Patterns, Beliefs, Norms and Perceived Harms of Hookah Smoking in North Iran

Document Type : Research Articles


1 Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran

2 Environmental Health Research Center, Golestan University of Medical Sciences, Gorgan, Iran

3 School of Health, Golestan University of Medical Sciences, Gorgan, Iran

4 Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

5 Public Health Department, School of Health, Qom University of Medical Sciences, Qom, Iran

6 Social Determinants of Health Research Center, Department of Health Education &Health Promotion, Health School, Birjand University of Medical Sciences, Birjand, Iran

7 Maraveh Tappeh Health Care Center, Maraveh Tappeh


Introduction: Hookah smoking is considered as a public health threat around the globe. The aim of this study was to investigatethe hookah smoking patterns, beliefs, norms and perceived harms in Golestan province of Iran. Methods: A cross-sectional study was conducted on 395 hookah smokers using convenience sampling method in 2015. To collect data, Heinz’s hookah patternwas utilized. Ordinal regression models were used to exploring of covariates related to the odds of life time, last-30-day, and current hookah use. Results: In general, 357 (90.4%) subjects were male smokers. Most of subjects smoked hookah in café (62.2%) and with friends (75.6%). The majority of them (71.1%) did not consider themselves as a hooked person. Cigarette smoking (OR =.65, 95 % CI .42-.98), low perceived addictiveness of hookah than cigarettes (OR =2.33, 95 % CI 1.45-3.73), Social context of hookah smoking with friends in café (OR =1.14, 95 % CI 1.08-1.2), and number of close friends who smoked hookah (OR =1.38, 95 % CI 1.18-1.61) were effective variables affected the past month use of hookah. Conclusion:Development, implementation and assessment of interventions particularly adapted to hookah smoking regarding increase of perceived harm of hookah than cigarette and its probable addiction focusing on close friends appeared to be beneficial.


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