BACKGROUND: The harmful effects of shisha (hookah or waterpipe) tobacco smoking are similar to those of cigarette smoking, including lung cancer and lowering immunity levels. Shisha smokers inhale carbon monoxide, metals, cancer causing chemicals and more nicotine than cigarette smokers. Countries in the Southern Africa sub-region, including Zambia have had no data on the prevalence and correlates for shisha smoking. This study presents first ever results on the prevalence and correlates for ever smoked shisha among school going adolescents in Zambia.
METHODS: This was a cross-sectional study, stratified by region (Lusaka, Tobacco growing and rest of country). In each region, the required sample sizes were 25 schools and 1875 students. A total of 8336 students were selected using a stratified two-stage cluster sampling method. Data were collected using an adapted Global Youth Tobacco Survey questionnaire. Associations were established using adjusted odds ratios and their 95% confidence intervals.
RESULTS: A total of 6499 students participated in the survey, giving an overall response rate of 75.1%. The prevalence for ever smoked shisha was 17.5%. By the age of 15 years 74.1% of the students had tried smoking shisha. Major factors associated with ever smoked shisha were: <12 years of age (AOR=3.38, 95% CI: 3.25, 3.51), ever used smokeless tobacco (AOR=2.45, 95% CI: 2.42, 2.48), having no closest friend who smoke tobacco (AOR=0.61, 95% CI: 0.60, 0.62), and ever smoked cigarettes (AOR=2.16, 95% CI: 2.13, 2.19).
CONCLUSIONS: The results indicate that shisha smoking may be common in Zambia. It is important to establish its current prevalence and its correlates in order to suggest interventions to curtail shisha smoking in the country.