AN EXPLORATORY QUALITATIVE STUDY INTO SAUDI WOMEN’S KNOWLEDGE OF AND ATTITUDES TOWARDS SHISHA SMOKING

Abstract

Background: Shisha smoking is the most common type of tobacco used by Saudi women. This study aims to explore Saudi women’s knowledge of and attitudes towards shisha smoking; as well as to look at other health promotion initiatives to be incorporated into current services to make them more effective when addressing women that smoke shisha. Methods: The study was qualitative, consisting of semi-structured interviews that entailed open-ended questions; they were carried during 2 months in 2020, in the city of Makkah in Saudi Arabia. The participants were 8-women, ages 25 to 47-years-old who smoked shisha and were selected through snowball sampling. Given the circumstances of the COVID-19 pandemic, the interviews were conducted via Zoom, FaceTime, and imo video calling applications according to participants preferences. Afterwards, the data collected was thematically analysed. Results: Peer pressure, adopting shisha smoking as a hobby, parental smoking, and shisha availability among other external influences, such as socio-cultural permissiveness, were determinants of shisha smoking among Saudi women. Participants indicated various reasons for shisha smoking, including using it as a coping mechanism to stressors such as loneliness, boredom, and emptiness. Most were driven by social misconceptions that regarded shisha as less harmful and less addictive than cigarettes. Participants also perceived it as a better alternative to cigarette smoking. Heavy taxation, warning labels policies, and shisha ban implementation were identified as activities to be implemented to curb the increasing prevalence of shisha smoking. Conclusion: Overall, this study indicates that shisha smoking among women has been normalized almost entirely in most societies across Saudi Arabia. This change has been promoted by family norms, external influences, such as friends and societal environment. Childhood education that focuses on detrimental effects and addressing misconceptions can be an effective health promotion approach to curb the prevalence of shisha smoking. Recommendations: Study suggests adopting heavy taxation laws to reduce importation of shisha, adding graphic health warning labels (GHWLs) in shisha packages, use of mass media to promote government led smoke cessation campaigns and adopting a health education approach directed towards children and young people on the harmful effects of shisha smoking.