Predictors of Hookah Smoking among Women in Bandar Abbas, Southern Iran: A Cross-Sectional Study Based on the Intervention Mapping Protocol

Abstract

Background: The purpose of this study was to determine the predictors of hookah smoking (HS) among professional HS women in Bandar Abbas, southern Iran using intervention mapping protocol. Methods: The present cross-sectional study is part of a larger study, which was conducted on 332 HS women using a multistage (clustered and randomized) process. Data were collected from October 2018 to August 2019 using a researcher-made questionnaire. Results: Mean age of the participants was 36.1 ± 13.3 years. Ordinal regression model, after the control of confounding variables, showed that attitudes, self-efficacy, habits, and intention were the most important predictors of HS behavior in women (OR = 1.14). The prevalence of HS was 1.76 times higher in women who did not want to quit hookah. Knowledge and Social norms were not associated with the HS behavior. Conclusions: According to the present findings, changing or eliminating women’s positive attitude toward HS is deemed possible through reducing the social acceptance of HS in enculturating the negative attitude in society, enhancing women’s self-efficacy via purposeful and specific education on resisting hookah temptation, unraveling all factors involved in habit formation and adjusting these factors through long-term interventions and timely interventions to affect intention to consumption before the actual occurrence of behavior (HS).

Keywords:

• Hookah
• smoking
• women
• intervention mapping
• predictions

TRIAL REGISTRATION:

• IRCT20190126042494N1

Acknowledgements

The authors would like to thank National Institute for Medical Research as their financial support. The authors also express their gratitude to the participants for their sincere cooperation in this study.

Ethical considerations

Ethical approval was received for this study from the National Institute for Medical Research, (IR.NIMAD.REC.1398.21). Women provided written consent to participate in the study.

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Funding

This research received a grant from Nimad National Institute for medical research Development Grant No. 983514.