Prevalence of Hookah Smoking among University Students in Iran: A Meta-Analysis of Observational Studies
-
Mahmoud KHODADOST
,
Khadije MAAJANI
,
Abbas ABBASI-GHAHRAMANLOO
,
Morteza NASERBAKHT
,
Ebrahim GHODUSI
,
Fatemeh SARVI
,
Azar MOHAMMADZADEH
,
Seyed Abbas MOTEVALIAN
,
Ahmad HAJEBI
Abstract
Background: The rise in popularity of waterpipe smoking among younger people cause increase its deleterious effects on health in recent years. The aim of this study was to estimate the pooled prevalence of water-pipe smoking in university students in Iran.
Methods: We performed the literature search from 1946 to January 21, 2019, in several international and national databases such as Medline/PubMed, Web of Science, Scopus, Google Scholar, Magiran, Iranmedex, and IranPsych. To investigate the between-study heterogeneity we used the chi-squared test and I2 index. We used a random-effects model to estimate the pooled prevalence of water-pipe smoking. The potential source of heterogeneity was assessed by subgroup analysis and meta-regression.
Results: According to the eligibility criteria, we included 37 relevant studies in our meta-analysis. The pooled prevalence of lifetime water-pipe smoking was 25% (95% CI: 22-29) and in male and female subgroups was 37% (95%CI: 30-45), 17% (95%CI: 15-19) respectively. The pooled prevalence of water-pipe smoking in last year was 21% (95%CI: 16-25) and in last month was 8% (95%CI: 5-11). Results of meta-regression analysis showed that there was not any significant association between suspected variables and the prevalence of water-pipe smoking.
Conclusion: The higher prevalence rate of water pipe smoking among university students indicates the emergency need for planning preventive program.
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8. Tamim H, Terro A, Kassem H et al (2003). Tobacco use by university students, Lebanon, 2001. Addiction, 98:933-9.
9. Al-Turki YA (2006). Smoking habits among medical students in Central Saudi Arabia. Saudi Med J, 27:700-3.
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28. Maziak W, Nakkash R, Bahelah R et al (2014). Tobacco in the Arab world: old and new epidemics amidst policy paralysis. Health Policy Plan, 29:784-794.
29. Baddoura R, Wehbeh-Chidiac C (2001). Prevalence of tobacco use among the adult Lebanese population. East Mediterr Health J, 7:819-28.
30. Azab M, Khabour OF, Alkaraki AK et al (2010). Water pipe tobacco smoking among university students in Jordan. Nicotine Tob Res, 12:606-612.
31. Saade G, Warren C, Jones N, Mokdad A (2009). Tobacco use and cessation counseling among health professional students: Lebanon Global Health Professions Student Survey. J Med Liban, 57:243-247.
32. Poyrazoğlu S, Şarli Ş, Gencer Z, Günay O (2010). Waterpipe (narghile) smoking among medical and non-medical university students in Turkey. Ups J Med Sci, 115:210-216.
33. Akl EA, Gunukula SK, Aleem S et al (2011). The prevalence of waterpipe tobacco smoking among the general and specific populations: a systematic review. BMC Public Health, 11:244.
34. Nemati S, Rafei A, Freedman ND et al (2017). Cigarette and water-pipe use in Iran: Geographical distribution and time trends among the adult population; A pooled analysis of national STEPS surveys, 2006–2009. Arch Iran Med, 20:295-301.
35. Akl EA, Jawad M, Lam WY et al (2013). Motives, beliefs and attitudes towards waterpipe tobacco smoking: a systematic review. Harm Reduct J, 10:12.
36. Maziak W, Rastam S, Ibrahim I et al (2009). CO exposure, puff topography, and subjective effects in waterpipe tobacco smokers. Nicotine Tob Res, 11:806-811.
37. Maziak W (2008). The waterpipe: time for action. Addiction, 103:1763-1767.
38. Afrashteh S, Ghaem H, Abbasi-Ghahramanloo A et al (2017). Clustering and combining pattern of high-risk behaviors among Iranian university students: A latent class analysis. J Res Health Sci, 17:e00398.
39. Mohammadpoorasl A, Ghahramanloo AA, Allahverdipour H (2013). Risk-taking behaviors and subgrouping of college students: a latent class analysis. Am J Mens Health, 7:475-481.
40. Roskin J, Aveyard P (2009). Canadian and English students' beliefs about waterpipe smoking: a qualitative study. BMC Public Health, 9:10.
41. Safiri S, Rahimi-Movaghar A, Yunesian M et al (2016). Subgrouping of risky behaviors among Iranian college students: a latent class analysis. Neuropsychiatr Dis Treat, 12:1809-16.
42. Zahedi R, Noroozi A, Hajebi A et al (2018). Self-Reported and Network Scale-Up Estimates of Substance Use Prevalence among University Students in Kerman, Iran. J Res Health Sci, 18:e00413.
43. Taremian F, Bolhari J, Pairavi H, Ghazi Tabatabaeii M (2008). The Prevalence of Drug Abuse among University Students in Tehran. Iran J Psychiatry Clin Psychol, 13(4):335-42.
44. Abbasi-Ghahramanloo A, Fotouhi A, Zeraati H, Rahimi-Movaghar A (2015). Prescription drugs, alcohol, and illicit substance use and their correlations among medical sciences students in iran. Int J High Risk Behav Addict, 4(1):e21945.
45. Akbari Zardkhaneh S, Sohrabi F, Taraghijah S et al (2011). Demographic characteristics and substance use among students at state universities. Journal of Educational Psychology Studies, 7:1-22[Pesian].
46. Allahverdipour H, Abbasi-Ghahramanloo A, Mohammadpoorasl A, Nowzari P (2015). Cigarette Smoking and its Relationship with Perceived Familial Support and Religiosity of University Students in Tabriz. Iran J Psychiatry, 10:136-43.
47. Babaei Heydarabadi A, Ramezankhani A, Barekati H et al (2015). Prevalence of Substance Abuse Among Dormitory Students of Shahid Beheshti University of Medical Sciences, Tehran, Iran. Int J High Risk Behav Addict, 4:e22350.
48. Dehghani K, Zare A, Dehghani H, Sedghi H, Poormovahed Z (2010). Drug Abuse Prevalence and Risk Factors in Students of Shaheed Sadoughi University of Medical Sciences, Yazd, Journal of Shahid Sadoughi University of Medical Sciences, 18:164-169[Persian].
49. Goreishi A, Shajari Z (2013). Substance Abuse among Students of Zanjan’s Universities (Iran): A Knot of Today's Society. Addict Health, 5:66-72.
50. Heydari ST, Izedi S, Sarikhani Y et al (2015). The Prevalence of Substance use and Associated Risk Factors Among University Students in the City of Jahrom, Southern Iran. Int J High Risk Behav Addict, 4:e22381.
51. Jeihooni AK, Khiyali Z, Kashfi SM, et al (2018). Knowledge and attitudes of university students towards hookah smoking in Fasa, Iran. Iran J Psychiatry Behav Sci, 12: e11676.
52. Latifi A, Mohammadi S, Barkhordari A et al (2017). Self-efficacy of young adults across stages of waterpipe cessation-a model-based cross-sectional study. J Evolution Med Dent Sci, 6:6545-6550.
53. Maghsoudi A, Jalali M, Neydavoodi M et al (2017). Estimating the prevalence of high-risk behaviors using network scale-up method in university students of Larestan in 2014. J Subst Use, 22:145-148.
54. Makvandi Z, Sharifi M, Barati M (2017). Assessment of Factors Associated With Hookah Consumption Among College Students of Asad Abad City Base on The Theory of Planned Behavior (TPB) in 2015-2016. Iran J Health Educ Health Promot, 5:270-279.
55. Mardani H, Sheikhi A, Kavosian J (2012). The Prevalence of Substance Use among Bandar Abas Azad Islamic University Students. Research on Addiction,6(23):65-82 [Persian].
56. MohammadPoorasl A, Abbasi Ghahramanloo A, Allahverdipour H, Modaresi Esfeh J (2014). Prevalence of hookah smoking in relation to religiosity and familial support in college students of Tabriz, northwest of Iran. J Res Health Sci, 14(4):268-71.
57. Mozafarinia R, Assarian M, Ziaaddini A (2017). Prevalence of Substance Abuse among Students of Tehran University of Medical Sciences, Iran. Addict Health, 9(2):103-9.
58. Amin-Esmaeili M, Yunesian M, Sahimi-Izadian E et al (2017). The Prevalence of illicit substance use among students of medical sciences in Tehran: results from four repeated surveys from 2006 to 2009. J Child Adolesc Subst Abuse, 26(2):152-161.
59. Refahi SAA, Hosseinbor M, Poudineh Z, Sharif Hosseinbor M, Masumian S (2016). Prevalence of Consumption of Addictive Substances Among Students of Islamic Azad University (Zahedan Branch). Int J High Risk Behav Addict, 6:e19645.
60. Rezakhani Moghadam H, Shojaeizadeh D, Lashgarara B et al (2013). Comparison of Substance Abuse and its Causes among Students of Tehran University of Medical Sciences and University of Tehran. J Health Syst Res, 8(7): 1300-10.
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2. Mathers CD, Loncar D (2006). Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med, 3:e442.
3. Abbasi-Ghahramanloo A, Rahimi-Movaghar A, Zeraati H et al (2016). Prevalence of Hookah Smoking and Its Related Factors Among Students of Tehran University of Medical Sciences, 2012 - 2013. Iran J Psychiatry Behav Sci, 10:e4551.
4. Nasrollahzadeh D, Kamangar F, Aghcheli K et al (2008). Opium, tobacco, and alcohol use in relation to oesophageal squamous cell carcinoma in a high-risk area of Iran. Br J Cancer, 98:1857-63.
5. Dar-Odeh NS, Abu-Hammad OA (2009). Narghile smoking and its adverse health consequences: a literature review. Br Dent J, 206:571-3.
6. Jawad M, Charide R, Waziry R et al (2018). The prevalence and trends of waterpipe tobacco smoking: A systematic review. PLoS One, 13:e0192191.
7. Maziak W, Ward KD, Afifi Soweid RA, Eissenberg T (2004). Tobacco smoking using a waterpipe: a re-emerging strain in a global epidemic. Tob Control, 13:327-33.
8. Tamim H, Terro A, Kassem H et al (2003). Tobacco use by university students, Lebanon, 2001. Addiction, 98:933-9.
9. Al-Turki YA (2006). Smoking habits among medical students in Central Saudi Arabia. Saudi Med J, 27:700-3.
10. Jawaid A, Zafar AM, Rehman TU et al (2008). Knowledge, attitudes and practice of university students regarding waterpipe smoking in Pakistan. Int J Tuberc Lung Dis, 12:1077-84.
11. Primack BA, Sidani J, Agarwal AA et al (2008). Prevalence of and associations with waterpipe tobacco smoking among US university students. Ann Behav Med, 36:81-86.
12. Jackson D, Aveyard P (2008). Waterpipe smoking in students: prevalence, risk factors, symptoms of addiction, and smoke intake. Evidence from one British university. BMC Public Health, 8:174.
13. Mohammad K, Nourbala A, Madjdzadeh R, Karimlou M (2001). Trend of smoking prevalence in Iran from 1991 to 1999 based on two national health survey. Hakim Res J, 3:290-94.
14. Ghelichkhani P, Yaseri M, Yousefifard M et al (2018). The Gap of Cigarette and Hookah Smoking Between Socioeconomic Groups in Iran: Effect of Inequalities on Socioeconomic Position. Arch Iran Med, 21:418-424.
15. Martinasek MP, McDermott RJ, Martini L (2011). Waterpipe (hookah) tobacco smoking among youth. Curr Probl Pediatr Adolesc Health Care, 41:34-57.
16. Khodadost M, Maajani K, Arabsalmani M et al (2017). Is tattooing a risk factor for hepatitis c transmission?: an updated systematic review and meta-analysis. Hepat Mon, 17: e14308.
17. Monirpoor N, Khoosfi H, Gholamy Zarch M et al (2014). Vulnerability to substance abuse and the risk of suicide in students of region 12 of islamic azad university. Int J High Risk Behav Addict, 3:e11229.
18. Sahraian A, Sharifian M, Omidvar B, Javadpour A (2010). Prevalence of substance abuse among the medical students in Southern Iran. Shiraz E-Medical Journal, 11:198-202.
19. Sharifirad G, Charkazi A, Berdi-Ghourchaei A et al (2012). Smoking behavior based on stages of change model among Iranian male students in 2009-2010 academic year. Zahedan J Res Med Sci, 14:13-17.
20. Tarrahi MJ, Mohammadpoorasl A, Ansari H, Mohammadi Y (2017). Substance Abuse and Its Predictors in Freshmen Students of Lorestan Universities: Subgrouping of College Students in West of Iran. Health Scope, 6:e64186.
21. Rahimzadeh M, Rastegar H, Fazel Kalkhoran J (2017). Prevalence and Causes of Tendency to Cigarette and Water Pipe Smoking among Male and Female Physical Education Students in University of Kurdistan. J Health, 7:680-686.
22. Sutfin EL, McCoy TP, Reboussin BA et al (2011). Prevalence and correlates of waterpipe tobacco smoking by college students in North Carolina. Drug Alcohol Depend, 115:131-136.
23. Johnston LD, Miech RA, O'Malley PM et al (2018) Monitoring the Future national survey results on drug use, 1975-2017: Overview, key findings on adolescent drug use. (ed)^(eds), Institute for Social Research, The University of Michigan, Michigan pp. 1-123.
24. Haider MR, Salloum RG, Islam F et al (2015). Factors associated with smoking frequency among current waterpipe smokers in the United States: findings from the National College Health Assessment II. Drug Alcohol Depend, 153:359-363.
25. Jarrett T, Blosnich J, Tworek C, Horn K (2012). Hookah use among US college students: results from the National College Health Assessment II. Nicotine Tob Res, 14:1145-1153.
26. Kruger L, van Walbeek C, Vellios N (2016). Waterpipe and cigarette smoking among university students in the Western Cape, South Africa. Am J Health Behav, 40:416-426.
27. Maziak W, Ward K, Mzayek F et al (2005). Mapping the health and environmental situation in informal zones in Aleppo, Syria: report from the Aleppo household survey. Int Arch Occup Environ Health, 78:547-558.
28. Maziak W, Nakkash R, Bahelah R et al (2014). Tobacco in the Arab world: old and new epidemics amidst policy paralysis. Health Policy Plan, 29:784-794.
29. Baddoura R, Wehbeh-Chidiac C (2001). Prevalence of tobacco use among the adult Lebanese population. East Mediterr Health J, 7:819-28.
30. Azab M, Khabour OF, Alkaraki AK et al (2010). Water pipe tobacco smoking among university students in Jordan. Nicotine Tob Res, 12:606-612.
31. Saade G, Warren C, Jones N, Mokdad A (2009). Tobacco use and cessation counseling among health professional students: Lebanon Global Health Professions Student Survey. J Med Liban, 57:243-247.
32. Poyrazoğlu S, Şarli Ş, Gencer Z, Günay O (2010). Waterpipe (narghile) smoking among medical and non-medical university students in Turkey. Ups J Med Sci, 115:210-216.
33. Akl EA, Gunukula SK, Aleem S et al (2011). The prevalence of waterpipe tobacco smoking among the general and specific populations: a systematic review. BMC Public Health, 11:244.
34. Nemati S, Rafei A, Freedman ND et al (2017). Cigarette and water-pipe use in Iran: Geographical distribution and time trends among the adult population; A pooled analysis of national STEPS surveys, 2006–2009. Arch Iran Med, 20:295-301.
35. Akl EA, Jawad M, Lam WY et al (2013). Motives, beliefs and attitudes towards waterpipe tobacco smoking: a systematic review. Harm Reduct J, 10:12.
36. Maziak W, Rastam S, Ibrahim I et al (2009). CO exposure, puff topography, and subjective effects in waterpipe tobacco smokers. Nicotine Tob Res, 11:806-811.
37. Maziak W (2008). The waterpipe: time for action. Addiction, 103:1763-1767.
38. Afrashteh S, Ghaem H, Abbasi-Ghahramanloo A et al (2017). Clustering and combining pattern of high-risk behaviors among Iranian university students: A latent class analysis. J Res Health Sci, 17:e00398.
39. Mohammadpoorasl A, Ghahramanloo AA, Allahverdipour H (2013). Risk-taking behaviors and subgrouping of college students: a latent class analysis. Am J Mens Health, 7:475-481.
40. Roskin J, Aveyard P (2009). Canadian and English students' beliefs about waterpipe smoking: a qualitative study. BMC Public Health, 9:10.
41. Safiri S, Rahimi-Movaghar A, Yunesian M et al (2016). Subgrouping of risky behaviors among Iranian college students: a latent class analysis. Neuropsychiatr Dis Treat, 12:1809-16.
42. Zahedi R, Noroozi A, Hajebi A et al (2018). Self-Reported and Network Scale-Up Estimates of Substance Use Prevalence among University Students in Kerman, Iran. J Res Health Sci, 18:e00413.
43. Taremian F, Bolhari J, Pairavi H, Ghazi Tabatabaeii M (2008). The Prevalence of Drug Abuse among University Students in Tehran. Iran J Psychiatry Clin Psychol, 13(4):335-42.
44. Abbasi-Ghahramanloo A, Fotouhi A, Zeraati H, Rahimi-Movaghar A (2015). Prescription drugs, alcohol, and illicit substance use and their correlations among medical sciences students in iran. Int J High Risk Behav Addict, 4(1):e21945.
45. Akbari Zardkhaneh S, Sohrabi F, Taraghijah S et al (2011). Demographic characteristics and substance use among students at state universities. Journal of Educational Psychology Studies, 7:1-22[Pesian].
46. Allahverdipour H, Abbasi-Ghahramanloo A, Mohammadpoorasl A, Nowzari P (2015). Cigarette Smoking and its Relationship with Perceived Familial Support and Religiosity of University Students in Tabriz. Iran J Psychiatry, 10:136-43.
47. Babaei Heydarabadi A, Ramezankhani A, Barekati H et al (2015). Prevalence of Substance Abuse Among Dormitory Students of Shahid Beheshti University of Medical Sciences, Tehran, Iran. Int J High Risk Behav Addict, 4:e22350.
48. Dehghani K, Zare A, Dehghani H, Sedghi H, Poormovahed Z (2010). Drug Abuse Prevalence and Risk Factors in Students of Shaheed Sadoughi University of Medical Sciences, Yazd, Journal of Shahid Sadoughi University of Medical Sciences, 18:164-169[Persian].
49. Goreishi A, Shajari Z (2013). Substance Abuse among Students of Zanjan’s Universities (Iran): A Knot of Today's Society. Addict Health, 5:66-72.
50. Heydari ST, Izedi S, Sarikhani Y et al (2015). The Prevalence of Substance use and Associated Risk Factors Among University Students in the City of Jahrom, Southern Iran. Int J High Risk Behav Addict, 4:e22381.
51. Jeihooni AK, Khiyali Z, Kashfi SM, et al (2018). Knowledge and attitudes of university students towards hookah smoking in Fasa, Iran. Iran J Psychiatry Behav Sci, 12: e11676.
52. Latifi A, Mohammadi S, Barkhordari A et al (2017). Self-efficacy of young adults across stages of waterpipe cessation-a model-based cross-sectional study. J Evolution Med Dent Sci, 6:6545-6550.
53. Maghsoudi A, Jalali M, Neydavoodi M et al (2017). Estimating the prevalence of high-risk behaviors using network scale-up method in university students of Larestan in 2014. J Subst Use, 22:145-148.
54. Makvandi Z, Sharifi M, Barati M (2017). Assessment of Factors Associated With Hookah Consumption Among College Students of Asad Abad City Base on The Theory of Planned Behavior (TPB) in 2015-2016. Iran J Health Educ Health Promot, 5:270-279.
55. Mardani H, Sheikhi A, Kavosian J (2012). The Prevalence of Substance Use among Bandar Abas Azad Islamic University Students. Research on Addiction,6(23):65-82 [Persian].
56. MohammadPoorasl A, Abbasi Ghahramanloo A, Allahverdipour H, Modaresi Esfeh J (2014). Prevalence of hookah smoking in relation to religiosity and familial support in college students of Tabriz, northwest of Iran. J Res Health Sci, 14(4):268-71.
57. Mozafarinia R, Assarian M, Ziaaddini A (2017). Prevalence of Substance Abuse among Students of Tehran University of Medical Sciences, Iran. Addict Health, 9(2):103-9.
58. Amin-Esmaeili M, Yunesian M, Sahimi-Izadian E et al (2017). The Prevalence of illicit substance use among students of medical sciences in Tehran: results from four repeated surveys from 2006 to 2009. J Child Adolesc Subst Abuse, 26(2):152-161.
59. Refahi SAA, Hosseinbor M, Poudineh Z, Sharif Hosseinbor M, Masumian S (2016). Prevalence of Consumption of Addictive Substances Among Students of Islamic Azad University (Zahedan Branch). Int J High Risk Behav Addict, 6:e19645.
60. Rezakhani Moghadam H, Shojaeizadeh D, Lashgarara B et al (2013). Comparison of Substance Abuse and its Causes among Students of Tehran University of Medical Sciences and University of Tehran. J Health Syst Res, 8(7): 1300-10.
61. Roohafza H, Sadeghi M, Shahnam M et al (2011). Perceived factors related to cigarette and waterpipe (ghelyan) initiation and maintenance in university students of Iran. Int J Public Health, 56(2):175-80.
62. Sohrabi F, Akbari Zardkhaneh S, Taragijah S et al (2009). Substance Abuse Among State University students, Iran, 1385-1386. Social Welfare, 2009;9(34):65-82 [Persian].
63. Taremian F, Bolhari J, Peyravi H, Asgari A (2014). Drug use prevalence among students of universities of medical sciences in Tehran. Research on Addiction,7(28):9-21 [Persian].
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| Files | ||
| Issue | Vol 49 No 1 (2020) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v49i1.3045 | |
| Keywords | ||
| Prevalence Hookah College students Iran Meta-analysis | ||
| Rights and permissions | |
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
KHODADOST M, MAAJANI K, ABBASI-GHAHRAMANLOO A, NASERBAKHT M, GHODUSI E, SARVI F, MOHAMMADZADEH A, MOTEVALIAN SA, HAJEBI A. Prevalence of Hookah Smoking among University Students in Iran: A Meta-Analysis of Observational Studies. Iran J Public Health. 2020;49(1):1-13.
