Water pipe Smoking: Prevalence and Addiction among University students in Palestine, Jordan, and Turkey

Abstract Background Smoking is one of the main causes of lung cancer. It was estimated that tobacco smoking might kill 10 million people annually in the next 20–30 years, and Shisha smoking has been a common habit worldwide during the last 20 years, especially in the Middle East. This study aimed to determine the prevalence of Shisha smoking and to make comparisons among three countries in the Middle East, thereby establishing factors associated with shisha smoking among university students in Palestine, Jordan, and Turkey. Method An online cross-sectional study was carried out among university students from Palestine, Jordan, and Turkey. A total of 2030 students were selected for the study. The students were asked to answer an online structured questionnaire consisting of questions concerning the prevalence and patterns of Water pipe smoking and associated factors. Result The overall prevalence of Water pipe smoking was 31.8%. Less than a quarter of university students (21.7%) had ever smoked Water pipe. The highest percentage of current Water pipe smokers were Palestinians (36.11%), and the lowest percentage was from Turkey (20.23%). Approximately 43% of Water pipe smokers believe that they will be addicted to Water pipe smoking and almost half of them smoke Water pipe daily. The highest percentage of Water pipe smokers were university students 25 years old and above. However, the highest percentages of university students who are Water pipe smokers were students with a low monthly income. The university students living with their families were smoking Water pipe less frequently than students living in private residencies. Conclusion This study concludes that there is a high prevalence of Water pipe smoking among university students in Palestine, Jordan, and Turkey. The highest percentage was found among Palestinians, which might be because there are no Water pipe smoking regulations in Palestine, whereas there are in Turkey. Monthly income and living with the family were factors affecting the prevalence of Water pipe smoking.