Beliefs and attitudes related to narghile (waterpipe) smoking among university students in Syria

Wasim Maziak, Thomas Eissenberg, Samer Rastam, Fadi Hammal, Taghrio Asfar, Mohamed E. Bachir, Mohamed F. Fouad, Kenneth D. Ward

Research output: Contribution to journalArticlepeer-review

133 Scopus citations


Purpose To assess the beliefs and attitudes related to narghile (waterpipe) smoking that are likely to contribute to its increased popularity among young people in Syria. Methods In 2003, a cross-sectional survey was administered to university students in Aleppo, using an interviewer-administered questionnaire. Overall, 587 students participated in the study (278 males, 309 females; mean age, 21.8 ± 2.1; response rate 98.8%). Results The most common positive perceptions of narghile were related to its smell and taste. Negative perceptions of narghile included the smoke produced, the pollution, and perceived adverse health effects. Students believed the popularity of narghile to be part of a rising regional trend in its use, due to its being an appealing way to spend leisure time socializing with friends. More students (49.7%) believed narghile to be more harmful to health than cigarettes, compared with 30% who believed the opposite. Respiratory disease was the most commonly cited health effect of narghile smoking. Family attitudes regarding tobacco use by younger members were more permissive about narghile compared with cigarettes, and, surprisingly, were more permissive about females smoking narghile than males doing so. Conclusions The rise in narghile smoking as a trendy social habit appears to be occurring despite considerable appreciation of its potential health risks. Permissiveness of adult family members towards narghile use by young female members, especially in the presence of a strong taboo against female cigarette smoking may contribute to the continuous spread of narghile smoking among women in Syria.

Original languageEnglish (US)
Pages (from-to)646-654
Number of pages9
JournalAnnals of Epidemiology
Issue number9
StatePublished - Oct 2004
Externally publishedYes


  • Attitudes
  • Beliefs
  • Narghile Smoking
  • Syria
  • University Students
  • Waterpipe

ASJC Scopus subject areas

  • Epidemiology


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