Prevalence of Hookah smoking and associated factors among male high school students in Iraq.

Abstract

Background The use of the hookah-smoking device is increasing at a large scale in the Eastern Mediterranean region and reaching to Western countries. Hookah smoke users are exposed to a lot of chemical compounds and several chronic diseases. The purpose of this study was to determine the prevalence of hookah use among male high school students and to study different associated factors linked with hookah smoking and provide tobacco control officials an understanding of this public health problem.Methods A descriptive cross-sectional study was conducted among students in three high schools in Al-Karkh District, Baghdad. The study period was from Oct. 2017 till Jan. 2019 and included 847 male students aged 15–18 years old. A convenient non-probability sampling within one of the two districts in Baghdad was selected to be place of study. Descriptive, chi-square test of significance, bivariate and multivariate logistic regression analysis of data was carried out for identifying risk factors associated with hookah smoking among high school adolescence.Results The overall prevalence of hookah smoking among high school male students was high (46.1%). More than two-thirds (70.6%) of them think that hookah smoking is acceptable socially more than cigarette smoking. Hearing first about it from friends, the media and presence of a café for hookah near residence were found to be significantly associated (p > 0.05) with hookah smoking among students. Similarly, having friends surrounding students who used hookah were found to be significantly associated with hookah smoking among students. Among hookah smokers, they were less likely to say it is forbidden in Islam and more likely to say it is allowed in Islam than non-hookah users.Conclusions Hookah smoking is high among high school students and becoming a socially acceptable behavior. Social and religious factors play a role in that. Family members, relatives and peers have an important role in prevention of hookah smoking among these students. Teenage students need to be educated about hookah effects on their health.