Vol. 7, Issue 4, Part A (2024)

Background: Hookah, also known as shisha, nargile, and goza, is a popular method of tobacco consumption, particularly among adolescents in the Middle East. Despite its health hazards, many people still perceive hookah smoking as a safer alternative to cigarettes. Aims of the Study: This study aimed to explore adolescents' perceptions of the health risks associated with hookah smoking, patterns of use, and the social acceptance of hookah compared to cigarette smoking.

Subjects and Methods: A descriptive cross-sectional study was conducted among 500 male students from 10 secondary schools in Baghdad's Second Education Directorate/Al-Karkh. Data were collected through a self-administered questionnaire.

Results: The mean age of the students was 15 years. Of the participants, 59.8% were current hookah smokers, 16.2% had tried hookah in the past, and 40% smoked cigarettes. Daily hookah use was reported by 31.8%, weekly by 41.5%, and monthly by 26.8%. Most students (65.9%) smoked hookah with friends, with cafés being the most common smoking venue (52%). Although 64.8% agreed that hookah smoking is harmful, 36.6% believed it was not a bad habit, and 30.2% thought that smoking for a year or two posed no health risks. Community acceptance of hookah smoking was higher than for cigarette smoking (46% vs 32%). While most students knew that hookah smoke contains harmful chemicals and can cause cancer, heart disease, and second-hand smoke exposure risks, significant misconceptions about its safety persisted.

Conclusions: Hookah smoking was more prevalent than cigarette smoking, with considerable misinformation regarding its health risks. Non-smokers demonstrated better knowledge of hookah's hazards than current smokers.