health Organization; 2011. [Last accessed on 2017 Jan 17]. Available from: http://www.who.int/tobacco/global_report/2011/en/
    1. Samet JM, Yoon SY. World Health Organization; 2010. [Last accessed on 2017 Feb 19]. Gender, Women and the Tobacco Epidemic. Available from: http://www.whqlibdoc.who.int/publications/2010/9789241599511_eng.pdf .
    1. Bowler S. Reducing Hookah use, a Public Health Challenge for 21st Century 2013. The BACCHUS Network. 2013. [Last accessed on 2017 Feb 19]. Available from: http://www.tobaccofreeu.org/pdf/HookahWhitePaper.pdf .
    1. Maziak W, Ward KD, Afifi Soweid RA, Eissenberg T. Tobacco smoking using a waterpipe: A re-emerging strain in a global epidemic. Tob Control. 2004;13:327–33. - PMC - PubMed
    1. Haseebullah MA. Smoking in Saudi Arabia and its control measures. Brit J Human Soc Sci. 2012;5:69–75.