OJEpi  Vol.3 No.4 , November 2013
Water-pipe tobacco epidemic in tobacco naive communities: Experience from Ethiopia*
ABSTRACT
Water-pipe tobacco (WPT) is a public health threat of the 21st century. As a fashion, it swiftly spreads to all corners of the world in no more than two decades. It is a new phenomenon for Ethiopiain general and for Amhara National Regional Statein particular. The major objective of this study was to gain in-depth baseline information about water-pipe tobacco smoking practice in Bahir Dar City, 2012. An explorative study was conducted at Bahir Dar City—capital of Amhara National Regional State. It is home for one of the largest universities in the country with more than 40,000 students. Of the total 50 WPT lounges, six were identified based on their customer variety, and loaded by the help of police officers who had ample experience in fighting the expansion of WPT smoking in the city. A total of 115 people participated in this study. In-depth interviews and focus group discussions (FGD) were conducted, and the tape recorded data were thematically analyzed. More than 80% of the study participants were below 40 Years, and more than 30% of the total study participants were students. The profession of the remaining participants ranges from daily laborers to university instructors. Females accounted for 37.39%. The following factors were found to be pertinent for rapid increment of water-pipe tobacco smoking: geographic and economic accessibility, peer pressure, deceiving characteristics of WPT-non-irritant and aromatic, lack of knowledge, and absence of effective policy. The most outstanding findings of this study were the following: almost all of the study participants were tobacco naive and really unaware of the contents WPT; but about 94% of them had been khat chewers before they started with WPT smoking. In this region, khat had until recently been used by the Muslims only. WPT smoking is an even more recent phenomenon. “Khat stimulates, and WPT calms down,” said study participants. That means by using the later as an antidote for the former, people start ruining their health with substances containing chemicals proven to be notorious to human health. This combination of deadly addictions seems to be peculiar to Ethiopia and appears to be a serious public health threat to tobacco naive communities in the region. Therefore, their rapid progression needs to be met with appropriate interventions urgently. It also warrants further investigations.

Cite this paper
Gedefaw, M. , Eshete, A. , Aychiluhem, M. and Azale, T. (2013) Water-pipe tobacco epidemic in tobacco naive communities: Experience from Ethiopia*. Open Journal of Epidemiology, 3, 184-192. doi: 10.4236/ojepi.2013.34027.
References
[1]   World Health Organization (2004) Tools for advancing tobacco control in the 21st century tobacco control legislation: An introductory guide. Geneva.

[2]   World Health Organization (2008) WHO report on tobacco epidemic. MPOWER Package. Geneva.

[3]   Smoking and Health Action Foundation (2013) Waterpipe smoking: Bubble trouble.

[4]   Shane MacGuill (2012) Japan tobacco extends scope with acquisition of the world’s largest Shisha manufacturer. Euro-Monitor International.

[5]   Maziak, W. (2008) The water-pipe: Time for action. Addiction.

[6]   WHO (2006) WHO the health hazards of smoking Shisha. Regional office for the Eastern Mediterranean. Cairo.

[7]   Egyptian Smoking Prevention Research Institute (2006) Tobacco use in Shisha: Studies on water-pipe smoking in Egypt/WHO Regional Office for the Eastern Mediterranean.

[8]   American Lung Association (2009) An emerging deadly trend: Water-pipe tobacco use.

[9]   Akl, E.A., Gunukula, S.K., Aleem, S., Obeid, R., Jaoude, P.A., Honeine, R. and Irani, J. (2011) The prevalence of water-pipe tobacco smoking among the general and specific populations: A systematic review. BMC Public Health, 11, 244. http://dx.doi.org/10.1186/1471-2458-11-244

[10]   Chaouachi, K. (2009) Hookah (Shisha, Narghile) Smoking and environmental Tobacco smoke (ETS). A critical review of the relevant literature and the public health consequences. International Journal of Environmental Research and Public Health, 6, 798-843. http://dx.doi.org/10.3390/ijerph6020798

[11]   Federal Institute for Risk Assessment (BFR) (2009) Frequently asked questions about water-pipe.

[12]   Non-Smokers’ Rights Association (2012) Water-pipe smoking in Canada: New trend, old tradition.

[13]   Reda, A.A., Moges, A., Biadgilign, S. and Wondmagegn, B.Y. Prevalence and determinants of Khat (Catha edulis) chewing among high school students in Eastern Ethiopia: A cross-Sectional Study. PLOS ONE, 7, e33946. http://dx.doi.org/10.1371/journal.pone.0033946

[14]   Colzato, L.S., Ruiz1, M.J., Van den Wildenberg, W.P.M., Hommel, B. Khat use is associated with impaired working memory and cognitive flexibility. PLOS ONE, 6, e20602. http://dx.doi.org/10.1371/journal.pone.0020602

[15]   Dessie, G. (2013) Is khat a social ill? Ethical arguments about a “stimulant” among the learned Ethiopians. ASC Working Paper African Studies Centre, Leiden.

[16]   Dhaifalah, I. and Santavy, J. (2004) Khat habit and its health effect. A natural amphetamine. Biomed Papers, 148, 11-15. http://dx.doi.org/10.5507/bp.2004.002

[17]   The scientific basis of tobacco product regulation: Report of a WHO study group. WHO technical report series.

[18]   Korn, L., Harel-Fisch, Y., Amitai, G. and Social and Behavioral Determinants of Nargila Smoking among Israeli Youth (2008) Findings from the 2002 HBSC survey. Journal of Substance Use, 13, 225-238. http://dx.doi.org/10.1080/14659890701682220

[19]   Aljarrah, K., Ababneh, Z.Q. and Al-Delaimy, W.K. (2009) Perceptions of hookah smoking harmfulness: Predictors and characteristics among current hookah users. Tobacco Induced Diseases, 5, 16. http://dx.doi.org/10.1186/1617-9625-5-16

[20]   Azab, M., Khabour, O.F., Alkaraki, A.K., Eissenberg, T., Alzoubi, K.H. and Primack, B.A. (2010) Water pipe tobacco smoking among university students in Jordan. Nicotine & Tobacco Research, 12, 606-612. http://dx.doi.org/10.1093/ntr/ntq055

[21]   Cobb, C.O., Shihadeh, A., Weaver, M.F. and Eissenberg T. (2011) Water-pipe tobacco smoking and cigarette smoking: A direct comparison of toxicant exposure and subjective effects. Nicotine & Tobacco Research, 13, 78-87. http://dx.doi.org/10.1093/ntr/ntq212

[22]   Nakkash, R.T., Khalil, J. and Afifi, R.A. (2011) The rise in narghile (shisha, hookah) waterpipe tobacco smoking: A qualitative study of perceptions of smokers and non smokers. BMC Public Health, 11, 315. http://dx.doi.org/10.1186/1471-2458-11-315

[23]   Ray, C.S. (2009) The hookah—The Indian water-pipe. Current Science, 96, 25.

[24]   Sameer-Ur-Rehman, S.M.A., Parekh, M.A. and Zubairi, A.B.S. (2012) Cross-sectional study identifying forms of tobacco used by Shisha smokers in Pakistan. JPMA, 62, 192.

[25]   Action on Smoking and Health (2010) Fact sheet on water-pipes. www.ash.org.uk

[26]   Daniels, K.E. and Roman, N.V. (2013) A descriptive study of the perceptions and behaviors of water-pipe use by university students in the Western Cape, South Africa. Bio Med Central. Tobacco Induced Diseases, 11, 4.

[27]   Schubert, J., Kappenstein, O., Luch, A. and Schulz, T.G. (2011) Analysis of primary aromatic amines in the main-stream water-pipe smoke using liquid chromatography electro spray ionization tandem mass spectrometry. Journal of Chromatography, A. 12, 5628-5637.

[28]   Eissenberg, T. and Shihadeh, A. (2009) Waterpipe tobacco and cigarette smoking. Direct comparison of toxicant exposure. American Journal of Preventive Medicine, 37, 518-523.

 
 
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