BackgroundIn 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.MethodsWe 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.ResultsWe 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.ConclusionsSocializing, 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.

Overall, healthcare students' and professionals' attitudes toward persons with physical disabilities were favorable. However, some studies revealed the possibility that some healthcare providers demonstrate fear and anxiety with the challenge of caring for a patient with physical disabilities. Some of the factors associated with providers' attitudes toward patients with physical disabilities are potentially modifiable (e.g., experience) and could be the target of educational interventions to ameliorate this fear and facilitate higher quality care.

Real-world perspective-taking problems frequently involve interactions among individuals, suggesting a potential social element to this seemingly spatial problem. Previous studies have suggested that the agency of the target in a perspective-taking task might influence reasoning. This hypothesis is tested directly by manipulating whether one takes the perspective of a potential agent or an object. The results were striking: Even though no overall differences in performance were observed with and without agents, performance was differentially associated with social skills. In particular, participants with better social skills were more accurate than less social peers when the target was a potential agent, whereas no such relationship was observed when the target was an object. These results suggest that bringing domain-specific investigations to bear on real-world problems requires understanding how that domain exists in the broader context of interacting skills and biases.