A Comparison of Shisha Smoking among University students in Palestine, Jordan and Turkey

Abstract Background: Smoking is one of the main causes that is related to lung cancer. It was estimated that tobacco smoking may kill 10 million people annually in the next 20–30 years, and Shisha smoking was very common habit worldwide during the last 20 years, especially in the Middle East. This study aimed to determine the prevalence of shisha smoking and make a comparison between three different countries in the Middle East, and establishing factors associated with shisha smoking among students in universities in Palestine, Jordan and Turkey. Methods: An online cross-sectional study was carried out among university students from 3 different Middle East countries; Palestine, Jordan, and Turkey. A total of 812 students were selected for the study. They were asked to answer an online structured questionnaire consisted of questions concerning prevalence and patterns of Shisha smoking, and associated factors. Data was analyzed by Statistical Package for Social Sciences. Results: The overall prevalence of Shisha smoking was 31.77%. Less than quarter of university students (21.67%) had smoked shisha before. The highest percentage of current Shisha smokers were Palestinians (36.11%), and lowest percentage was from Turkey (20.23%). Approximately 43% of Shisha smokers believe that they will be addicted to Shisha smoking and almost half of them smoke Shisha daily. Approximately, 66% of Jordanian students’ current Shisha smokers were smoking shisha at least once daily while the 44% of Turkish students’ current shisha smokers were smoking shisha once monthly. The highest percentage of Shisha smokers were university students aged 25 years old and above. However, highest percentages of university students who are Shisha smokers were low monthly income’s students. The university students living with their families were smoking Shisha less frequently than students’ living in private residencies. Conclusions: There was a high prevalence of Shisha smoking among university students. The highest percentage of university students smoking Shisha were Palestinians. High percentage of smokers between the students believes that they will be addicted to Shisha smoking. The majority of current Shisha smokers was smoking Shisha daily; especially in Jordan and followed by Palestine. The monthly income was affecting the prevalence of Shisha smoking.