Investigating the factors affecting hookah smoking during the COVID-19 pandemic: Application of Protection Motivation Theory

Introduction In recent decades, hookah use has been considered a common method of smoking. Since hookah use is one of the factors exacerbating the coronavirus disease, COVID-19, the present study aimed to determine the factors affecting hookah smoking during the COVID-19 pandemic using protection motivation theory (PMT). Methods This is a cross-sectional study and conducted on 560 people aged ≥13 years living in Hamedan. Data were collected electronically using a researcher-made questionnaire consisting of three parts. The first, second, and third parts included demographic information, questions about hookah use, and information about the constructs of PMT, respectively. Data were analyzed using SPSS 22 software. Results The mean age of the participants was 28.8 ± 9.6 years. In the regression analysis of perceived reward structures (β=0.378), perception sensitivity (β=0.208), self-efficacy (β=0.0166) were respectively the important predictors for the intention of hookah use behavior. Overall, the constructs of the PMT explain 71% of the variance of the changes in the behavioral intention construct in the participants. No significant relationship was observed between self-efficacy constructs (r=0.039) and perceived cost. The prevalence of hookah use before the COVID-19 pandemic in participants was 41.8%, which decreased to 35% during the COVID-19 pandemic. Conclusions A greater correlation between the constructs of the PMT concerning protective behaviors against COVID-19 emphasizes designing educational programs based on this theory and the role of media to increase people’s knowledge in preventive behaviors.