An Exploration of the Role of Family Influences on Waterpipe TobaccoSmoking among Women

Background: Background: Waterpipe tobacco smoking (WTS) is a traditional method for tobaccosmoking. Despite the serious health outcomes of WTS, its popularity has significantly boostedamong adolescent and young adult women. Various factors have led to this catastrophe. For years,family influence has reigned as the most important contributor to adolescent smoking initiation, inthe views of researchers, the general public, and the tobacco companies. This study focused onrole of family influences on WTS among women.Methods: In this qualitative study, Participants included ۳۴ adolescent and young adult womenwho had the experience of WTS and lived in Isfahan and Hamadan, Iran. However, to increase thestrength and consistency of the data, people who were somehow connected with this the issue arealso eligible to participate in the interviews. Other participants included ۸ family members,friends, WTS providers, teachers, and smoking control staffs. Sampling was done through bothpurposeful and snowball sampling and was continued up to data saturation. Data were collectedthrough individual in-depth semi-structured interviews and were analyzed by content analysis.Results: Two categories of facilitative and inhibitory factors related to the role of the family inwomen's WTS were revealed. The presence of a hookah user in the family and the girl'sparticipation in preparing hookah for family members, parents' divorce and family conflicts,insufficient financial and emotional support by the family have caused the tendency of women touse hookah. Having a healthy family, the family's negative attitude towards WTS and the creationof restrictions and bans on consumption at home, as well as the serious reactions of familymembers towards WTS, have played a deterrent role and caused them to reduce or stop usinghookah.Conclusion: These findings suggest that problem of WTS is not just an individual phenomenon,and provide insight for designing intervention strategies to promote household WTS bans.Therefore, WTS prevention interventions should be focused on targeting the family as well.