Predictors of hookah smoking among women in the south of Iran: a cross-sectional study

Abstract

Background The prevalence of hookah smoking has grown over the past decades in Iran especially in the south of the country more than other geographical areas. The present research aims to determine the socio-demographic predictors of hookah smoking among women in the south of Iran. Method This research was conducted on 400 female hookah smokers selected through the multi-stratified sampling method. Data were collected from October 2018 to September 2019 using a researcher-made questionnaire. Ordinal logistic regression analysis was run to determine the influential behavioral and socio-demographic factors involved in hookah smoking. Variables with a P-value < 0.05 in the final fitting model were declared to be associated with the outcome variable. Results Participants’ age ranged between 15 and 85 years (mean=34.91±13.3 years). As for demographic factors, women in the 35-50 age group (p=.01) and those above 50 years (p=.02) showed more tendency to smoke hookahs than those below 20 years of age. The ‘ever-married’ group tended to smoke hookahs three times as much as the ‘never married’ (p=.002). Those of a low socio-economic status (SES) showed a stronger tendency to smoke hookahs than those of a high SES (6.5 times as strong) (p=.000). The statistical analysis of behavioral factors showed that the following were associated with a higher frequency of hookah smoking among women: lower age of beginning to smoke hookahs (p<.001) <15 years, 15-30 years (p=.003), longer duration of hookah smoking (p=.000), hookah smoking among family members (p=.000), absence of either parent in family (single-parent families) (p=.000), beginning to smoke hookahs with peers (p=.000) and a lack of prior intention to cease smoking (p=.000). Conclusion As the present results showed, hookah smoking was ordinary and popular among women in the present research. Increasing the social unacceptance of hookahs, focus on those surrounding women smokers, quitting the habit of hookah smoking and effective interventions to decrease one’s intention to smoke hookahs can help to reduce such unhealthy behaviors.