Factors Affecting Hookah Smoking Trend in the Society: A Review Article

Document Type : Review Article(s)


1 PhD Candidate, Department of Health Education and Health Promotion, School of Health, Shiraz University of ‎Medical Sciences, Shiraz, Iran

2 Associate Professor, Research Center for Health Sciences AND Department of Health Education and Health ‎Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran‎

3 PhD Candidate, Department of Environmental Health Engineering, School of Health, Tehran University of Medical ‎Sciences, Tehran, Iran

4 PhD Candidate, Department of Geriatrics, ‎University of Social Welfare and Rehabilitation Sciences, Tehran, Iran


Background: An increase in hookah smoking is considered to be a serious health problem in societies with different cigarette smoking patterns. Thus, determinants of increase in this behavior are needed to be identified. This study aimed to review the articles related to the causes of hookah smoking in the society.Methods: This study reviewed the scientific references of authentic databases and journals, including Web of Science, PubMed, Iranian Databases, Elsevier, Embase, Scopus, MEDLINE, CINAHL, CDC, and World Health Organization (WHO). Overall, 84 scientific studies conducted during 1990-2015 were collected.Results: Several studies on the prevalence of smoking hookah and its associated factors in the society suggested that numerous factors played a role in interest in smoking hookah. The most common reasons for individuals’ inclination to smoke hookah were positive viewpoints toward smoking hookah, wrong beliefs about its low risks, presumed lack of addiction, social acceptance, ease of access, wrong cultural habits, and regulative weakness.Conclusion: Evidence indicated that a large spectrum of individual and social factors was effective in various levels of hookah consumption. Besides, it seems that single-component interventions and those solely based on individual factors could not result in effective prevention. On the other hand, interventions based on ecological approaches are suggested in this regard. Overall, it is essential to focus on the exclusion of positive viewpoints toward hookah, develop the ability to say “no,” relaxation, and resistance against temptations to smoke hookah, culturalization, and regulation of strong laws.


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