The Prevalence Waterpipe Use among Adults in Saudi Arabia Systematic Literature Review

Abstract

Background: Waterpipe (WP) smoking is an established form of tobacco use that is increasing among adults in the Kingdom of Saudi Arabia (KSA) and is associated with major preventable health harms. Aim: The purpose of this systematic literature review was to identify the prevalence of the WP use among adults in Saudi Arabia and demographic and contextual factors associated with the phenomenon. Search Strategy: A systematic search of the articles was conducted using PRISMA 2020 guidelines in MEDLINE (Ovid), CINAHL (EBSCOhost), PubMed and Scopus. Inclusion criteria included the studies published after the year 2015, in English, that reported the prevalence of WP among adults (age: 18 years and above) in Saudi Arabia. JBI Critical Appraisal Checklist was used to measure the methodological quality. Results: Thirteen cross sectional studies met the inclusion criteria. Twelve studies were rated high quality on the Joanna Briggs Institute checklist with scores between 75 percent and 100 percent. One study was rated moderate quality with a score of 62.5 percent. Current self-reported WP use in university students ranged from about 11.8% to 34.0%, in healthcare professionals from 26% to 45%, and in adult general or clinical samples from 17.0% to 51.8%. Conclusion: WP smoking is common among university students and some healthcare and dental groups. The use is closely linked with social context, peer influence, inaccurate risk perceptions and polytobacco use. The findings support the need for routine surveillance of WP use, targeted health education for young adults and health professionals, integration of WP into clinical smoking assessment and counselling, and stronger regulation of WP products and venues in Saudi Arabia. Keywords: Waterpipe Smoking, Prevalence of WP Use, Tobacco Control