Prevalence of shisha smoking in college, university and madarsa students aged 20-25 years in Pakistan

ABSTRACT

To estimate the prevalence of shisha smoking, its trends and associated factors in college, university and madarsa students aged 20-25 years in Pakistan. This survey was done on 7582 subjects belonging to 71 institutions from five cities and Federal Capital Islamabad, using a population based sample. Data was collected using cluster sampling from public/private colleges, universities and madarsas. After taking informed consent, about 10% students from each speciality including both genders were collected using a structured self administered questionnaire designed in Urdu and English. Variables included age, gender, socio-economic status, habits, trends, knowledge and perceptions about shisha smoking. The study was approved by Institutional Review Board. Data was analyzed on SPSS version 15 and chi square was used for statistical significance. Out of 71 educational institutions, 43 were public and 28 private including 8 madarsas. There were 2971 students from professional and 4174 from non-professional institutions. Overall prevalence of shisha smoking was 19.7% [n=1410] being more common in males [29.8%] than females [10.4%] Students started smoking shisha at 17-18 years age [57.2%] and almost 75% started this habit in year 2009-2010. The highest prevalence of shisha smoking was seen in Federal Capital Islamabad [28.1%], and lowest in Peshawar [11.2%]. The shisha smoking was more in professional and private educational institutions [p<0.000] with almost 29% students using it in engineering colleges and none using it in madarsas [alma/alia courses]. The trend was highest in students belonging to high socio-economic status [30.7%] and those already smoking cigarettes [74.1%] Pleasure seeking was the commonest reason for smoking shisha [7.1%] and almost 11% students were influenced by their friends. Shisha cafe's were site used by most smokers and majority preferred double apple or mint flavor. Almost a quarter [23.8%] students smoked shisha just for enjoyment and 12.1% thought that it is less harmful than cigarette smoking. Almost 20% students in colleges and universities are smoking shisha. Majority thinking shisha to be harmless or less harmful than cigarette smoking indicating that knowledge about adverse effects of shisha smoking is tremendously low in this educated youth of our country. Shisha should be subjected to the same regulation as cigarettes and other tobacco products and public should be educated about its harmful effects