The Trend of Hookah Use among Adolescents and Youth: A Qualitative Study

Recently, there has been an increasing trend in hookah use. If this trend continues, morbidity and mortality due to smoking will increase dramatically. Thus, the aim of this study was to investigate the causes of the increasing trend in hookah use in adolescents and youth living in Bushehr, Iran. This qualitative study was performed using qualitative content analysis. The research environment consisted of all public areas and the research population was comprised of all children and youth in Bushehr. The 12 participants were selected using purposive sampling. Data was collected using semi-structured interviews. After gaining the consent of the participants, the interviews were tape recorded and transcribed verbatim. Qualitative content analysis was used to analyze the data. Data analysis led to the extraction of the 5 main themes of "the influence of culture, media preparation, sensory appeal, mistaken belief, and difficulty of quitting". Hookah use among family and friends, lack of enforcement of laws prohibiting public consumption, lack of awareness and the mistaken belief that it is less harmful than cigarettes, the pleasant fruity smell and taste, not having any alternative healthy pastimes, and social pressure were the most common reasons for the increasing trend of hookah use in Bushehr. These results suggest the need for authorities to view this issue as an important dilemma, and to plan to reduce hookah use and solve this problem using effective methods to educate and inform people.