Factors Affecting Hookah Smoking Trend in the Society: A Review Article

BACKGROUND An increase in hookah smoking is considered to be a serious health problem in societies withdifferent cigarette smoking patterns. Thus, determinants of increase in this behavior are needed to beidentified. This study aimed to review the articles related to the causes of hookah smoking in the society. METHODS This study reviewed the scientific references of authentic databases and journals, including Web ofScience, PubMed, Iranian Databases, Elsevier, Embase, Scopus, MEDLINE, CINAHL, CDC, and WorldHealth Organization (WHO). Overall, 84 scientific studies conducted during 1990-2015 were collected. FINDINGS Several studies on the prevalence of smoking hookah and its associated factors in the societysuggested that numerous factors played a role in interest in smoking hookah. The most common reasons forindividuals' inclination to smoke hookah were positive viewpoints toward smoking hookah, wrong beliefsabout its low risks, presumed lack of addiction, social acceptance, ease of access, wrong cultural habits, andregulative weakness. CONCLUSION Evidence indicated that a large spectrum of individual and social factors was effective in variouslevels of hookah consumption. Besides, it seems that single-component interventions and those solely basedon individual factors could not result in effective prevention. On the other hand, interventions based onecological approaches are suggested in this regard. Overall, it is essential to focus on the exclusion of positiveviewpoints toward hookah, develop the ability to say "no," relaxation, and resistance against temptations tosmoke hookah, culturalization, and regulation of strong laws.