Pattern of water pipe (ghalyan) use among intermediate and high school students: a cross-sectional study in Tehran, Iran

To determine the pattern of waterpipe (ghalyan) use and the relevant indicators among adolescent students in Tehran, Iran.

A cross-sectional study was conducted on 4361 schoolchildren (2219 boys and 2142 girls) selected by two-stage cluster random sampling from intermediate (orientation) and high schools (including vocational schools) in Tehran's Municipal District 13. We determined the pattern for waterpipe smoking through a self·administered, anonymous questionnaire.

Overall, the prevalence of lifetime waterpipe smoking was 56.90/o and most adolescents (28.8%) had tried waterpipe between the ages of 12 and 13 for the first time (60.6% in boys vs. 53.1% in girls, P <0.001). The overall prevalence of current waterpipe smoking was 25.7% (30.7% in boys vs. 20.6% in girls; P<0.001). The majority of those who had experimented with the waterpipe (51.4% ol) often did so wit their families. However, 58.5% of current users had been smoking with their friends on most occasions. Common places (27.5%) for smoking were cafes or traditional restaurants and the fruit-flavored (Maasel) tobacco was the most common type (91.1%) smoked by all new users. Most of the new users' parents (71.8%) were aware of waterpipe smoking by their children. Girls' parents were frequently more inattentive 10 their children's habit compared to boys' parents, while boys' parents were more likely to oppose the practice compared to girls' parents.

The high prevalence of waterpipe smoking among Tehran adolescents can expose them to tobacco addiction and its complications. Therefore, there is a need for more detailed studies on the determinants and consequences of waterpipc smoking (especially fruit-flavored tobacco) and on preventive interventions in adolescents.