Prevalence and determinants of hookah use among college-going women of Delhi

As governments across the world implement tobacco-control measures, the tobacco industry responds by coming up with new products such as hookah, which are more appealing and affordable for young people-especially women-their primary target group. We assessed the prevalence and determinants of tobacco use among undergraduate women students of the University of Delhi with special emphasis on hookah use.

Using an anonymous self-administered questionnaire, we conducted a survey among the undergraduate women students of four colleges of the University of Delhi during March 2016. The tool was adapted from standard global surveys and had specific sections on tobacco use and patterns-use of shisha (hookah), smokeless tobacco as well as cessation and exposure to media and awareness about the harmful health effects of tobacco use. Point estimates along with 95% confidence intervals were estimated. Multivariate logistic regression was done to identify the determinants of current tobacco use and hookah use.

Of the 780 respondents (mean [SD] age 19.3 [1.08] years), 22.9% (20.1-26.0) used tobacco in any form, with hookah being the most prevalent form (20.3%). One-third of the respondents believed that hookah smoking was less harmful than cigarette smoking. The major determinants of hookah use were-attending a private school (1.84; 1.11-3.01) or all-women college (2.79; 1.80-4.33); tobacco use by friends (2.47; 1.61-3.77); belief that smoking is a sign of women empowerment (2.09; 1.05-4.1 7) and the belief that hookah smoking is less harmful than cigarette smoking (2.81; 1.92-4.13).

High prevalence of hookah use among young girls and women calls for a comprehensive approach including legislative options as well as increasing awareness about tobacco-cessation programmes among them.