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Male students' experiences on predictors of waterpipe smoking reduction: A qualitative study in Iran.

ABSTRACT: INTRODUCTION:In recent years, waterpipe smoking (WPS) has increased among adolescents in Iran. This study aimed to explain the experiences of high school students in Iran on predictors of WPS reduction based on a multi-theory model (MTM) of health behaviour change. METHODS:This study was a qualitative study of directed content analysis that was conducted in high school male students in Hamadan, Iran, in 2017. In this study, 34 students who had smoked waterpipe (WP) in the last month were recruited through snowball sampling that was continued until data saturation. The data were collected through semi-structured, individual interviews and were then analyzed using directed qualitative content analysis. RESULTS:The data analysis resulted in the extraction of 104 final codes around the six themes of predetermined MTM constructs consisting of participatory dialogue, behavioural confidence, changes in the physical environment, emotional transformation, practice for change, and changes in the social environment. The findings of this study showed that this model has the potential to explain the behaviour of WPS reduction. The main predictors of reduction in WPS are behavioural confidence, social environment change, and participatory dialogue. CONCLUSIONS:Findings of the research showed that the belief in an individual's ability, support from friends and the benefits of WPS reduction are the most important factors in reducing WPS among students. Therefore, it is suggested that comprehensive interventions be developed to improve the individual and social factors that are effective in WPS reduction.

SUBMITTER: Bashirian S

PROVIDER: S-EPMC7205133 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Male students' experiences on predictors of waterpipe smoking reduction: A qualitative study in Iran.

Bashirian Saeed S Barati Majid M Ahmadi Fazlolah F Abasi Hamid H Sharma Manoj M

Tobacco prevention & cessation 20190930

<h4>Introduction</h4>In recent years, waterpipe smoking (WPS) has increased among adolescents in Iran. This study aimed to explain the experiences of high school students in Iran on predictors of WPS reduction based on a multi-theory model (MTM) of health behaviour change.<h4>Methods</h4>This study was a qualitative study of directed content analysis that was conducted in high school male students in Hamadan, Iran, in 2017. In this study, 34 students who had smoked waterpipe (WP) in the last mon ...[more]

PMID: 32411893

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Project description:BackgroundIn recent years waterpipe smoking has become a popular practice amongst young adults in eastern Mediterranean countries, including Iran. The aim of this study was to assess waterpipe smoking perceptions and practices among first-year health sciences university students in Iran and to identify factors associated with the initiation and maintenance of waterpipe use in this population.ResultsOut of 371 first-year health sciences students surveyed, 358 eight students completed a self-administered questionnaire in the classrooms describing their use and perceptions towards waterpipe smoking. Two hundred and ninety six responders met study inclusion criteria. Waterpipe smoking was common among first-year health sciences university students, with 51% of students indicating they were current waterpipe smokers. Women were smoking waterpipes almost as frequently as men (48% versus 52%, respectively). The majority of waterpipe smokers (75.5%) indicated that the fun and social aspect of waterpipe use was the main motivating factor for them to continue smoking. Of waterpipe smokers, 55.3% were occasional smokers, using waterpipes once a month or less, while 44.7% were frequent smokers, using waterpipes more than once a month. A large number of frequent waterpipe smokers perceived that waterpipe smoking was a healthier way to use tobacco (40.6%) while only 20.6% thought it was addictive. Compared to occasional smokers, significantly more frequent smokers reported waterpipe smoking was relaxing (62.5% vs. 26.2%, p = 0.002), energizing (48.5% vs. 11.4%, p = 0.001), a part of their culture (58.8% vs. 34.1%, p = 0.04), and the healthiest way to use tobacco (40.6% vs. 11.1%, p = 0.005).ConclusionsSocial and recreational use of waterpipes is widespread among first-year health sciences university students in Iran. Women and men were almost equally likely to be current waterpipe users. Public health initiatives to combat the increasing use of waterpipes among university students in Iran must consider the equal gender distribution and its perception by many waterpipe smokers as being a healthier and non-addictive way to use tobacco.

Project description:BACKGROUND:Waterpipe smoking is a traditional method of tobacco smoking that is being increasingly practiced worldwide. However, the research evidence describing the practice and prevalence of waterpipe smoking in Australia is limited. Arabic-speaking communities residing in an area of metropolitan Sydney identified increasing rates of waterpipe smoking as a community health concern during a tobacco intervention project. A qualitative research project was conducted to explore community perceptions about waterpipe smoking and the health promotion interventions that would be acceptable to Arabic speaking communities. METHODS:Participants from Arabic-speaking community groups and networks were recruited by trained bilingual community research assistants (BCRAs). Ten focus groups were conducted, eight by the BCRAs and two by the research team, and included a total of 88 participants. Notes were taken during the focus groups by the BCRAs and provided to the research team. The data was coded and managed using NVivo 11, and examined for themes and subthemes. RESULTS:Eleven themes were identified from the data relating to the perceptions of waterpipe smoking (practices, cultural identity, acceptability, social connectedness, knowledge and perceptions of harm, trend and fashion, availability and access) and possible health promotion interventions (health information and social marketing, health education, policy and legislation, intervention target groups and messages). Waterpipe smoking was reported to be widely practiced and was related to a number of factors including feelings of cultural identity and belonging. The study highlighted the misconceptions of harm that exist in communities about the health effects of waterpipe smoking, as well as the significant role of the family in passing on the practice of waterpipe smoking. These factors should be considered in the development of health promotion interventions. CONCLUSIONS:Our findings suggest that until waterpipe smoking is perceived as a problem, community readiness for accepting health promotion interventions will be limited. Interventions should focus on debunking the myths that contribute toward a reduced perception of harm. A culturally sensitive approach, that considers the cultural connection to waterpipe smoking, should be taken toward the development and implementation of interventions.

Project description:IntroductionDespite cigarette-like adverse health outcomes associated with waterpipe tobacco smoking and increase in its use among youth, it is a much underexplored research area. We aimed to measure the prevalence and patterns of waterpipe tobacco use and evaluate tobacco control policy with respect to waterpipe tobacco, in several universities across the UK. We also aimed to measure stop smoking practitioners' encounter of waterpipe tobacco smoking.MethodsWe distributed an online survey to six UK universities, asking detailed questions on waterpipe tobacco. Multivariable logistic regression models, adjusted for age, gender, ethnicity, graduate status, university and socioeconomic status (SES) assessed associations between waterpipe tobacco smoking (single use and dual use with cigarettes) and sociodemographic variables. SES was ascertained by average weekly self-spend on non-essentials. We also descriptively analysed data from a 2012 survey of stop smoking practitioners to assess the proportion of clients that used waterpipe regularly.Resultsf 2217 student responses, 66.0% (95% CI 63.9-68.0%) had tried waterpipe tobacco smoking; 14.3% (95% CI 12.8-15.8%) reported past-30 day use, and 8.7% (95% CI 7.6-9.9%) reported at least monthly users. Past-30 day waterpipe-only use was associated with being younger (AOR 0.95, 95% CI 0.91-0.99), male (AOR 1.44, 95% CI 1.08-1.94), higher SES (AOR 1.16, 95% CI 1.06-1.28) and belonging to non-white ethnicities (vs. white, AOR 2.24, 95% CI 1.66-3.04). Compared to less than monthly users, monthly users were significantly more likely to have urges to smoke waterpipe (28.1% vs. 3.1%, p<0.001) report difficulty in quitting (15.5% vs. 0.8%, p<0.001), report feeling guilty, and annoyed when criticised about waterpipe smoking (19.2% vs. 9.2%, p<0.001). Nearly a third (32.5%) of respondents who had tried waterpipe had violated the UK smokefree law and a quarter (24.5%) reporting seeing health warnings on waterpipe tobacco packaging or apparatuses. Of 1,282 smoking cessation practitioners, a quarter (23.4%, 95% CI 21.5-26.1%) reported having some clients who regularly use waterpipes, but 69.5% (95% CI 67.0-72.0%) never ask clients about waterpipe use. Three quarters (74.8%, 95% CI 72.4-77.1%) want more information about waterpipe tobacco smoking.ConclusionsWhile two thirds of university students have ever tried waterpipe tobacco, at least monthly use is less common. Regular users display features of waterpipe tobacco dependence, and a substantial minority of SSS practitioners encounter clients who regularly use waterpipe. The lack of training on waterpipe for SSS practitioners and reported violations of smokefree laws for waterpipe highlight the need for regular surveillance of and a coordinated tobacco control strategy for waterpipe use.

Dataset Information

Male students' experiences on predictors of waterpipe smoking reduction: A qualitative study in Iran.

Publications

Male students' experiences on predictors of waterpipe smoking reduction: A qualitative study in Iran.

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