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Free Content A qualitative analysis among regular waterpipe tobacco smokers in London universities

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BACKGROUND: Waterpipe smoking is popular in the West despite the significant harm associated with its use. Little is known about the habits and practices of British smokers.

DESIGN: A total of 32 regular waterpipe smokers attended focus groups, where trained facilitators explored knowledge, belief and attitudes to waterpipes. Transcripts were thematically analysed and grouped into seven broad categories.

RESULTS: Waterpipes played a clearly defined social role, accentuated by reduced harm perception and greater social acceptance than cigarettes. Knowledge about waterpipes was lacking, partly due to the lack of media attention. Addiction was described as a ‘social addiction’, although this may mask true nicotine addiction. Waterpipe smokers were less interested in quitting due to intermittent smoking patterns, reinforcing the belief of reduced exposure to harm. Legislative issues were explored, including the need to legislate on waterpipes on a par with cigarettes.

CONCLUSION: Waterpipe smokers exhibited specific habits and attitudes not traditionally seen in cigarette smokers. It is important to encourage education to dispel the myths surrounding reduced harm perception and addiction to tackle its strong social acceptance. Legislation should play a more active role in prevention and education, and more emphasis should be placed on gathering nationwide epidemiological data to gauge the potential for escalation.
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Keywords: health behaviour; hookah; public health; shisha; smoking

Document Type: Research Article

Affiliations: 1: Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK 2: School of Medicine, Faculty of Medicine, Imperial College London, London, UK 3: School of Medicine, King's College London, London, UK

Publication date: October 1, 2013

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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