Document Type : Original Article


1 Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran

2 Research Center for Environmental Determinacies of Health, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran

3 Department of PublicHealth, School of Health, Hamadan University of Medical Sciences, Hamadan, Iran


BACKGROUND: The prevalence of water pipe smoking is increasing among young people, but
there are limited data on its use among adolescents in Iran. The aim of this study is to investigate the
prevalence of WP smoking and associated risk factors among female adolescents in Western Iran.
MATERIALS AND METHODS: This cross‑sectional study was conducted in schools. It included 1302
middle school (48.1%) and high school (51.9%) female students (grades 7–12) recruited through
stage random sampling and conducted in 2019 in the western city of Kermanshah, Iran. The data
collection tool was a researcher‑made questionnaire. Logistic regression analyses and descriptive
statistics were executed using SPSS version 22.
RESULTS: The mean (standard deviation) ages of the students and the ages when the participants
started WP smoking were 15.22 ± 1.85 and 13.64 (1.64), respectively. Nearly 32.2% had a single
experience of WP smoking during their lifetime and 20.4% were current consumers of WP. Most
of the subjects smoked WPs at their friends’ home (45.8%) and with their friends (47.4%). The
significantly important factors that affect WP smoking in these age groups are the father’s and
mother’s occupation, family size, living with others, father’s education, having a friend who smokes
WPs, friends’ encouragement to smoke WP, and being in a family that smoke WPs.
CONCLUSIONS: Considering the increasing popularity of WP among adolescent females and its
increasing prevalence, the results showed that Water pipe smoking with friends played a key role in
WP smoking among female adolescents. There is a need to design interventional studies to increase
people’s skills and to design and implement programs to prevent water pipe.


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