Predictors of Shisha Consumption among Students in Tertiary Institutions: A Systematic Review

Abstract

Tobacco use is a risk factor for several diseases, disabilities and premature deaths. Shisha is specially flavoured tobacco and majority of the users perceive hookah smoking to be safer than cigarette. Shisha use has become rampant and trendy among students in tertiary institutions. This review aims to evaluate predictors of shisha consumption among students in tertiary institutions. We reviewed references of authentic databases and journals including Web of Science, PubMed, Iranian Databases, National Agency for the Campaign against Alcohol and Drug Abuse, CDC and WHO. The review focused on data documented from 2010 up to 2020.Predictors of shisha use were: shisha availability and accessibility, flavouring ,gender, awareness level, parental factors, marital status, social acceptability, peer pressure, birth order, monthly stipend, course enrolled in, internet and legal framework on hookah smoking. Most students using shisha reported to be poly drug users with marijuana, tobacco products, alcohol and khat. Most students consume shisha either singly or concurrently or simultaneously alongside other drugs. However, it is not possible to tell if shisha use preceded use of other drugs or was an aftermath. There is need to strengthen laws and policies regulating waterpipe industry. Since nearly all the reviewed literature was based on self-reported history which is prone to both social desirability bias and memory recall bias there is need to have confirmed incidence of shisha use in this sub-population.