Factors Influencing Shisha Smoking Among Students in Tertiary Institutions in Kisumu County, Kenya

The use of tobacco products poses a significant public health challenge, affecting approximately 1.1 billion smokers and is expected to rise. In Kenya, 37% of university students in Nairobi County were engaging in Shisha smoking. Despite the growing prevalence of Shisha smoking among the youth, studies specifically focusing on reasons for its use in Kenya remain limited. This study aimed to establish individual factors influencing Shisha smoking among students in tertiary institutions in Kisumu County. The study used a cross-sectional study design. The target population was 26,384 students aged 18 - 24 years. The sample size obtained was 398 students, which was computed based on a known prevalence of 37%. The study targeted tertiary institutions: Maseno University, Uzima University College, Great Lakes University of Kisumu, Kenya Medical Training College-Kisumu, and Kisumu National Polytechnic. Institutions were purposely sampled, and each sample was determined using population proportionate to size, stratified sampling was employed to obtain students across all academic years and simple random sampling was used to achieve the sample size. The reliability of the questionnaires was assessed using a Cronbach’s Alpha with a score of more than 0.7 for all the objectives, and data collection was conducted by trained research assistants using pre-tested questionnaires. Data analysis was conducted using SPSS version 25. Frequencies and percentages were used to determine the prevalence and reasons for Shisha smoking. Cramer’s V and Chi-square p-value <0.05 were used to establish associations. Curiosity (26.6%), pleasure-seeking (21.8%) and the appeal of flavours (19.4%) of the students led them to smoke shisha. There was no significant association between self-esteem and shisha smoking (p-value 0.407). The study concludes that curiosity and social factors: as the appealing and stylish nature of flavoured Shisha were identified to be the motivators for tobacco smoking among the students the study recommends that there should be social and behavioural change communication strategies for promoting healthy Shisha, conducting support groups and working with parents in sensitisation of education initiatives on Shisha smoking.