Hookah Smoking in Saudi Arabia

The issue of hookah smoking is a topical and strongly controversial in the current course of time. To be more precise, the dilemma involves the definition of the hookah that varies between a casual habit and health threatening dependency. The problem that was explored and analyzed deals with the dramatically increasing rate of hookah use in Saudi Arabia. The topicality of the study relies on the fact that Saudi Arabia has a high rate of the health and social risks associated with smoking hookah.

Hookah Smoking: Knowledge, Attitudes, and Behavior in Saudi Arabia

The purpose of the given study was to conduct a survey devoted to the attitudes, way of thinking and behavior involving hookah smoking in Saudi Arabia, and to provide credible and consistent data regarding the scope of concern. The course of investigation was conducted by means of employing a mixed method of quantitative and qualitative research design evaluating the knowledge, attitudes, and behavioral patterns of the respondents. The participants of the study were Saudi Arabian youths who used social media. The age group of the respondents varied between 18-27 years and included both male and female participants. The survey was offered to 120 individuals, when only 30 of them (25%) responded. The findings revealed that regarding hookah as a social event and as an image-making tool was one of the main reasons to try it. Moreover, the participants revealed comparatively low level of awareness about the risks and threats of hookah smoking, but knew about the harm of passive smoking. It was recommended to conduct more in-depth research regarding the motivation to smoke and to broaden the scope of information on a topic.

The given study is aimed at conducting an online survey among the young citizens of Saudi Arabia within the age group starting from 18 years in order to identify the attitude, comprehension, and behavioral patterns involving hookah smoking, and to result in credible and consistent data in the scope of concern. The responses to the questions of the given survey were provided on the voluntary basis. The survey was forwarded via WhatsApp application to the individual users and 163 of them responded. The given chapter analyzes the acquired outcomes from the survey constructively, and presents the justified and perspective conclusions. To be more precise, the attitudes, knowledge, and behavioral patterns of Saudi Arabian youth about hookah smoking will be discussed. As a matter of fact, both active and passive types of smoking are investigated. The final results are evaluated and summarized so that to demonstrate the actual contribution to the field of research and outline the perspective for further investigation.

The majority of the respondents were in the age group starting from 28 years and older, namely, 31.9 %. The respondents in the age group of 27 counted for 11.66%, 26-years old participants were 12.27% of the whole group, and 25-years olds individuals constituted approximately 6,13%. Moreover, the participants in the age of 24 were 6.75%, 23-years old respondents counted for 5.52%, the age groups of 22 and 21 covered 6.75% and 8.59% respectively, whereas 20-years old presented 6.13% of the whole group. The age groups that were most weakly represented in the given survey were people of 19 and 18 years – 2.45% and 1.84% correspondently.

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The given survey involved the participants of both sexes in order to provide objective outcomes for the consequent analysis. As a matter of fact, there were no limitations, obligatory requirements or restrictions in terms of sex factor. The respondents indicated such aspect in their answers, and the statistics is as follows: the number of male participants constitutes for 52.44%, whereas the female part is 47.56%. Hence, both sexes represented their stance according to the issue in question on equal terms.

One of the most important and predetermining questions of the currently discussed survey was as follows: “Have you ever smoke hookah, even one or two times?” The question is crucial as far as it outlines the preliminary scope of research and intensity of the tendency that is explored. The prevailing majority of the answers were positive, namely, 56.17% confirmed that they tried hookah smoking at least once. Moreover, it is crucial to highlight that two people refused to answer the aforementioned question. Hence, the statistics was based only on the responses of 162 participants. The fourth question was developed in the following way: “Do you know about the health risks and hazards of hookah smoking?” It is a generalized, but essential question that clarifies whether the young generation in Saudi Arabia is aware of the potential threat of the hookah, or ignorant about it. The answers to the given question globalize the problem and put the responsibility on the authorities of the country and medical system. As a matter of fact, 90.26% of the respondents confirmed their knowledge about the risks the hookah smoking could provoke. Two respondents skipped this question.

The next question addresses other habits that may be considered less harmful than smoking hookah. The habit of chewing tobacco gum is considered less threatening for the young generation of Saudi Arabia by 9.88% respondents, whereas electronic cigarettes were confirmed by 29.01% as more healthy habit. Smoking cigars was regarded as less harmful by only 7.41% of the participants, and 19.14% stated that smoking tobacco was less harmful than hookah. Furthermore, 28.40% of the individuals involved in the given survey activity stated that they did not know the difference between the levels of harm caused by the products represented in the list of unhealthy smoking habits. Additionally, 27.78% chose the option “I do not think any of the above is less harmful than smoking a hookah.” The number of the individuals who responded to this question was also 162.

The next important data that was acquired in the course of survey involved the revelation of the major reasons that motivated the youth of Saudi Arabia to start smoking hookah. It should be mentioned that five respondents skipped the aforementioned questions, and the amount of the actual respondents was 159. As a matter of fact, 51.57% of the participants stated that they did not smoke hookah. It means that they had only one time experience with the currently discussed activity. 3.77% of the respondents explained the reason of hookah smoking experience by the image they received due to it. To be more precise, hookah smoking made them popular and trendy, or, in other words, contributed to their reputation among the peers. The significant amount of the survey participants (27.67%) confessed that they wanted merely to experiment on the initial stage of smoking activity. 25.79% stated that hookah made them feel good, and it became a reason to start smoking on a regular basis. The rest part of the whole group of respondents, 1.26%, emphasized that hookah smoking was a socializing factor and contributed to their new friendship.
The seventh question was aimed at revealing the attitudes and opinions to passive smoking. Four respondents ignored the question.

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Five participants out of 160 (3.13%) considered breathing the hookah smoke safe, whereas the majority of the individuals who were surveyed, namely, 99 people (61.88%) stated that passive smoking provoked much harm. The respondents who chose other options of attitude were differentiated in the following way: little harm of passive hookah smoking was supported by 11.25% (18 individuals) and some harm was selected by 23.75% (38 respondents).

In order to narrow the scope of research and acquire more specific outcomes, the next question addresses the following aspect: “During the last 30 days, how many days did you smoke a hookah?” The amount of actual responses was 160, out of which the majority, namely, 65.63% (105 individuals) confirmed that they did not smoke hookah during the last 30 days. Nonetheless, the rest of the participants apparently adhered to such activity occasionally. To be more precise, the one-time or two-time practice of hookah smoking was chosen by 20 participants (12.50%), whereas the frequency between 3-6 times per month was revealed by 2.50% (4 individuals). Ten people (6.25%) smoked hookah starting from seven to 14 times during the last 30 days, and only three of the whole group did it 14-22 times per month (1.88%). Additionally, 9 respondents (5.63%) smoked hookah from 22 to 29 times per last month, and the same quantity of people stated that they smoked hookah every day during the last month. Hence, the practice of every day hookah smoking is evidently an ordinary issue for the substantial quantity of the surveyed individuals.
The ninth question features the starting point in terms of hookah smoking, namely, the age at which the respondents started smoking.

Five individuals skipped the given question. Therefore, the statistics was calculated on the basis of the answers provided by 159 people. The prevailing majority of the participants of the given survey, 74 people (46.54%), highlighted that they had never been hookah smokers. Moreover, the age group from 8 to 11 was not checked as a starting point of hookah smoking. As a matter of fact, the youngest smoker was one individual (0.63%) who tried smoking hookah in the age of twelve. Furthermore, there was another single respondent who tried smoking hookah when he or she was 14 (0.63%). Nonetheless, the age groups starting from 15 years reveal gradual decrease in the quantity of hookah smokers. To be more precise, four persons (2.52%) started smoking in the age of 15, the same number tried it in 16, and twelve respondents chose the age of 17 as the time of starting hookah smoking. Eight participants (5.03%) chose the option of 18 years, and eleven respondents (6.92%) stated that they started smoking hookah a year later, in 19. The age of 20 was the beginning of hookah experience for eleven people (6.92%), and 21 for seven other participants (4.40%). Eight respondents (5.03%) started smoking in 22, and only 3 people (1.89%) in 23. Furthermore, 24 was the age when 7 people (4.40%) started hookah smoking, and only eight respondents out of 159 participants (5.03%) began their hookah experience in the age of 25 years or older.

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Finally, the tenth question of the currently discussed survey was as follows: “Have you ever thought about quitting hookah smoking?” The question is a perspective final element of the given research. Only four respondents skipped it, and the results are based on the responses of 160 people. 101 participants chose a box stating “I do not smoke a hookah.” Hence, 63.13% of the participants considered themselves automatically to be non-smokers on the regular basis. In addition, 5% of the whole survey group (eight people) stated it was their aim to quit hookah smoking during the next month, whereas 6 participants (3.75%) considered it to be their target for the next six months. The other four respondents were determined to quit smoking within a year. 29 respondents (18.13%) revealed their will to quit the given habit, but highlighted that they did not make a precise decision concerning the time, and twelve participants of the survey (7.50%) stated that they were not intended to quit hookah smoking.

Furthermore, it is appropriate to discuss the limitations, assumptions, and their actual violation. It was assumed that every case of participation in the given survey was voluntary and presupposed honest responses. Nonetheless, every question featured particular inquiry that provoked several participants to skip the actual response. As a result, it may be interpreted as a violation of the initial assumption, since the individuals were willing to partake in the surveying activity. In any case, it should be noted that there was no voluntary readiness to provide honest and precise data about their opinions, experience, and attitudes within the scope of concern. Moreover, the assumption that none of the participants lied during the entire study period did not become questionable as far as those who did not want to be honest in terms of responding the given questions skipped them. At the same time, the rest of the answers were provided on the sincere and clear terms. Furthermore, the assumption that the methods of computation of the collected data were accurate was also proved in the course of the given study.

The issue of limitations of the present investigation was connected with the demographic, age, and geographic factors. It is caused by the fact that the given survey study was specifically developed to evaluate the actual awareness of the young generation in Saudi Arabian world, their attitudes, and behavioral patterns related to hookah smoking. Nevertheless, it was done in such way in order to narrow the scope of research and provide credible and detailed outcomes.

Evaluation of Findings

The findings of the survey that was conducted online and included ten significantly guiding questions reveal peculiar tendencies and attitudes toward the practice of hookah smoking among the youth in Saudi Arabia. First, it is important to highlight that although the majority of the respondents confirmed that they tried hookah smoking, it was not prevailing, while 43.83% of the respondents never tried it at all. Nonetheless, the overall tendency is disturbing as far as substantial quantity of young people in Saudi Arabia smoke hookah regularly. Moreover, the fact that the prevailing majority of them is aware of potential risks and threats that are imposed by hookah smoking, they are not intended to refuse the habit. It reveals comparatively low level of informative provision, since 9.26% of the respondents are ignorant about the threat of hookah. It leads to the assumption that they regard hookah smoking as one of diverse types of traditions connected with the social context.


The preliminary research in the given field featured the hookah smoking practice as a unique social event. Moreover, Sharma, Beck & Clark (2013) highlight that the issue of concern provokes great risks connected with health condition. Hence, the findings of the given study align with data acquired in the course of preliminary research.
Consequently, the depth and appropriateness of the risks comprehension imposed by hookah smoking demonstrated by the participants of the survey should be considered questionable. It is caused by the fact that the outcomes of the fifth question revealed that the smokers are usually unaware of alternatives that are really less harmful for their health. Hence, if they are ignorant about major issues connected with the impact of hookah on health condition, they are most certainly unaware about the diversity of diseases hookah may provoke as the study of previous research indicates. The discussion of the reasons of hookah smoking illustrated that the majority of actual smokers or those who at least tried it initiated smoking experience in order to align with the experience of others.

To be more precise, even the answer “to experiment” that acquired the majority of the voices among the respondents who were actual smokers should be related to the socially relevant roles and stereotypes. It means that the experiments are usually conducted in cases when it is a popular, challenging or obligatory activity within a particular community. Moreover, the answer “It just makes me feel good” should also be regarded as the one that relies on socially predetermined experience, considering the fact that the person is expected to know that is good from the close surrounding in order to try it. Hence, the aforementioned evaluation aligns with the stance featured by Abdalla, Al-Kaabba, et al. (2006), who state that “Arab adolescents could believe smoking to help increase the masculine image and perception of maturity among peers.”. Furthermore, the outcomes of questions concerning passive and active smoking are essential in the given context. The responses reveal proper and sufficient understanding of the harm that is provoked by inhaling the hookah when other people smoke. Such aspect of the currently discussed dilemma is crucial as far as it concerns health, environmental, and social issues. Nevertheless, the fact that substantial number of people did not try hookah smoking at all should be regarded as a step toward the enhancement of the given problem. Consequently, the stance presented by Fida and Abdelmoneim (2013) correlated with the acquired results.

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Finally, it is crucial to highlight that there is a perspective that the majority of current hookah smokers will eventually quit their habit. In any case, most of them have not decided it precisely yet. Hence, the preliminary decision is made, but the terms are not set. It means that diverse policies and supporting programs should be introduced in Saudi Arabia in order to help such individuals make a proper and rightful decision.

The evaluation of the survey findings resulted in proper alignment between preliminary study of the scope of concern and primary data. The tendency to smoke hookah is interpreted as a social event and is regarded as a strong threat to the health condition of the youth of Saudi Arabia.

Thus, the conducted survey revealed that the tendency to smoke hookah is strong and widely spread. The reasons of smoking were primarily related to considering hookah a social event and an image-making instrument. Moreover, the individuals revealed comparatively low level of awareness about the risks and threats of hookah smoking. Nonetheless, they were informed about the harm of passive smoking. Therefore, it is evident that more thorough and constructive informative support is necessary in order to contribute to elimination of hookah use among the youth in Saudi Arabia. Consequently, implementation of different programs, strategies, and policies at state level will be appropriate. Furthermore, it is recommended to conduct more in-depth research regarding the motivation to smoke to broaden the scope of research.

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