Top

BMC Public Health

Published in:

Open Access 01-12-2018 | Research article

Shisha use among students in a private university in Kigali city, Rwanda: prevalence and associated factors

Authors: Omoboriowo Joad Omotehinwa, Ogendi Japheths, Iyamuremye Jean Damascene, Michael Habtu

Published in: BMC Public Health | Issue 1/2018

Abstract

Background

All over the globe shisha smoking is fast growing among different age brackets. Shisha use has been reported to be increasing among youths in African major cities. Its use is documented to result in health effects such as lung cancer, cardiovascular and respiratory conditions, periodontal diseases, keratoacanthoma which are also associated with cigarette smoking. In Kigali, Rwanda’s capital, reports indicate that shisha use is increasing among the youths, particularly the university students. The study aimed at determining the prevalence, and establishing factors associated with shisha use among students in a university in Kigali Rwanda, which will be a significant step in stemming shisha fame among youths in Rwanda as there was no previously documented evidence-based study.

Methods

A total of 427 students were selected for this cross-sectional study using stratified sampling method. A questionnaire was used to collect data on shisha use, knowledge about shisha, attitude towards shisha, and factors associated with use of shisha. The association between the independent variables and shisha use was assessed using chi-square p value < 0.05. Binary logistic regression was used to determine variables that were independently associated with shisha smoking.

Results

Prevalence of ever smoking shisha among the university students was 26.1% and that of those that smoked in the last month (30 days) was 20.8%. About 40 % (39.9%) of the participants that had heard about shisha before demonstrated low level of knowledge, and 41.6% of these reported shisha use in the last 30 days. Logistic regression revealed that the followings were independently associated with shisha smoking: always drink alcohol (p = 0.003); drink alcohol occasionally (p = 0.045); having friend(s) who smoke shisha (p = 0.001); being aware of shisha’s availability in cafes, bars and restaurants in Kigali (p = 0.022); positive attitude towards shisha smoking (p < 0.001) and participants with age < 20 years (p = 0.039).

Conclusions

There is a relative high prevalence of shisha smoking and a poor knowledge about its impact on health among these university students. Regular medical education and health promotion targeting the youths could improve knowledge and practices about shisha use. Shisha laws and regulations should be enacted, and fines imposed on individuals or group who flout them.

Available only for authorised users

World Health Organization T. WHO report on the global tobacco epidemic, 2011: warning about the dangers of tobacco. Most. 2011;152:1–152. Available from: http://www.who.int/about/licensing/%5Cnhttp://whqlibdoc.who.int/publications/2011/9789240687813_eng.pdf

Lopez AD, Murray CCJ. The global burden of disease, 1990 – 2020. Nat Med. 1998;4(11):1241–3.CrossRefPubMed

World Health Organization. WHO report on the global tobacco epidemic: Enforcing bans on tobacco advertising, promotion and sponsorship. Geneva; 2013. Available from: http://www.afro.who.int/publications/who-report-global-tobacco-epidemic-2013.

American Lung Association. An Emerging Deadly Trend: Waterpipe Tobacco Use. Tob Policy Trend Alert. 2007:1–9. Available from: https://www.sribd.com/document/36779247/Tobacco-Policy-Trend-Alert.

Raad D, Gaddam S, Schunemann HJ, Irani J, Abou Jaoude P, Honeine R, et al. Effects of water-pipe smoking on lung function: a systematic review and meta-analysis. Chest. 2011;139(4):764–74.CrossRefPubMed

El-Hakim IE, Uthman MAE. Squamous cell carcinoma and keratoacanthoma of the lower lip associated with “Goza” and “Shisha” smoking. Int J Dermatol. 1999;38(2):108–10.CrossRefPubMed

Cobb CO, Shihadeh A, Weaver MF, Eissenberg T. Waterpipe tobacco smoking and cigarette smoking: a direct comparison of toxicant exposure and subjective effects. Nicotine Tob Res. 2011;13(2):78–87.CrossRefPubMed

Eissenberg T, Shihadeh A. Waterpipe tobacco and cigarette smoking. Am J Prev Med. 2009;37(6):518–23. Available from: https://www.ajpmonline.org/article/S0749-3797(09)00583-2/fulltext.CrossRefPubMedPubMedCentral

Knishkowy B. Water-pipe (Narghile) smoking: an emerging health risk behavior. Pediatrics. 2005;116(1):e113–9. Available from: http://pediatrics.aappublications.org/content/116/1/e113.CrossRefPubMed

10.

Hakim F, Hellou E, Goldbart A, Katz R, Bentur Y, Bentur L. The acute effects of water-pipe smoking on the cardiorespiratory system. Chest 2011;139(4):775–81. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21030492.

11.

Habib M, Mohamed MK, Abdel-Aziz F, Magder LS, Abdel-Hamid M, Gamil F, et al. Hepatitis C virus infection in a community in the Nile Delta: risk factors for seropositivity. Hepatology (Baltimore, Md.). 2001;33(1):248–53. Available from: https://doi.org/10.1053/jhep.2001.20797.pdf (accessed 06 Apr 2018)CrossRef

12.

Steentoft J, Wittendorf J, Andersen JR. Tuberculosis and water pipes as source of infection. Ugeskr Laeger. 2006;168(9):904–7. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/16513054PubMed

13.

Neergaard J, Singh P, Job J, Montgomery S. Waterpipe smoking and nicotine exposure: a review of the current evidence. Nicotine Tob Res. 2007;9(10):987–94. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17943617%0Ahttp://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC3276363CrossRefPubMed

14.

Combrink A, Irwin I, Laudin G, Naidoo K, Plagerson S, Mathee A. High prevalence of hookah smoking among secondary school students in a disadvantaged community in Johannesburg. S Afr Med J. 2010;100(5):297–9.CrossRefPubMed

15.

Van der Merwe N, Banoobhai T, Gqweta A, Gwala A, Masiea T, Misra M, et al. Hookah pipe smoking among health sciences students. S Afr Med J. 2013;103(11):847–9.CrossRefPubMed

16.

Christine A. Knowledge, attitude and practices of shisha smoking among youths in Kampala. In: Unpublished master thesis; Makarere university Uganda; 2015.

17.

Hakim F, Hellou E, Goldbart A, Katz R, Bentur Y, Bentur L. The acute effects of water-pipe smoking on the cardiorespiratory system. Chest. 2011;139(4):775-81. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21030492.

18.

El Sherbiny NA, El Essawy A, Abdel Khalek EM. Knowledge and attitude towards smoking among Fayoum university students. Bulletin of High Institute of Public Health. 2010;40(3) Available from: http://www.fayoum.edu.eg/Medicine/ChestDiseases/pdf/DrAssem15.pdf (accessed 06 Apr 2018)

19.

Martinasek MP, Haddad LG, Wheldon CW, Barnett TE. Beliefs and attitudes associated with hookah smoking among a United States college population. Respir Care. 2017;62(3):370–9. Available from: http://rc.rcjournal.com/content/62/3/370.CrossRefPubMed

20.

Chaaya M, El-Roueiheb Z, Chemaitelly H, Azar G, Nasr J, Al-Sahab B. Argileh smoking among university students: a new tobacco epidemic. Nicotine Tob Res. 2004;6(3):457–63. Available from: https://academic.oup.com/ntr/article-abstract/6/3/457/1131201?redirectedFrom=fulltext.CrossRefPubMed

21.

Bishop M. Shisha; the new craze in Kigali. In: The New Times | Rwanda; 2013. Available from: www.newtimes.co.rw/section/read/66116. Accessed 07 Aug 2016.

22.

Manirakiza A. Shisha: smoking your way to death. In: The new times Rwanda; 2016.

23.

Republic of Rwanda Ministry of Health. Health Laws: Tobacco control law. 2013. Retrieved from: http://www.moh.gov.rw/fileadmin/templates/HLaws/Tobacco_control_law.pdf (date accessed 7 Sept 2017).

24.

Michielsen K, Beauclair R, Delva W, Roelens K, Van Rossem R, Temmerman M. Effectiveness of a peer-led HIV prevention intervention in secondary schools in Rwanda: results from a non-randomized controlled trial. BMC Public Health. 2012;12(1):729. Available from: http://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-12-729 CrossRefPubMedPubMedCentral

25.

Wosinski J. HIV risk among nursing students in Rwanda: self-efficacy, knowledge and attitudes. HIV Risk Among Nursing Students in Rwanda: Self-efficacy, Knowledge & Attitudes. 2008. Available from: http://ezproxy.ithaca.edu:2048/login?qurl=http%3A%2F%2Fsearch.ebscohost.com%2Flogin.aspx%3Fdirect%3Dtrue%26db%3Dcin20%26AN%3D109850757%26site%3Dehost-live%26scope%3Dsite.

26.

Van Decraen E, Michielsen K, Herbots S, Van Rossem R, Temmerman M. Sexual coercion among in-school adolescents in Rwanda: prevalence and correlates of victimization and normative acceptance. Afr J Reprod Health. 2012;16(3):139–53. Available from: https://tspace.library.utoronto.ca/bitstream/1807/61743/1/rh12051.pdf.

27.

Republic of Rwanda Ministry of Education. National school health policy. 2014 Retrieved from:https://hivhealthclearinghouse.unesco.org/sites/default/files/resources/rwanda_school_health_policy.pdf. Accessed 10 June 2017.

28.

Rwanda Ministry of Health Bans Shisha Smoking. The New Times | Rwanda. 2017. Retrieved from: www.newtimes.co.rw/section/read/225667. Accessed 12 Apr 2018.

29.

WHO. Advisory note: Waterpipe Tobacco Smoking: health effects, research needs and recommended actions for regulators, WHO study Group on tobacco Product regulation (TobReg). 2nd ed; 2015. Retrieved from: http://apps.who.int/iris/bitstream/handle/10665/161991/9789241508469_eng.pdf?sequenceAQ21=1.pdf. Accessed 20 Apr 2018.

30.

World Bank. The World Bank DataBank. Data Bank 2016. Available from: http://databank.worldbank.org/data/reports.aspx?Code=NY.GNP.PCAP.CD&id=1ff4a498&report_name=Popular-Indicators&populartype=series&ispopular=y.

31.

The Academic Registrar Office. Mount Kenya university. 2016.

32.

Cochran WG. Sampling techniques. New York: John Wiley and Sons; 1977. p. 428.

33.

Parker M. Types of Sampling. Univ Texas Austin; 2013. p. 1–5. Available from: www.ma.utexas.edu/users/parker/sampling/srs.htm#main.

34.

Maziak W, Ward KD, Afifi RA, Eissenberg T. Standardizing questionnaire items for the assessment of waterpipe tobacco use in epidemiological studies. Public Health. 2005;119(5):400–4.CrossRefPubMed

35.

Norman G. Likert scales, levels of measurement and the “laws” of statistics. Adv Health Sci Educ: Theory Pract. 2010;15(5):625–32.

36.

Viscusi WK. Age variations in risk perceptions and smoking decisions. Rev Econ Stat. 1991;73(4):577–88.

37.

Bilodeau M, Brenner D. Theory of Multivariate Statistics. Springer. 1999;288. Available from: http://books.google.com/books?hl=en&lr=&id=1pa0VpPC8gsC&oi=fnd&pg=PP7&dq=Theory+of+Multivariate+Statistics&ots=2c5AHYjia1&sig=GIuX5kyJwKxlONsrnuz_BGUBhkE. Accessed 30 Nov 2017.

38.

d’Amour MJ, Kwibuka E. Nationwide review of “Ubudehe” starts. In: The new times Rwanda; 2015.

39.

Jawad M, Lee JT, Millett C. Waterpipe tobacco smoking prevalence and correlates in 25 Eastern Mediterranean and Eastern European countries: cross-sectional analysis of the global youth tobacco survey. Nicotine Tob Res. 2016;18(4):395–402.CrossRefPubMed

40.

Zavery A, Qureshi F, Riaz A, Pervez F, Iqbal N, Khan JA. Water pipe (shisha) use and legislation awareness against shisha smoking among medical students: a study from Karachi, Pakistan. J Community Health. 2017;42(3):461–5.CrossRefPubMed

41.

Jawad M, Nakkash RT, Mahfoud Z, Bteddini M, Haddad P, Afifi RA. Parenteral smoking and exposure to environmental tobacco smoke are associated with waterpipe smoking among youth: results from a national survey in Lebanon. Public Health. 2015;129(4):370–6. https://doi.org/10.1016/j.puhe.2015.01.011 CrossRefPubMed

42.

Gilreath TD, Leventhal A, Barrington-Trimis JL, Unger JB, Cruz TB, Berhane K, et al. Patterns of alternative tobacco product use: emergence of hookah and E-cigarettes as preferred products amongst youth. J Adolesc Health. 2016;58(2):181–5.CrossRefPubMed

43.

Mandil A, Hussein A, Omer H, Turki G, Gaber I. Characteristics and risk factors of tabacco consumption among University of Sharjah students, 2005. East Mediterr Heal J. 2007;13(6):1449–58.CrossRef

44.

Taha AZ, Sabra AA, Al-Mustafa ZZ, Al-Awami HR, Al-Khalaf MA, Al-Momen MM. Water pipe (shisha) smoking among male students of medical colleges in the eastern region of Saudi Arabia. Ann Saudi Med. 2010;30(3):222–6. https://doi.org/10.4103/0256-4947.62838 CrossRefPubMedPubMedCentral

45.

Ministry of Health Republic of Uganda. The tobacco control Act 2015. 2015. Retrieved from: http://health.go.ug/sites/default/files/Uganda_Tobacco_Control_Act_0.pdf (accessed 10 Oct 2017).

46.

Tanzania bans shisha smoking over health concerns. British Broadcasting Corporation (BBC) News. 2016. Retrieved from: www.bbc.com/news/world-africa-36715088 (accessed 30 Sept 2017).

47.

Mohammed H, Newman I, Tayeh R. Sheesha smoking among a sample of future teachers in Kuwait. Kuwait Med J. 2006;38(2):107–13.

48.

Amin TT, Amr MAM, Zaza BO, Suleman W. Harm perception, attitudes and pradictors of waterpipe (shisha) smoking among secondary school adolescents in Al-Hassa, Saudi Arabia. Asian Pacific J Cancer Prev. 2010;11:293–301. Available from: http://s3.amazonaws.com/academia.edu.documents/30693956/293_Tarewk_Amin.pdf?AWSAccessKeyId=AKIAJ56TQJRTWSMTNPEA&Expires=1468914734&Signature=xZo1304bCGKkvbaspz6kWC4J2Yk%3D&response-content-disposition=inline%3B filename%3DHarm_perception_attitudes_and_pre

49.

Sutfin EL, McCoy TP, Reboussin BA, Wagoner KG, Spangler J, Wolfson M. Prevalence and correlates of waterpipe tobacco smoking by college students in North Carolina. Drug Alcohol Depend. 2011;115(1–2):131–6.CrossRefPubMedPubMedCentral

50.

Dugas E, Tremblay M, Low NCP, Cournoyer D, O’Loughlin J. Water-pipe smoking among North American youths. Pediatrics. 2010;125(6):1184–9. Available from: http://pediatrics.aappublications.org/content/125/6/1184.CrossRefPubMed

51.

Al MA. The prevalence of smoking among Karbala/Iraq university students in Iraq in 2005. Tob use insights. 2014;7:9–14. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=4335460&tool=pmcentrez&rendertype=abstract

52.

Hussain HY, Abdul Satar BA. Prevalence and determinants of tobacco use among Iraqi adolescents: Iraq GYTS 2012. Tob Induc Dis. 2013;11(1):14. Available from: http://tobaccoinduceddiseases.biomedcentral.com/articles/10.1186/1617-9625-11-14 CrossRefPubMedPubMedCentral

53.

Nuzzo E, Shensa A, Kim KH, Fine MJ, Barnett TE, Cook R, et al. Associations between hookah tobacco smoking knowledge and hookah smoking behavior among US college students. Health Educ Res. 2013;28(1):92–100.CrossRefPubMed

54.

Jamil H, Janisse J, Elsouhag D, Fakhouri M, Arnetz JE, Arnetz BB. Do household smoking behaviors constitute a risk factor for hookah use? Nicotine Tob Res. 2011;13(5):384–8.CrossRefPubMed

55.

Eissenberg T, Ward KD, Smith-Simone S, Maziak W. Waterpipe tobacco smoking on a U.S. college campus: prevalence and correlates. J Adolesc Health. 2008;42(5):526–9.CrossRefPubMed

56.

Marcia JE. Development and validation of ego-identity status. J Pers Soc Psychol. 1966;3:551–8.CrossRefPubMed

57.

Jawaid A, Zafar AM, Rehman TU, Nazir MR, Ghafoor ZA, Afzal O, et al. Knowledge, attitudes and practice of university students regarding waterpipe smoking in Pakistan. Int J Tuberc Lung Dis. 2008;12(9):1077–84.PubMed

58.

Al-Naggar Ra BY. Shisha smoking and associated factors among medical students in Malaysia. Asian Pac J Cancer Prev. 2012;13(11):5627–32.CrossRefPubMed

Title: Shisha use among students in a private university in Kigali city, Rwanda: prevalence and associated factors
Authors: Omoboriowo Joad Omotehinwa
Ogendi Japheths
Iyamuremye Jean Damascene
Michael Habtu
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: BMC Public Health / Issue 1/2018
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-018-5596-1

At a glance: The STEP trials

Springer Medicine

Shisha use among students in a private university in Kigali city, Rwanda: prevalence and associated factors

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2018

Construction of China cardiovascular health index

Prevalence of poppers use and its sexual risks among men who have sex with men in southwestern China: a cross-sectional study

A qualitative assessment of the smoking policies and cessation activities at smaller workplaces

Improving cardiometabolic health through nudging dietary behaviours and physical activity in low SES adults: design of the Supreme Nudge project

Safety monitoring of ROTAVAC vaccine and etiological investigation of intussusception in India: study protocol

Current high prevalences of Strongyloides stercoralis and Opisthorchis viverrini infections in rural communities in northeast Thailand and associated risk factors