Factors associated with hookah smoking among women: A systematic review

Sakineh Dadipoor, Gerjo Kok, Teamur Aghamolaei*, Ali Heyrani, Mohtasham Ghaffari, Amin Ghanbarnezhad

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review


INTRODUCTION The present study aimed to determine factors associated with hookah smoking among women on a global scale based on a systematic review of related literature. Intervention Mapping was the guiding framework for this review.

METHODS Searches were performed in Web of Science, PubMed, Iranian databases, Elsevier, Embase, Scopus, Medline, Google Scholar, and the World Health Organization (WHO) website, using keywords related to hookah and associated terms. Studies in English or Persian, published between 1990 and 2018, were included in this review if they were available in full text and had a target population of women. Determinants of hookah smoking at the intrapersonal, interpersonal, institutional/organizational, community, and political levels, were extracted.

RESULTS Positive attitude, social-psychological needs, low perceived risk, social-cultural acceptance of hookah, easy access and lack of laws were among the reasons given for consuming hookah. Because hookah smoking is a multifactorial issue, the qualitative method alone was not sufficient to identify the determinants of hookah smoking among women. The opinions of experts in the field of smoking control had been largely neglected in the obtained studies, and most quantitative studies lacked a theoretical framework.

CONCLUSIONS To reduce the rate of hookah consumption, actions to be taken include changing women's positive attitude toward hookah, learning to resist friends' pressure to smoke, highlighting the unpleasantness of hookah smoking by segregating places with transparent walls within public places, showing in the virtual world that hookah smoking is socially unacceptable, limiting access to hookah tobacco products, and effectively implementing rules that restrict hookah smoking in public places.

Original languageEnglish
Article number26
Number of pages11
JournalTobacco prevention & cessation
Publication statusPublished - Aug 2019


  • women
  • hookah
  • waterpipe
  • shisha
  • narghile
  • galyan
  • hubble bubble
  • PIPE


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