Chapter # 1

Introduction

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Introduction

Historically, addiction has been defined as physical and psychological dependence on

psychoactive substances for example alcohol, tobacco, heroin and other drugs. Addiction

is a term used for a complex behavioral disorder. The most obvious symptom is that

addicts reach a point where they cannot control their own actions. Even when they can

see the harm, they continue the uncontrollable behavior. They are unable to stop; their

desire for that particular thing goes to extreme where there is no sense of right and

wrong. (Doyle, 2008)

(Taylor, 2002) Addiction was first described as a failure of will power. We now know

this is incorrect. Addiction is a real disease with psychological, genetic, and psychosocial

aspects. It is not a character flaw or a failure of morality. There are actual changes that

occur in the brains of addicts and treatments for addiction must address the reason behind

the behavior.

(Peter, 2010) Shisha (Also called hookah, hooka, huka, nargile, narghile, shisha, shesha,

sheesha, nargila, or shishah and even Hubbly Bubbly) is known by many names. Shisha

is most commonly referred to as goza and narghile, although most of the people know it

as hookah. Originating in Turkey over 500 years ago, this smoking culture has been the

standard for centuries in the Middle East and was smoked by royalty and people alike to

smoke away the day’s stress. Today this experience is shared across the world as many

people prefer Shisha smoking to cigarettes and cigars because of the smooth, flavorful,

and cool taste of the smoke. Shisha is a tobacco waterpipe that was first used in Asia and

the Middle East but has gained popularity in many countries. Shisha essentially is a

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waterpipe used for smoking purposes, originating about is a unique waterpipe device that

is used as a smoking tool and has been the standard of smoking for centuries. Shisha

Tobacco (Also called tabac, tombako, tumbak, gouza, guza, moassel, sheesha) tobacco is

available in a variety of flavors including apple, apricot, strawberry, cappuccino, mint,

peach, mixed fruits and plenty of others. Shisha is quickly becoming very fashionable

and popular amongst this new generation of smokers.

(Eissenberg, 2006) Waterpipe smoking is often a social activity and two or more people

may share the same pipe. In some cultures, children may smoke with their parents.

Although their usage appeared to be declining by the mid 1980’s, more recently there has

been an upturn in their popularity in the eastern Mediterranean region and hookah cafes

and bars are also beginning to appear in North America, Brazil and Europe.

(Motarreb, 2001) The tobacco is heated by coals and the smoke comes through the water

after which it emerges through the suction tube, from where it is smoked. The water filter

is a gimmick. Most of the toxic chemicals and nicotine are not water-soluble. Hence, they

pass through the filter and are inhaled by a smoker. Shisha smoking can lead to physical

addiction and can also create psychological and habitual dependence to the user. Smokers

have been advised to stop immediately, because it damages the body by causing wrinkled

skin and many chronic diseases. The reason behind the increase in the shisha smoking

phenomenon is that people do not take the health risks seriously. Carbon monoxide

absorption is greatly increased when shisha is smoked just prior to sleeping.  Even

minimal exposure to carbon monoxide is known to be harmful and people who smoke

shisha as little as once a day put themselves at risk.

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(Eissenberg, 2006) According to the U.S. News & World Report, shisha also carries

strong risks of addiction. Shisha is a danger to health because it can lead to daily

waterpipe use. One of the most serious concerns of shisha is cancer. The smoke increases

the risk of various cancers such as lung cancer and cancer of the mouth. In addition to

cancer, there are various gum diseases that are linked to shisha. Shisha has dangerous

effects on the body because it exposes the smoker to a much larger volume of smoke than

what would be inhaled from a cigarette. The tobacco smoke has high levels of toxins,

including carbon monoxide. Smoking cigarette is said to be haram because of its harmful

affects on our health, and hookah smoking is even worse than cigarette. So it is not wrong

to say that shisha addiction is not a good thing and whoever is thinking that they are safe

with hookahs as opposed to cigarettes is only fooling them. It is sad to see this trend

catching on fire in the Muslim world. Most prominently in Pakistan, it is noticed how this

has become the “cool” alternative thing to do. Especially among young generation, said

to be the future of Pakistan.

Although it is traditionally very common in rural areas of Pakistan for generations but

now hookahs have become very popular in the cities. Many clubs and cafes are offering

them and it has become quite popular amongst the youth and students in Pakistan. This

form of smoking has become very popular for social gatherings, functions, and events.

There are a large number of cafes and restaurants offering a variety of hookahs. Karachi

has seen a growth in this business. Now Islamabad also prospers by this trade.

(Khan, 2006) Water pipe smoking appears to be particularly popular among students and

young people who enjoy the novelty and conviviality of sharing the waterpipe, although

in some countries many young people appear to be even unaware that it contains tobacco.

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Young women, in particular, are being targeted in some Middle Eastern countries with

custom-made flavored tobacco for use with waterpipes. Another factor that attracts the

young people towards shisha is that it offers a mixture of crude types of tobacco

fermented with molasses and fruits and the sweet odor of fruits conceals the natural smell

of tobaccos tar and nicotine. A large number of school and college students of both

genders hang at Shisha houses for smoking as they don’t face any hurdle there to satisfy

their desire. Among women in many countries, there is less of a stigma associated with

Shisha than with cigarette smoking and therefore more and more women are taking up

this habit as a fashion

(Safdar, 2009) scientific studies done to see the adverse health consequences of shisha

smoking point to dangers that are similar to those associated with cigarette smoking. The

research conducted on Shisha use has clearly shown that it has particularly serious health

consequences on 2 vital organs of body namely the lungs and heart. Lung Cancer,

Cancers of the Food Pipe, Chronic Obstructive Lung Disease, Emphysema, low birth

weight, precipitation of Asthma attacks and pneumonia are some of the health hazards

associated with shisha smoking. Nicotine dependence may also result from repeated

inhalation of tobacco smoke from Shisha. Besides Lung Cancer Shisha use is also linked

with increased risk of, Mouth and Urinary Bladder Cancer. Research published in the

Journal of Periodontology (Nov. 2005) found that the effects of waterpipe smoking are

the same as that of cigarette smoking. Additional dangers not encountered with cigarette

smoking are infectious diseases resulting from pipe sharing and the frequent addition of

alcohol or psychoactive drugs to the tobacco.

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Objectives

Some of the objectives of the study are discussed under:

1. To study the socio-economic conditions of correspondents.

2. To study/explore the consequences of shisha addiction on young generation.

3. To study the behavioral changes of shisha addicts and attraction towards other

drugs due to shisha smoking.

4. To study policy measures to minimize the affect of shisha addiction on young

generation.

Significance of the study

The study focuses on the affects of shisha smoking among youngsters in twin cities. This

trend is not new in Pakistan as a matter of fact it has been a popular practice in rural areas

since very long. It has been given more attention as an up coming trend, becoming

popular among young people in Pakistan. People are adopting such practices without

thinking about the negative impacts of shisha smoking on their health. Researches have

proved that shisha smoking is worse than cigarette smoking. It’s not just affecting their

health but it also disturbs the social life of the youngsters. Young people are adopting this

new trend more often as compare to the elders. Shisha smoking has brought a lot more

hazards to the social setup as it has got hype in urban society too. People have adopted

this trend with much strong acceptance of it than before. There are a couple of researches

held in different countries, addressing the dangerous affects of shisha smoking. It is

necessary to make people know why they should quit shisha smoking and how to save

themselves from such a risky thing which not only affects their health but also their

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education. Other social activities are also disturbed because of their addiction to shisha

smoking.

Hypothesis

More attraction towards shisha leads to acceptance of other drugs.

More involvement in shisha smoking, less importance is given to education.

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Chapter # 2

Literature review

8

Literature review

In today’s context, Shisha refers to the flavored tobacco used in the smoking process

using a hookah, also commonly known as ‘Hubble bubble’ and ‘narghile’. The

composition of the tobacco used in waterpipe smoking is not well standardized and thus

can be a great risk to the lives of the shisha smokers. (Barrawy, 2005)

(Mohamed, 2007) Heat sources that are commonly used in Shisha pipes to burn the

tobacco are likely to increase the health risks because when they burn they produce their

own toxins. Shisha smokers and those around them are put at greater risk.” Center of

Tobacco Studies added a great amount of work in this combine research. The new study

stresses that it is the very social nature of shisha smoking that makes the problem worse.

(Knishkowy, 2005) The latest study makes clear that the clean air policies should include

the water pipe, as it can be responsible for the buildup of toxic levels of indoor air

pollutants similar to what is seen in cigarettes. The social nature of this tobacco use

method makes such regulations more needed, but perhaps more difficult to implement as

well. The public health community in the meantime must wake up to the hazardous

nature of this emerging tobacco use method, both to users and those exposed. Existing

evidence on waterpipe smoking shows that it carries many of the same health risks and

has been linked to many of the same diseases caused by cigarette smoking. Access to this

new form of tobacco use continues to grow, especially in hookah cafes targeting 18-to-

24-year olds.

(Maziak et-al, 2004) A typical hour long shisha session involves inhaling 100 to 200

times the volume of smoke inhaled when smoking a cigarette and there is no proof that

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any adaptation can make waterpipes safer. The latest study provides evidence about the

potential hazards of exposure to waterpipe-associated secondhand smoke. Hazardous

particles of various sizes can build up gradually during waterpipe use to reach

dangerously high levels presenting a risk to non-smokers.

It is said that the problem was only recently being addressed by western scientists and

that had lead to dangerous misconceptions. The historical lack of evidence has

unfortunately allowed many shisha users to believe that the practice was safe, or at least

safer than other forms of tobacco use. This is certainly not true. Researchers went on

stress that it was the shisha smoker who is at risk and warned that the tobacco industry

will try to undermine the science; every recent study has found that shisha smoke

contains large quantities of the chemicals that lead to heart disease, cancer, and addiction

in cigarette smokers. (Shidaheh et-al, 2005)

According to a research conducted by Mark O’Malley and Bachman most trends

emerging among youngsters are followed with some sequences. They don’t directly get

addicted to serious drugs; instead they get some interest in minor drugs, including

cigarettes and use of flavors in their drugs to make it more thrilling and exciting. Intake

of tobacco through waterpipe adds more dangers to health. Sharing the mouth piece is

also a dangerous thing. Passing the shisha from person to person is unhygienic and may

result in transmission of communicable diseases. (Johnston et-al, 2005)

International organization “ASH” working in different areas around the world in order to

protect the new generation from the injurious effects of smoking shisha/hookah. In their

report to the WHO the researchers stressed, Waterpipes should be subjected to the same

regulations as cigarettes and other tobacco products. Waterpipes and waterpipe tobacco

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should contain health warnings. Claims of harm reduction and safety should be

prohibited. It would help in reduction of shisha addicts. Study concluded that regular

shisha smokers carry a risk of deforming their teeth. It is also suggested that shisha

smoking may be responsible for abnormal changes in their chromosomes.

(Bergstrom, 2005) Although research into the health impacts of prolonged waterpipe

usage is still in its infancy, there is now enough evidence of its harm to include waterpipe

smoking in public smoking bans. In countries where there is a tradition of using

waterpipes, work to change cultural norms and attitudes will be required alongside any

proscriptive laws and regulations. However in countries where waterpipe usage is still a

novelty, public health advocates should seize the opportunity to limit its spread through a

combination of education and legal measures. Laws to ban or restrict smoking in public

places should be drafted to ensure that waterpipes are covered by the relevant legislation.

According to the recent publication by the American Lung Association (February 2007)

“An emerging Deadly Trend: Waterpipe Tobacco Use”

This new research suggests that the waterpipes have three additional lethal risks

over the risks of smoking cigarettes:

Flavored tobacco is smoked over coals and fumes from these fuels add new toxins to the

already dangerous smoke.

Shisha smokers inhale up to 200 times more smoke in a single shisha session that they

would from a cigarette.

Café owners have stress the social importance of their product but researchers say it is

exactly that social aspect that results in high level of highly dangerous secondhand

smoke.

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(Wiley, 2000) Most of the young people who smoke water pipe regularly are already

addicted to nicotine. In fact, they have the same kind of addiction as adult smokers.

Almost 3 out of every 4 regular smokers in young age have already tried to quit but

failed. Yet out of 100 young smokers, only 3 think they will still be smoking in 5 years.

Studies show that about 60 of them will still be smoking 7 to 9 years later. Most teen

shisha smokers say that they would like to quit and many have tried to do so without

success. Those who try to quit shisha smoking report withdrawal symptoms much like

those reported by adults.

(Saleh et al, 1993) Waterpipe use may increase exposure to carcinogens because smokers

use a water pipe over a much longer period of time, often 40 to 45 minutes, rather than

the 5 to 10 minutes it takes to smoke a cigarette. Due to the longer, more sustained period

of inhalation and exposure, a waterpipe smoker may inhale as much smoke as consuming

100 or more cigarettes during a single session. The younger you are when you begin to

smoke, the more likely you are to be an adult smoker. Almost 90% of adults who are

regular smokers started at or before the age 19. And people who start smoking at younger

ages are more likely to develop long-term nicotine addiction than people who start later

in life.

An international researcher added that every second young person knows that waterpipe

smoke is damaging their health. The tobacco in shisha pipes is not directly inhaled, he

explained. Instead the tobacco being originally served, it is added with the smells such as

strawberry and apple, these are heated up on charcoal and then sucked through water.

This means that during smoking, there is not this uncomfortable, scratchy feeling, he

said. Many believe that therefore smoking from a water pipe is even healthy, which is

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certainly not true. Further more he added the fact that the tobacco is under lower

temperatures than when set alight, means that more poison is released this way. And the

fact that the smoke coming out of the water pipe is cooler means smokers inhale it more

heavily. Heavy metals like chrome, nickel or lead are sucked more deeply into the lungs.

In the long term this increases the danger of lung cancer as well as tumors on the lips and

mouth. And it is among younger people that the shisha pipes are increasingly popular

many do not even rate themselves as smokers if they have a water pipe a couple of times

a month, although many smoke them more frequently. (Lang et al, 2007)

Research published in the Journal of Periodontology (Nov. 2005) found that the effects of

water pipe smoking are the same as that of cigarette smoking and sometimes even worse

than that. The occurrence of periodontal (gum tissue) diseases in the study was 30 percent

among shisha smokers, 24 percent in cigarette smokers and eight percent in non-

smokers.  Research from this study shows that the relative risk for periodontal disease

increased five-fold in water pipe and 3.8-fold in cigarette smokers, compared to non-

smokers.

(Kenneth et al, 2004) Even though the smoke is filtered out by water, inhalation of toxic

substances is similar to or even greater than that of cigarette smoking. Many people are

misled in believing that water filters out the toxins and that nicotine is reduced in

waterpipe smoking. Not only does water pipe smoking include the same substances as

cigarette smoke such as carbon monoxide and tar, tobacco used for water pipe smoking

contains two to four percent nicotine, as opposed to the one to three percent for

cigarettes. Researchers found increased levels of nicotine and cotinine (a by product of

nicotine) in the blood plasma, saliva and urine of shisha smokers, which is further

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evidence that waterpipe smoking affects the periodontal tissues in the same way as

cigarette smoking. Abdel-Hafiz al-Khameri, a professor of psychology and the head of

the Human Development Foundation, said that stress is a major psychological factor

driving people to smoke the shisha.

Hookahs are marketed as a safe alternative to cigarettes. This claim is false. The water

does not filter out many of the toxins. In fact, hookah smoke has been shown to contain

concentrations of toxins, such as carbon monoxide, nicotine, tar, and heavy metals that

are high or higher than those that are seen with cigarette smoke. Several types of cancer,

including lung cancer, have been linked to hookah smoking. Hookah is also linked to

other unique risks not associated with cigarette smoking. For example, infectious diseases

including tuberculosis (which can infect the lungs or other parts of the body), aspergillus

(a fungus that can cause serious lung infections), and helicobacter (which can cause

stomach ulcers) may be spread by sharing the pipe or through the way the tobacco is

prepared.

(American Lung Association, 2006) Existing evidence on waterpipe smoking shows that

it carries many of the same health risks and has been linked to many of the same diseases

caused by cigarette smoking. Access to this new form of tobacco use continues to grow,

especially in hookah cafes targeting 18-to-24-year olds. Water pipes can become yet

another inducement to smoking that appeal particularly to a younger audience attracted

by the reportedly sweeter, smoother smoke. They may have an appeal similar to the

sweeter, candy-flavored cigarettes and tobacco products that the tobacco industry has

begun to market to young adults and youth who appear to be more attracted to these

flavors than adults.

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(Soweid et al, 2004) The global tobacco epidemic may kill 10 million people annually in

the next 20-30 years, with 70% of these deaths occurring in developing countries. Current

research, treatment, and policy efforts focus on cigarettes, while many people in

developing regions (Asia, Indian subcontinent, Eastern Mediterranean) smoke tobacco

using waterpipes. Waterpipes are increasing in popularity, and more must be learned

about them so that we can understand their effects on public health, restrict their spread,

and help their users quit. This integrative review paper suggests that perceptions

regarding health effects and traditional values may facilitate waterpipe use among women

and children. Waterpipe smoke contains harmful constituents and there is preliminary

evidence linking waterpipe smoking to a variety of life threatening conditions, including

cancer, pulmonary disease, and coronary heart disease. More scientific documentation

and careful analysis is required before the spread of waterpipe use and its health effects

can be understood, and the necessary empirically guided treatment and public policy

strategies can be implemented.

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Chapter # 3

Methodology

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Methodology

Methodology may be a description of process to include a philosophically coherent

collection of theories, concepts or ideas as they relate to a particular discipline or field of

inquiry. Methodology may refer to nothing more than a simple set of methods or

procedures, or it may refer to the rationale and the philosophical assumptions that

underlie a particular study relative to scientific method. Methodology guides the

researcher how and what steps need to be followed to the collect relevant data.

Methodology is complete frame work of the whole research activity.

This chapter highlights the methodology strategy under which present research had been

carried out. The methodology to find out answers to questions depends upon the nature of

question.

The current research addresses the, ‘‘shisha addiction among youngsters in twin cities’’.

Topic

‘‘Shisha addiction among youngsters ’’.

Research design

In order to conduct the present research, quantitative research method was used to get the

proposed information from the respondents.

Universe

In research, the target group to be studied is called population of study (Henlin, 1997).

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The entire group from which a sample is known as the population or universe. In other

words, any set of individuals or objects having some common observable characteristics

under study constitutes a population or universe.

The study was conducted in the twin cities; Islamabad and Rawalpindi. Keeping in view

the significance of the topic and the problems, I restricted my study only to the shisha

smokers. The research topic under consideration required working with the shisha

smokers and the shisha bars in twin cities.

Sample

A sample is a small part of population, which represents the characteristics of the whole

population. Time and cost are usually limited factors in research. The study aim to know

the addiction of shisha smoking among youngsters, therefore shisha smokers in the

research local was the population out of which the researcher picks the sample randomly.

Sample Size

A sample of 260 respondents selected from the universe.

Data collection

The procedure a researcher follows together relevant data (Ferranti, 2006). In this study

questionnaire was used to collect data, having different kinds of questions to get the

required information in most appropriate manner. Different types of questions were asked

such as matrix, open ended and close ended questions.

Tools of data collection

The success of research depends upon how carefully data was collected. The validity of

research mostly depends upon the tool of the data collection. In the present study, the

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data was collected with the help of questionnaire. Questionnaire is a set of questions,

which are asked from the respondents in face -to-face interaction.

Pre-testing

It is always useful to make a test of the tool, formulated before giving it final shape, so

that a researcher may come to know the acceptability of questions. Pre-testing not only

provides ways to modify the interviewing schedule but it also discovers new aspects of

the problem under study.

Ten respondents were selected by researcher for pre-testing. Many important issues were

highlighted during field-testing of the instruments. These main issues were related to the

sequence and phrasing of questions and interviewing techniques. After field test, some

modifications were made, based on the information received.

Editing

Editing is the process of checking and adjusting the data for omissions, legibility and

consistency. Editing may be differentiated from coding, which is the assignment of

numerical scales or classifying symbols to previously edited data. The purpose of editing

is to ensure the completeness, consistency and readability of the data to be transferred to

data storage. The editor’s task is to check errors and omissions in the questionnaires or

other data collection forms.

Coding

Coding involves assigning numbers or other symbols to answers so the responses can be

grouped into limited number of categories. The classifying of data into limited categories

sacrifices some data detail but is necessary for efficient analysis. Codes are generally

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considered to be numerical symbols; they are more broadly defined as the rules for

interpreting, classifying and recording data. Codes allow data to be processed in

computer. Researches organize data into fields, records, and files. A field is a collection

of characters (a character is a single number, letter of alphabet, or special symbol such as

the question mark) that represent a single type of data. A record is collection of related

fields. A file is collection of related records. File, records, and fields are stored on

magnetic tapes, floppy disks, or hard drives.

Conceptualization

The process through which we specify what we mean when we use particular terms in

research is called conceptualization. Conceptualization gives definite meaning to a

concept by specifying one or more indicator of what we have in our mind. An indicator is

a sign of the presence of the concept we are studying. The clarification of concept is a

continuing process in social research. Conceptualization is the refinement and

specification of abstract concepts, and operationalization is the development of specific

research procedures (operations) that will result in empirical observations representing

those concepts in the real world.

Perception

Perception is defined as the process of attaining understanding or acquiring basic

information or knowledge about any aspect or phenomenon. It is referred to an

understanding of trainees.

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Socioeconomic characteristics

According to Chapin (1978) the prevalent average standard of cultural processions,

effective income, material procession and the participation in the group activities of

community determine the person’s socio-economic status. For the present study the

indicators identifying socio-economic characteristics were respondents age, education,

family, occupation, income, type and size of family etc.

1. Age

Age is one of important variables in any social research which affects the attitude and

behavior of person at different stages of life. Age is defined as the total number of years

completed by the respondents since their birth to the time of interviews. Such as 18, 19

etc.

2. Education

According to Francis (1970), education is a consciously controlled process whereby

changes in behavior are produced and through the person within the group. Education is

considered one of the most important factors for variation in knowledge. Being an

educated person means you have access to optimal state of mind regardless of the

situation you are in. Education plays an influential role and is considered to be very

important sociological indicator in understanding and defining respondent’s behavior.

Mostly, various researches described and measured education under the categories of

illiterate, primary, middle, secondary, intermediate, graduation, and post graduation but

here in study respondent’s educational attainments were asked in completed years of

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schooling question was asked “What is your level of education (in complete years)?” and

options were given:

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 16+

It indicates that how many years cover respondent’s educational achievement.

3. Family structure

Family defined as ‘‘a relatively permanent group of people related by ancestry, marriage,

or adoption, who live together, from an economic unit, and undertake of their young’’

(Robertson, 1987). It is one of the basic institutions of human society. The family

structure has important demographic, economic, and social consequences. According to

the structure there are three types of family.

Nuclear family

Nuclear family consists of a father, mother and their children. This kind of family is

common where families are relatively mobile, as in modern industrialized societies.

Joint family

In a joint family, parents and their children’s families often live under a single roof. This

type of family often includes multiple generations in a family.

Extended family

A family consisting of parents and children, along with grandparents, grandchildren,

aunts and uncles etc. A family group consisting of the biological or adoptive parents,

their children, grandparents, and other family members. Who live in close geographic

proximity rather than under the same roof. The extended family is the basic family group

in many societies.

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Data analysis

The data was analyzed to draw the conclusions and suitable statistical techniques were

used. The researcher used the widely statistical package for the social science (SPSS).

The analysis data has been presented is tabular forms. For the analysis of the quantitative

data, computer was used which facilitate me more than any ways such as time saving,

reduction of large amount of data to the basic pattern etc.

Data analysis is the process of probing unrefined data with the objective of making key

points or drawing conclusions about the information. Data analysis focuses on

conclusion; it is the process to draw a conclusion based exclusively on what is already

known by the researcher.

Statistical techniques

The data was systematically tabulated and statistically analyzed to bring into equivalent

form. Different statistical tools and techniques were used for the analysis and

interpretation of results.

Percentage

For the attainment of frequency distribution of the personal traits of the respondent,

simple percentages were calculated.

The percentages were calculated by using following formula:

F

P= _______________________ x 100

N

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Where

P =Percentage

F = Frequency of class

N = Total number of frequencies

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Chapter # 4

Data analysis and presentation

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Data analysis and presentation

Table 4.1

Distribution of respondents by their gender, age and current status.

GenderSr. no Categories Frequency percentagei Male 164 63.1ii Female 96 36.9

Total 260 100

Age

Sr. no Categories Frequency percentagei Less than 20 30 11.5ii 20-24 159 61.2iii 25-29 44 16.9iv 30 and above 27 10.4

Total 260 100Current status

Sr. no Categories Frequency Percentagei Students 190 73.1ii Employed 70 26.9

Total 260 100

Table no 4.1 includes three variable i.e. gender, age (in complete years) and current status

of the respondents.

Gender of the respondents is based on their biological differences. Male and female

respondents keep different positions that determine their roles in the society. It is an

important variable in order to know the involvement of certain gender in particular

activity. In this category male respondents were in majority having 63% of the total

sample. While 37% of the respondents were female.

Age of the respondents is one of the most important variables as it determines the age

group of the respondents which affects other aspects of the individual’s life. Majority of

the respondents e.g. 61% were in the range of 20-24 years. Whereas 17% of the

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respondents belonged to the age group of 25-29. A little more than 11% of the

respondents belonged to the age group of less than 20 years. Remaining 10% of the

respondents belonged to the age group of 30 and above.

This table includes another variable that defines the status of the respondents. This

category consisted of two options such as student and employed. In this category a little

more than 73% of the respondents were students and were dependent. Remaining 27% of

the respondents were employed and were independent to make expenses.

Table 4.2:

Frequency distribution of respondents by their city, type of family and marital

status.

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CitySr. no Categories Frequency percentagei Islamabad 142 54.6ii Rawalpindi 118 45.4

Total 260 100Type of family

Sr. no Categories Frequency percentagei Nuclear family 132 50.8ii Extended family 82 31.5iii Joint family 46 17.7

Total 260 100Marital status

Sr. no Categories Frequency Percentagei Married 42 16.2ii Unmarried 218 83.8

Total 260 100

Table no 4.2 consists of three variables i.e. city, type of family and marital status of the

respondents.

Two cities were selected to be studied in the research including Islamabad and

Rawalpindi. Whereas a little more than 54% of the sample were taken from Islamabad

and the remaining 45% of the sample consists of the people (shisha smokers) from

Rawalpindi.

Type of the family was studied to know the family structure of the respondents.

Respondents who belonged to joint family represented the strong bond among the family

members. Respondents from the extended family also represented good relations among

the family members. Whereas nuclear family system represented less restricted structure

of the family. According to the research a little more than 50% of the respondents

belonged to nuclear family system. Other 50% of the sample consisted of extended and

joint family with 32% and 18% respectively.

A person's marital status indicates whether the person is married or not. Questions about

marital status appear on many polls and forms, including censuses and credit card

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applications. It’s an important element in research to know whether respondents have

those responsibilities that a married person would have. Marital status of the respondents

was studied; according to the table 16% of the respondents were married and 84% of the

respondents were unmarried.

Table 4.3

Distribution of respondents by their level of education, mothers’ and fathers’ level

of education.

Respondents’ Level of educationSr. no Categories Frequency Percentagei Matric 5 2ii Intermediate 28 10.7iii Graduation 104 40

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iv Masters and above 123 47.3Total 260 100

Respondents’ mother’s level of education

Sr. no Categories Frequency Percentagei Primary 19 7.3ii Middle 10 3.8iii Matric 39 15iv Intermediate 43 16.5v Graduation 69 26.5vi Masters and above 80 30.7

Total 260 100Respondents’ father’s level of education

Sr. no Categories Frequency Percentagei Matric 6 2.3ii Intermediate 21 8.0iii Graduation 59 22.6iv Masters and above 174 66.9

Total 260 100

Table 4.3 consists of three variables i.e. respondents’ level of education, their mothers’

level of education and their fathers’ level of education.

Respondents’ level of education was calculated in completed years which included matric

to masters and above. According to the table 47% of the sample had educational status up

to masters and above where as 40% of the respondents had educational level up to

graduation level. Remaining 13% of the sample consisted of respondents who had

educational level up to intermediate and matric level which included 11% and 2%

respectively.

This table also includes mothers’ level of education of the respondents. This table shows

that 31% of the respondents’ mothers had educational level up to masters and above

while 27% had educational level up to graduation level. Whereas 17% of the

respondents’ mothers had educational level up to intermediate. Remaining 26% of the

sample had educational level up to matric, middle and primary, having 15%, 4% and 17%

respectively.

30

This table also shows the father’s level of education of the respondents. In this table 67%

of the fathers had educational level up to masters and above while 27% of the fathers

completed their education up to graduation level. Remaining 10% of the sample indicates

that the fathers of respondents had educational level up to intermediate and matric level,

having 8% and 2% respectively.

Table 4.4

Distribution of respondents by their rank among their sisters and brother, family

members of the respondents who smoke shisha along with their relation and ages.

Rank of respondents among their brothers and sistersSr. no Categories Frequency Percentagei Only child 25 9.6ii Eldest 70 26.9iii Middle 87 33.5iv Youngest 78 30.0

Total 260 100Number of family members of respondents who smoke shisha

Sr. no Categories Frequency Percentagei None 199 76.5ii One 61 23.5

Total 260 100Relation of respondents with other shisha smokers in their family

31

Sr. no Categories Frequency Percentagei None 199 76.5ii Brother 33 12.7iii Sister 11 4.2iv Uncle 4 1.5v Wife 4 1.5vi Cousin 9 3.5

Total 260 100Age of the family members of respondents who smoke shisha

Sr. no Categories Frequency Percentagei 16-25 29 47.5ii 26-35 27 44.2iii 36-45 3 4.9iv 46-55 2 3.2

Total 61 100

Table no 4.4 includes four variables i.e. rank of the respondents among their brothers and

sisters, number of family member of respondents who smoke shisha along with their age

and relation with the shisha smokers.

This table indicates the rank of the respondents which included only child, eldest, middle

and youngest. According to the table the highest percentage such as 34% of the

respondents had middle rank among there brothers and sisters where as 30% of the

respondents were youngest in rank while 27% of the respondents were eldest and 10% of

the sample were the only child of the family.

This table also indicates the number of family members of the shisha smokers who smoke

shisha. According to the research 77% of the respondents were the only shisha smoker of

the family and no other member had any interest in shisha smoking. Remaining 23% of

the respondents had one family member who smokes shisha other than them.

This table also includes the relation of those family members of the respondents who

smoke shisha. According to the results 13% of the respondents answered that their

brothers smoke shisha while a little more than 4% of the respondents said that their

sisters were also addicted to the shisha. Remaining 6% of the respondents answered

32

cousin, wife, and uncle as the family members who smoke shisha, having 4%, 1% and

1% respectively.

The final part of the table indicates the frequency of the age group of the family members

of the respondents who smoke shisha. According to the table a little more than 47% of

the family members belonged to the age group of 16-25 years. Whereas 44% of the

family members of the respondents belonged to the age group of 26-35 years. Remaining

8% of the family members belonged to the age group of 36-45 and 46-55 with 5% and

3% of the total of sample respectively.

Table 4.5

Distribution of respondents by their mother’s and father’s occupation.

Respondents’ mother’s occupationSr. no Categories Frequency Percentagei Teacher 21 8.1ii Banker 14 5.4iii Office job 38 14.6iv Doctor 25 9.6v House wife 155 59.6vi Business 2 .8vii Retired personnel 5 1.9

Total 260 100Respondents’ father’s occupation

Sr. no Categories Frequency percentagei Bureaucrat 56 21.5ii Army officer 40 51.4iii Engineer 38 14.6iv Doctor 27 10.4v Retired personnel 27 10.4vi Business man 60 23.1vii Teacher 12 4.6

Total 260 100

Table no 4.5 includes two variables i.e. mother’s occupation and father’s occupation of

the respondents.

33

Occupation of the respondents’ mothers and fathers was studied to know the economic

background of the shisha smokers. Several occupations were included in the

questionnaire to get the appropriate answers from the respondents.

According to the results 59% of the mothers were house wives. A little more than 14% of

the mothers of respondents were engaged in office jobs. Whereas 9% of the mothers were

doctors and 8% of the mothers of respondents were teachers. While a little more than 5%

of the mothers of respondents were bankers. Almost 2% of the mothers were retired

personnel remaining 1% of the mothers were engaged in business.

This table also includes the father’s occupation of the respondents and the distribution of

the frequency regarding their occupation. The table indicates that 51% of the fathers were

army officers.23% of the fathers were businessmen. Whereas 22% of the fathers of the

respondents were bureaucrats. A little more than 14% of the fathers of respondents were

engineer. Results indicate that 10% of the fathers were doctors and the same percentage

i.e. 10% were retired personnel. Remaining 5% of the fathers were teachers.

34

Table 4.6

Respondents having shisha for the first time, their feelings and the relation with the

one who introduced shisha to them.

Shisha smoked for the first timeSr. no Categories Frequency Percentagei More than one year 172 66.2ii A year before 63 24.2iii Less than one year 20 7.7iv A few months before 2 .8v A few weeks before 3 1.2

Total 260 100Feelings when shisha was tried for the first time

Sr. no Categories Frequency Percentagei Felt bad 15 5.8ii Started to cough 52 20.0iii Irritated by smell 19 7.3iv Quiet unusual 34 13.1v Relaxed 100 38.5vi Mind blockage 24 9.2vii Normal 16 6.2

Total 260 100Relation with those who introduced shisha

Sr. no Categories Frequency Percentagei Family 27 10.4ii Relatives 18 6.9iii Friends 145 55.8iv College/university fellows 27 10.4v Colleagues 3 1.2vi Own self 24 9.2vii Partner 16 6.2

Total 260 100

Table no 4.6 includes three variables i.e. first time when the respondents tried shisha,

how they felt when they tried shisha for the first time and relation with the person who

introduced shisha to them.

35

This table indicates that 66% of the people tried shisha for the first time more than one

year ago while 24% tried shisha a year before. Whereas a little more than 7% of the

respondents tried shisha less than one year ago. Remaining 2% of the respondents tried

shisha a few months before and a few weeks before having the same percentage which is

1%.

This table also includes feelings of respondents when they tried shisha for the first time.

Table indicates that a little more than 38% of the people felt relaxed when they had

shisha for the first time. 20% of the respondents started to cough while 13% of the

respondents felt quiet unusual when they had shisha for the first time. This table indicated

that 9% of the respondents experienced mind blockage when they had shisha for the first

time. Whereas 7.3% of the respondents were irritated by the smell of shisha. Remaining

12% of the sample felt normal and bad having 6% and a little more than 5% respectively.

This table also indicates the relation of the respondents with the people who introduced

shisha to them. According to the table a little more than 55% of the respondents answered

that their friends introduced shisha to them. Whereas family and college/university

fellows had the same frequency which is 10%. While 9% of the shisha smokers found it

by themselves. A little more than 6% of the respondents were introduced to shisha by

their relatives. Remaining 7% of the respondents were introduced shisha by their partners

and colleagues having 6% and 1% of the sample respectively.

Table 4.7

Distribution of respondents by their favorite flavor, influence and the cause of

attraction towards shisha.

36

Favorite flavor of shishaSr. no Categories Frequency Percentagei Double apple 56 21.5ii Cola 21 8.1iii Vanilla 25 9.6iv Cherry 27 10.4v Double apple mint 69 26.5vi Blue mist 62 23.8

Total 260 100Influence of shisha smoking

Sr. no Categories Frequency Percentagei Relaxation 31 11.9ii Break from hectic life 51 19.6iii Stress relief 34 13.1iv Friend to me 9 3.5v Fun and enjoyment 117 45.0vi A habit 18 6.9

Total 260 100Most attractive thing about shisha smoking

Sr. no Categories Frequency Percentagei Flavored tobacco 50 19.2ii Smoke rings 84 32.3iii Sharing with friends 99 38.1iv Urge to smoke 27 10.4

Total 260 100

Table no 4.7 includes three variables i.e. favorite flavors of shisha, influence of shisha on

respondents and the most attractive thing about shisha.

This table indicates that 26% of the respondents liked double apple mint flavor of shisha.

23% of the respondents said that the blue mist is their favorite flavor of shisha. Whereas a

little more than 21% of the respondents liked double apple flavor of shisha. 10% of the

respondents chosen cherry as their favorite flavor of shisha. A little more than 9% of the

respondents liked vanilla flavor of shisha. Remaining 8% of the respondents liked cola

flavor of shisha.

This table includes the influence of shisha smoking on the respondents. Results show that

45% of people answered fun and enjoyment. A little more than 19% of people answered

37

shisha as break from hectic life while 13% of the respondents found shisha as relief from

stress. 12% of the people found shisha relaxing whereas 7% of the people answered

shisha smoking as their habit. Remaining 3% of the respondents answered shisha as a

friend to them.

This table consists of the thing that attracts the shisha smokers towards shisha. It

indicates that 38% of the respondents liked to share shisha with their friends. 32% of the

respondents were attracted towards shisha because of smoke rings while 19% of the

respondents had attraction towards shisha because of flavored tobacco. Remaining 10%

of the respondents had urge to smoke that attracted them towards shisha smoking.

Table 4.8

Distribution of respondents by the time they smoke shisha in a week and the time

spend in shisha bar

Times shisha smoked in a weekSr. no Categories Frequency Percentagei 1-2 92 35.4ii 3-4 78 30.0iii 5-6 49 18.8iv 7-8 18 6.9v More than 8 23 8.8

Total 260 100 Time spend at shisha bar

Sr. no Categories Frequency Percentage

38

i 15-30 minutes 26 10.0ii 30-60 minutes 94 36.2iii 1-2 hours 101 38.8iv Longer than 2 hours 39 15.0

Total 260 100

Table no 4.8 includes two variables i.e. how many times respondents smoke shisha in a

week and time they spend at shisha bar.

This table indicates that 35% of the people smoked shisha for 1-2 times in a week. 30%

of the respondents smoked shisha for 3-4 times in a week while 18% of the respondents

smoked shisha for 5-6 times in a week. 9% of the shisha smokers smoked shisha for more

than 8 times in a week. Remaining 7% of the respondents smoked shisha for 7-8 times in

a week.

This table includes the time that shisha smokers spend at shisha bar. Results indicate that

39% of the respondents were used to spend 1-2 hours in the shisha bar where as 36% of

the respondents were used to spend 30-60 minutes at shisha bar. 15% of the respondents

were used to spend longer than 2 hours at shisha bar. Remaining 10% of the respondents

were used to spend 15-30 minutes at shisha bar.

Table 4.9

Preference given to accompany while visiting shisha bar and the payment of shisha

at shisha bar

Preferred to accompany while visiting shisha barSr. no Categories Frequency Percentagei Family 19 7.3ii Relatives 12 4.6iii Friends 114 43.8iv University/college friends 40 15.4v Street fellows 19 7.3vi Alone 8 3.1vii Partner 48 18.5

Total 260 100

39

Payment of shisha at shisha bar

Sr. no Categories Frequency Percentagei Family 15 5.8ii Relatives 5 1.9iii Friends 75 28.8iv Own self 115 44.2v Partner 17 6.5vi Share the amount 33 12.7

Total 260 100

Table no 4.9 consists of two variables i.e. preference given to the people to accompany

while visiting shisha bar and payment of shisha at shisha bar.

This table indicates that 44% of the respondents preferred to accompany by their friends

while visiting shisha bar. While 19% of the respondents preferred to their partners to

accompany them at shisha bar. Family and street fellows had the same frequency which

is 7%. While a little more than 4% of the respondents preferred their relatives to

accompany them while visiting shisha bar. Remaining 3% of the respondents preferred to

visit shisha bar alone.

This table includes frequency distribution of the people who normally pay for shisha at

shisha bar. It indicates that 44% of the respondents were used to pay for shisha on their

own. 29% of the respondents answered that their friends used to pay for shisha normally

while 13% of the respondents said that they were used to share the amount. A little more

than 5% of the respondents said that their family was used to pay for shisha normally. A

little more than 6% of the respondents answered that their partners were used to pay for

their shisha at shisha bar remaining 2% of the respondents answered that their relatives

were used to pay for shisha for them.

40

Table 4.10

Distribution of respondents by the types, distance and the most likable thing about

shisha bar.

Type of shisha bar preferredSr. no categories Frequency Percentagei With a lot of girls/boys 48 18.5ii With a lot of crowd 90 34.6iii Only for girls/boys 26 10.0iv Few people 96 36.9

Total 260 100Distance of shisha bar prefer to visit

Sr. no Categories Frequency Percentagei At a long distance 20 7.7ii At a short distance 53 20.4iii Closest one 43 16.5iv Depends on mood 144 55.4

Total 260 100Likable thing about shisha smoking at shisha bar

Sr. no Categories Frequency Percentagei New friends 38 14.6ii Romance 44 16.9iii Shisha smoking only 54 20.8iv Loud music 50 19.2

41

v Escape from worries 74 28.5Total 260 100

Table no 4.10 includes three variables such as types of shisha bar, how distant shisha bar

respondents prefer to visit and respondents like the most about shisha smoking at shisha

bar.

This table indicates that 36% of the respondents preferred to go to shisha bar with the few

people. Whereas 35% of the respondents liked to visit shisha bar with a lot of crowd. A

little more than 18% preferred to visit bar with a lot of girls/boys. Remaining 10% of the

respondents liked to visit shisha bar which is only for girls/boys.

The second variable of the table discuss about the distant shisha bar preferred by the

shisha smokers. Results show that 55% of the respondents preferred to visit shisha bar

depending their mood. Whereas 20% of the respondents liked to visit shisha bar at a short

distance while a little more than 16% of the respondents preferred to visit the closest

shisha bar. 8% of the respondents preferred shisha bar at a long distance.

This table shows what respondents like the most about shisha smoking at the shisha bar.

It indicates that a little more than 28% of the respondents answered for escape from

worries. 21% of the respondents went shisha bar only for shisha smoking. 19% of the

respondents liked loud music at shisha bar. A little more than 16% of respondents liked

romance at shisha bar while remaining 15% of the respondents liked to make new friends

while smoking shisha at shisha bar.

42

Table 4.11

Distribution of respondents by those who prepare shisha and the times they have

tried to prepare shisha.

Knowledge about preparing shishaSr. no categories Frequency Percentagei Yes 181 69.6ii No 79 30.4

Total 260 100Tried to prepare shisha

Sr. no categories Frequency Percentagei No 79 30.4ii Many times 137 52.7iii A few times 36 13.8iv Never 8 3.1

Total 260 100

Table no 4.11 includes two variables i.e. shisha smokers know how to prepare shisha and

shisha smokers ever try to prepare shisha.

Shisha has become really popular among youngsters. People learn how to prepare it so

that they can enjoy shisha whenever and wherever they want to. This table also indicates

that 70% of the respondents knew how to prepare shisha. Whereas 30% of the

respondents didn’t know how to prepare shisha.

43

This table also indicates that 53% of the respondents tried to make shisha for many times.

A little more than 13% of the respondents tried to prepare shisha for a few times.

Remaining 3% of the shisha smokers never tried to prepare shisha

Table 4.12

Distribution of respondents by smoking shisha at home, their parents know and

their reaction

Shisha smoking at homeSr. no categories Frequency Percentagei Frequently 72 27.7ii Sometimes 83 31.9iii Not at all 105 40.4

Total 260 100Parents knowledge about the habit of shisha smoking

Sr. no categories Frequency Percentagei Yes 141 54.2ii Maybe 49 18.8iii No 70 26.9

Total 260 100Reaction when parents show anger on habit of shisha smoking

Sr. no categories Frequency Percentage

i Anger 32 12.3ii Annoying 42 16.2

iii Normal 104 40.0iv Irritation 15 5.8

v Fear 45 17.3vi Arguing 22 8.5

Total 260 100

Table no 4.12 includes three variables i.e. shisha smoking at home, parents of

respondents know about their habit of shisha smoking and reaction of respondents when

parents show anger on their habit of shisha smoking.

44

This table indicates that 28% of the respondents frequently smoked shisha at their home.

Whereas 32% of the respondents sometimes smoked shisha at home. Remaining 40% of

the respondents never smoked shisha at home.

This table also includes the variable which shows that the parents know about their

children’s habit of shisha smoking. Result indicates that 54% of the respondents’ parents

knew that their children smoke shisha. While 27% of the respondents answered that their

parents didn’t know about their habit of shisha smoking while 19% of the respondents

answered may be.

This table also includes the reaction of respondents when parents show anger on their

habit of shisha smoking. According to the results 40% of the respondents answered that

they stayed normal on their parents’ anger. While 17% of the respondents answered fear,

16% of the respondents answered that they were used to get annoyed when their parents

showed anger on their habit of shisha smoking. Whereas 12% of the respondents

answered anger, a little more than 8% of the respondents said that they used to start

arguing with their parents when they showed anger on them. Remaining 6% of the

respondents were used to get irritated when their parents showed anger on them.

45

Table 4.13

Anybody ever stopped the respondents from shisha smoking.

Anybody ever stopped respondents from shisha smokingSr. no Categories Frequency Percentagei Mother 65 25.0ii Father 43 16.5iii Grand parents 19 7.3iv Sisters 11 4.2v Brothers 13 5.0vi Friends 49 18.8vii Teachers 9 3.5viii Partner 50 19.2ix None 1 .4

Total 260 100

Table no 4.13 includes a variable i.e. anybody ever stopped respondents from shisha

smoking.

This table shows that 25% of the respondents answered that their mothers stopped them

form shisha smoking. While 19% of the respondents answered partners whereas 19% of

the respondents answered that their friends stopped them from shisha smoking. While

16% of the respondents answered that their fathers stopped them from shisha smoking.

7% of the respondents answered grandparents. 5% of the respondents answered brothers

while 4% of the respondents said that their sisters stopped them from smoking. A little

more than 3% of the respondents said that their teachers stopped them from shisha

smoking only 0.4% of the respondents answered that nobody stopped them.

46

Table no 4.14

Extent to which respondents believe that shisha smoking cause various harms to

them.

shisha smoking cause addiction

Sr. no Categories Frequency Percentagei Strongly agreed 100 38.5ii Agreed 104 40.0iii Disagreed 40 15.4iv Strongly disagreed 16 6.2

Total 260 100shisha smoking cause chronic diseases

Sr. no Categories Frequency Percentagei Strongly agreed 43 16.5ii Agreed 139 53.5iii Disagreed 65 25.0iv Strongly disagreed 13 5.0

Total 260 100

Table no 4.14 includes two variables i.e. shisha smoking cause addiction and shisha

smoking cause chronic diseases.

This table includes the extent to which the respondents believe that shisha cause

addiction. 40% of the respondents agreed to that whereas a little more than 38% of the

respondents strongly agreed on this. 15% of the respondents disagreed to this statement

while only 6% strongly disagreed that shisha can cause addiction.

This table includes the extent to which respondents believe that shisha can cause chronic

diseases. 54% of the respondents agreed while 25% of the respondents disagreed that

shisha cause chronic diseases. 16% of the respondents strongly agreed with the statement

while only 5% of the respondents strongly disagreed that shisha cause chronic diseases.

Table 4.15

47

Extent to which respondents believe that shisha smoking cause various harms to

them.

Shisha smoking is totally wastage of moneySr. no Categories Frequency Percentagei Strongly agreed 37 14.2ii Agreed 119 45.8iii Disagreed 86 33.1iv Strongly disagreed 18 6.9

Total 260 100Shisha smoking is wastage of precious time

Sr. no Categories Frequency Percentagei Strongly agreed 26 10.0ii Agreed 99 38.1iii Disagreed 114 43.8iv Strongly disagreed 21 8.1

Total 260 100

This table includes the extent to which respondents believe that shisha smoking is totally

wastage of money. 46% of the respondents agreed that this statement is true. 33% of the

respondents disagreed with this statement. While 14% of the respondents strongly agreed

that shisha smoking is totally wastage of money. Remaining 7% of the respondents

strongly disagreed.

This table includes the extent to which respondents believe that shisha smoking is

wastage of precious time. A little more than 43% of the respondents disagreed with the

statement where as 38% of the respondents agreed. 10% of the respondents strongly

agreed with the statement that shisha smoking is wastage of precious time while

remaining 8% of the respondents strongly disagreed with this.

Table 4.16

Extent to which respondents believe that shisha smoking cause various harms to

them.

Shisha smoking leads to immorality

48

Sr. no Categories Frequency Percentagei Strongly agreed 29 11.2ii Agreed 99 38.1iii Disagreed 101 38.8iv Strongly disagreed 31 11.9

Total 260 100Education is given less priority because of shisha smoking

Sr. no Categories Frequency Percentagei Strongly agreed 39 15.0ii Agreed 120 46.2

iii Disagreed 76 29.2iv Strongly disagreed 25 9.6

Total 260 100Shisha smoking disturbs other activities of daily life

Sr. no Categories Frequency Percentagei Strongly agreed 36 13.8ii Agreed 105 40.4iii Disagreed 79 30.4iv Strongly disagreed 40 15.4

Total 260 100

Table no 4.16 includes three variables i.e. shisha smoking leads to immorality, education

is given less priority because of shisha smoking and shisha smoking disturbs other

activities of daily life.

This table includes the extent to which respondents believe that shisha smoking leads to

immorality. 39% of the respondents disagreed with the statement whereas 38% of the

respondents strongly agreed with this. A little more than 11% of the respondents strongly

disagreed that shisha smoking leads to immorality while 11% of the respondents strongly

agreed with the statement that shisha smoking leads to immorality.

This table includes the extent to which respondents believe that shisha smoking gets

priority on education. 46% of the respondents agreed that education is given less priority

because of shisha smoking. 29% of the respondents disagreed with the statement whereas

15% of the respondents strongly agreed that education is given less priority as compare to

shisha. Remaining 9% of the respondents strongly disagreed with this statement.

49

This table also includes the extent to which respondents believe that shisha smoking

disturbs other activities of daily life. 40% of the respondents agreed with the statement

whereas 30% of the respondents disagreed with the statement that shisha smoking

disturbs other activities of life. 15% of the respondents strongly disagreed while 14% of

the respondents strongly agreed that shisha smoking disturbs other activities of life.

Table 4.17

Respondents ever told or found addicted to other drugs previously and names of

those drugs.

Addiction to other drugs previouslySr. no Categories Frequency Percentagei Quiet frequently 17 6.5Ii Some times 51 19.6Iii Very few times 35 13.5Iv Never 157 60.4

Total 260 100Names of the drugs

Sr. no Categories Frequency PercentageI Cigarettes 60 58.2ii Cigar 16 15.5Iii Alcoholic drinks 21 20.3

50

Iv Heroin 6 5.8Total 103 100

Table no 4.17 includes two variables i.e. addiction to other drugs and names of those drugs.

This table includes respondents’ addiction to other drugs previously. This table shows

that 60% of the respondents have never been addicted to other drugs previously. A little

more than 19% of the respondents have been addicted to drugs other than shisha for some

times. 13% of the respondents were addicted to other drugs very few times whereas 7%

of the respondents have been taking drugs quite frequently other than shisha.

This table includes names of those drugs respondents have addicted to previously other

than shisha. 58% of the respondents were addicted to cigarettes where as 20% of the

respondents have been taking alcoholic drinks. 16% of the respondents were addicted to

cigar where as 6% of the respondents were addicted to heroin other than shisha.

Table 4.18

Effects of shisha smoking on the people in surroundings and objections on shisha

smoking in public places.

Shisha smoking affects the people in the surroundingsSr. no Categories Frequency Percentagei Yes 65 25.0ii Not much 110 42.3iii Maybe 43 16.5iv No 42 16.2

Total 260 100Respondents face any objection while smoking shisha in public

Sr. no Categories Frequency Percentagei Often 36 13.8ii Sometimes 112 43.1

51

iii Never 112 43.1Total 260 100

Table no 4.18 includes two variables i.e. effects of shisha smoking on surroundings and

objections that are faced by shisha smokers while smoking shisha in public.

This table includes the extent to which shisha smoking affects people in the surrounding.

42% of the respondents were having the view that shisha smoking does not affect much

on the people in the surroundings whereas 25% of the respondents said “yes”. 16% of the

respondents answered “maybe” while the same percentage i.e. 16% of the respondents

said that shisha smoking does not affect the people in the surroundings.

This table includes the extent to which respondents face objection while smoking shisha

in public. 43% of the respondents said that sometimes they face objection while the same

number of respondents which is 43% answered that they never face any objection while

smoking shisha in public. 14% of the respondents often faced objection while smoking in

public.

Table 4.19

The extent to which respondents believe that toxins are produced when shisha is

heated up and the health hazards of shisha smoking.

Toxins produced when shisha is heated up Sr. no Categories Frequency Percentagei To great extent 21 8.1ii To some extent 131 50.4iii Very less 50 19.2iv Not at all 58 22.3

Total 260 100 Health hazards of shisha smoking

Sr. no Categories Frequency Percentagei Lungs cancer 46 17.7ii Heart disease 49 18.8iii Tumors on lips and mouth 23 8.8

52

iv Periodontal(gum tissues) diseases 15 5.8v All above 85 32.7vi None of them 42 16.2

Total 260 100

Table no 4.19 includes two variables i.e. toxins produced when shisha is heated up and

health hazards of shisha smoking.

This table includes the extent to which respondents believe that toxins are produced when

shisha is heated up. This table indicates that 50% of the respondents believed that toxins

are produced to some extent while 22% of the respondents believe that toxins are not

produced at all. 19% of the respondents believed that very less toxins are produced when

shisha is heated up. Whereas 8% of the respondents believe that toxins are produced to

the great extent when shisha is heated up.

This table includes health hazards of shisha smoking. According to the table 33% of the

respondents answered that shisha smoking causes health hazards which are lungs cancer,

heart diseases, tumors on lips and mouth, periodontal (gum tissues) diseases. While 19%

of the respondents believe that shisha smoking cause health diseases whereas 18% of the

respondents believe that shisha causes lungs cancer. 16% of the respondents believe that

shisha has no health hazards. 9% of the respondents believe that shisha can cause tumors

on lips and mouth while 5% of the respondents said that shisha causes periodontal (gum

tissues) diseases.

53

Table 4.20

Complainants of changing behavior of shisha smokers and respondents to go

without smoking shisha for the whole day.

complainant of changing behaviorSr. no Categories Frequency Percentagei Mother 7 2.7ii Father 13 5.0iii Grand parents 11 4.2iv Sisters 11 4.2v Brothers 5 1.9vi Friends 29 11.2vii Teachers 13 5.0viii Partner 171 65.8

Total 260 100To go without smoking shisha for the whole day

Sr. no Categories Frequency Percentagei Very easy 65 25.0ii Fairly easy 90 34.6iii Fairly difficult 68 26.2iv Very difficult 37 14.2

Total 260 100

Table no 4.20 includes two variables i.e. complainant of shisha smoker’s changing

behavior and the shisha smokers to go without smoking for the whole day.

54

This table includes the complainants of changing behavior of shisha smokers. This table

indicates that 66% of the respondents said that their partners complain about their

changing behavior whereas 11% of sample said that their friends complain about their

changing behavior. 5% of the respondents said that their teachers complain about their

behavior while 5% of the respondents said that their father complains. 4% of the

respondents said that their grandparents complains about their changing behavior whereas

the same percentage i.e. 4% of the respondents said that their sisters complaints about

their changing behavior. Remaining 5% of the respondents said that their mothers and

brothers complain about their changing behavior with them having 3% and 2% of the

sample respectively.

This table includes the way shisha smokers go without smoking for the whole day. This

table indicates that 35% of the respondents found it fairly easy. 26% of the respondents

found it fairly difficult to go without smoking for the whole day whereas 25% of the

respondents found it very easy. Remaining 14% of the respondents found it very difficult

to go without smoking shisha for the whole day.

55

Table 4.21

Fears of respondents regarding their efforts to quit shisha smoking.

Fear of failureSr. no Categories Frequency Percentagei None 162 62.3ii Some 92 35.4iii A lot 6 2.3

Total 260 100Fear of being bad tempered

Sr. no Categories Frequency Percentagei None 145 55.8ii Some 108 41.5iii A lot 7 2.7

Total 260 100Fear of being nervous

Sr. no Categories Frequency Percentagei None 170 65.4ii Some 85 32.7iii A lot 5 1.9

56

Total 260 100

Table no 4.21 includes three variables i.e. fear of failure, fear of being bad tempered, fear

of being nervous regarding their efforts to quit shisha smoking.

This table includes respondents’ fear of failure regarding their efforts to quit shisha

smoking. 62% of respondents had no fear whereas 35% of the respondents had some fear

of failure while only 2% of the respondents had a lot of fear of failure regarding their

efforts to quit shisha smoking.

This table includes respondents’ fear of being bad tempered regarding their efforts to quit

shisha smoking. 56% of the respondents said none whereas a little more than 41% of the

respondents had some fear of being bad tempered whereas 3% of the respondents had a

lot of fear of being bad tempered regarding their efforts of quitting shisha smoking.

This table includes respondents’ fear of being nervous regarding their efforts to quit

shisha smoking. According to the table 65% of the respondents had no fear whereas 33%

of the respondents had some fear and 2% of the respondents had a lot of fear of being

nervous regarding their efforts to quit shisha smoking.

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Table 4.22

Fears of respondents regarding their efforts to quit shisha smoking.

Fear to be tensedSr. no Categories Frequency Percentagei None 167 64.2ii Some 87 33.5iii A lot 6 2.3

Total 260 100Fear of having difficulty in concentrating on other activities

Sr. no Categories Frequency Percentagei None 163 62.7ii Some 89 34.2iii A lot 8 3.1

Total 260 100Fear of missing or desiring shishaSr. no Categories Frequency Percentagei None 56 21.5ii Some 128 49.2iii A lot 76 29.2

Total 260 100

58

Table no 4.22 includes three variables i.e. fear to be tensed, fear of having difficulty in

concentrating on other activities and fear of missing or desiring shisha regarding their

efforts to quit shisha smoking.

This table includes respondents’ fear of being tensed regarding their efforts to quit shisha

smoking. Results indicate that 64% of the respondents had no fear. 34% of the

respondents had some fear whereas 2% of the respondents had a lot of fear to be tensed

regarding their efforts to quit shisha smoking.

This table includes respondents’ fear of having difficulty in concentrating on other

activities as a result of their efforts to quit shisha smoking. Table indicates that 63% of

the respondents had no fear. 34% of the respondents had some fear whereas 3% of the

respondents had a lot of fear of having difficulty in concentrating on other activities

regarding their efforts to quit shisha smoking.

This table includes respondents’ fear of missing or desiring shisha regarding their efforts

to quit shisha smoking. Table indicates that 49% of the respondents had some fear. 29%

of the respondents had a lot of fear whereas 21% of the respondents had no fear of

desiring or missing shisha regarding their efforts to quit shisha smoking.

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Table 4.23

Fears of respondents regarding their efforts to quit shisha smoking.

Fear of losing a pleasureSr. no Categories Frequency Percentagei None 76 29.2ii Some 111 42.7iii A lot 73 28.1

Total 260 100Fear of gaining weight

Sr. no Categories Frequency Percentagei None 146 56.2ii Some 92 35.4iii A lot 22 8.5

Total 260 100Fear to be not around other smokers

Sr. no Categories Frequency Percentagei None 116 44.6ii Some 124 47.7iii A lot 20 7.7

Total 260 100

This table includes three variables i.e. fear of losing a pleasure, fear of gaining weight

and fear to be not around other smokers regarding their efforts to quit shisha smoking.

60

This table includes respondents’ fear of losing the pleasure regarding their effort to quit

shisha smoking. This table shows that 43% of the respondents had some fear. 29% of the

respondents had no fear whereas 28% of the respondents had a lot of fear of losing the

pleasure regarding their effort to quit shisha smoking.

This table includes respondents’ fear of gaining weight regarding their efforts to quit

shisha smoking. According to the table 56% of the respondents had no fear. 35% of the

respondents had some fear while 9% of the respondents had a lot of fear of gaining

weight regarding their efforts to quit shisha smoking.

This table includes respondents’ fear of not to be around other smokers regarding their

efforts to quit shisha smoking. 48% of the respondents had some fear. 45% of the

respondents had no fear whereas 8% of the respondents had a lot of fear not to be around

other smokers regarding their efforts to quit shisha smoking.

Table 4.24

Quitting shisha smoking and respondents feeling of thinking themselves as a non

smoker.

Thought about quittingSr. no Categories Frequency Percentagei Often 44 16.9

ii Sometimes 140 53.8iii never 76 29.2

Total 260 100Feeling as a non smoker

Sr. no Categories Frequency Percentagei Comfortable 66 25.4ii Satisfied 110 42.3iii Never thought 62 23.8iv Dissatisfied 12 4.6v Uncomfortable 10 3.8

Total 260 100

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Table no 4.24 consists of two variables i.e. quitting shisha smoking and feeling of

respondents of thinking themselves as non smokers.

This table includes thoughts of shisha smokers regarding quitting shisha. Results show

that 54% of the respondents have thought about quitting shisha some times. 29% of the

respondents never thought about quitting shisha whereas 17% of the respondents often

thought about quitting shisha.

62

This table includes feelings of respondents thinking themselves as non smokers. 42% of

the respondents feel comfortable. 25% of the respondents felt comfortable to think

themselves as non smokers. 24% of the respondents never thought about quitting whereas

5% of the respondents feel dissatisfied, remaining 4% of the respondents feel

uncomfortable to think themselves as a non smoker.

Table no 4.25

Respondents know about the governments act against shisha bar and extent to

which shisha smokers are in favor of those efforts.

Governments act against shisha barsSr. no Categories Frequency Percentagei Yes 143 55.0ii No 117 45.0

Total 260 100In favor of Governments’ efforts against shisha barsSr. no Categories Frequency Percentagei To great extent 13 9.0ii To some extent 70 48.9iii Not much 37 25.8iv Not at all 23 16.0

Total 143 100

Table no 4.25 consists of 2 variables i.e. know about government’s act against shisha bar

and the extent to which respondents are in favor of those efforts.

This table includes respondents know how about the government’s act against shisha bar.

55% of the respondents had answered “yes” while 45% of the respondents said “no”.

This table includes the extent to which the respondents are in favor of those efforts of

government against shisha bar. According to the results 49% of the respondents were in

favor of those efforts to some extent. 26% of the respondents were not much in the favor

of those efforts while 16% of the respondents were not at all in favor of those efforts.

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Remaining 9% of the respondents were in favor of government’s efforts against shisha

bars to great extent.

Table no 4.26

Respondents regret being a shisha smoker and their motivation to quit shisha

smoking.

Shisha smokers regret being a shisha smokerSr. no Categories Frequency Percentagei Yes 44 16.9ii Some how 143 55.0iii No 73 28.1

Total 260 100Respondents’ rate of motivation to quit shisha smoking on a scale of 1-10

Sr. no Categories Frequency Percentagei 1 30 11.5ii 2 19 7.3iii 3 32 12.3iv 4 26 10.0v 5 33 12.7vi 6 33 12.7vii 7 14 5.4viii 8 20 7.7ix 9 10 3.8x 10 43 16.5

Total 260 100

Table no 4.26 consists of two variables i.e. shisha smokers regret being a shisha smoker

and respondents’ rate of motivation to quit shisha smoking on a scale of 1-10.

The table includes the regret of respondents being a shisha smoker. Table indicates that

55% of the respondents somehow regret to be a shisha smoker. 28% of the respondents

had no regret to be a shisha smoker while 17% of the respondents regret to be a shisha

smoker.

This table includes motivation rate of respondents to quit shisha smoking on a scale of 1-

10. This table shows that majority of the respondents i.e. 16% of the respondents rated

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their motivation up to highest level of scale which is 10. Whereas 12% of the respondents

rated their motivation up to 6,5 and 3 having the same ratio of respondents for each level

of scale. A little more than 11% of the respondents rated 1. According to the results 7%

of the respondents rated their motivation up to 8 and 2 on the scale having the same ratio

for each level. Remaining 9% of the respondents rated their motivation up to 9 and 7

having the ratio of 4% and 5% respectively.

65

Chapter # 5

SUMMARY, FINDINGS, CONCLUSIONS & SUGGESTIONS

Summary

Shisha smoking has been a popular trend among the people of Middle East for centuries.

It was originated in turkey over 500 years ago. This culture is now very popular across

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the world. People prefer shisha smoking to cigarettes and cigars because it smells good

and it has a soothing affect which is basically because of the flavors that are added to it.

If smoking cigarettes is harmful then hookah smoking is only worse. So those who are

thinking that they are safe with hookahs as opposed to cigarettes are only fooling them.

Shisha is quickly becoming very fashionable and popular amongst this new generation of

smokers.

It is especially sad to see this trend catching on fire in the Muslim world. In Pakistan it is

noticed how this has become the “cool” alternative thing to do. People in Pakistan

especially the youngsters are attracted towards shisha to great extent. It is needed to halt

this phenomenon, especially in preventing our youth from picking up this harmful habit.

Smoking shisha (Arabic water pipes, sometimes known as hookahs) brings the same risks

or even much severe than smoking cigarettes. It can lead to lungs cancer and many other

health problems. Shisha smoking can also affect your mental health, as it is linked with

anxiety and depression. Shisha smoking must be addressed in order to let the people

know about the dangers of it on their lives.

Major findings

Most of the respondents were male (63%) while female respondents were in less

percentage (37%).

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Majority of the respondents (61%) belonged to the age group of 20-24 years.

While second highest percentage (17%) of respondents were falling in the age

group of 25-29 years.

More number of respondents (73%) were students where as employed were in less

proportion (27%).

Majority of the respondents (55%) were from Islamabad while a little less

percentage of respondents (45%) from Rawalpindi. Sample was selected from

some famous shisha bars from both of the cities.

Major proportion of the sample (50%) belonged to nuclear family system. The

data indicates that second major proportion of sample belonged to extended

family where as very less of the proportion (17%) belonged to joint family

system.

Majority of the respondents (84%) were unmarried where as less of the proportion

(16%) were married.

The data reveals that the major proportion (47%) of the respondents had

educational level up to masters and above. Whereas other major proportion (40%)

of the respondents were graduate.

Majority of the respondents’ mothers (31%) had educational level up to masters

and above. While other major proportion (27%) of the respondents’ mothers had

educational level up to graduation.

According to the research (67%) of the respondents’ fathers had educational

level up to masters and above. Whereas a little less of the percentage (23%) of the

respondents’ fathers were graduate.

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Majority of the respondents (34%) of the respondents had middle rank among

their brothers and sisters. Whereas a little less proportion (30%) of the

respondents were youngest among their brothers and sisters.

Major proportion of the sample (77%) had no other shisha smoker at their home

whereas with a lot of different a very less proportion (23%) had one shisha

smoker at home, other than them.

Among shisha smokers in respondent’s family, major proportion (13%) of the

respondents’ brothers were shisha smokers. Majority of the proportion (47%) of

those family members of respondents were falling in the age group of 16-25.

Majority (60%) of the respondents’ mothers were house wives where as very less

proportion (15%) of the respondents’ mothers were engaged in office job.

Majority (51%) of the respondents’ fathers were army officer whereas other

(23%) of the respondents’ fathers were business man.

Majority of the respondents (66%) had tried shisha more than one year ago for the

first time. While other (24%) of the respondents tried shisha for the first time a

year before.

Major proportion (39%) of the respondents felt relaxed when they had shisha for

the first time. With less proportion (20%) of the respondents started to cough

when they had shisha for first time.

Majority (56%) of respondents’ friends introduced shisha to them. Whereas other

(10%) respondents were introduced to shisha by their college/university fellows.

Majority (27%) of the respondents liked double apple mint flavor of shisha while

a little less proportion (23%) of the respondents liked blue mist flavor of shisha

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the most.

Majority (45%) of the respondents had fun and enjoyment when they had shisha

while other major proportion (20%) of the respondents found shisha as a break

from hectic life.

Majority (38%) of the respondents were attracted towards shisha because they

share it with their friends. Other major proportion (32%) of the respondents found

smoke rings as the reason of their attraction towards shisha smoking.

Majority of the respondents (35%) were used to smoke 1-2 times in a week. A

little less of the sample (30%) of the respondents smoke shisha 3-4 times in a

week.

Data displays that majority (39%) of the respondents used to spend 1-2 hours in

the shisha bar. A little less proportion (36%) of the respondents used to spend 30-

60 minutes in shisha bar.

Majority (44%) of the respondents preferred to accompany their friends while

visiting shisha bar. Other (18%) of the respondents preferred to accompany their

partners while visiting shisha bar.

Major proportions (44%) of the respondents were used to pay for shisha on their

own. Whereas other (28%) of the respondents’ friends were used to pay for shisha

at shisha bar.

Majority of the respondents (37%) preferred to visit shisha bar with few people

while a little less (34%) of the respondents preferred to visit shisha bar with a lot

of crowd.

70

Major proportion (55%) of the respondents preferred to visit shisha bar depending

on their mood. Other major proportion (20%) of the respondents preferred to visit

shisha bar at a short distance.

Majority of the respondents (28%) said that shisha smoking at shisha bar helped

them in escaping from worries and that is what they liked the most about shisha

smoking. Other (19%) of the respondents answered that they liked loud music at

shisha bar.

Majority of the respondents (70%) knew how to prepare shisha while remaining

(30%) of the respondents didn’t know how to prepare shisha.

Major proportion (52%) of the respondents had tried to prepare shisha for many

times.

The data indicates that majority (40%) of the respondents never smoked shisha at

home. Other major proportion (32%) of the respondents smoked shisha at home

for some times.

Majority of the respondents (54%) said that their parents knew about their habit of

shisha smoking. While (26%) of the respondents said that their parents didn’t

know about their habit of shisha smoking.

Majority of the respondents (40%) reacted normal on their parent’s anger on

their habit of shisha smoking.

Majority (25%) of the respondents’ mothers stopped them from shisha smoking

where as other (19%) of the respondents answered that their partners stopped

them from shisha smoking.

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Majority (40%) of the respondents agreed with the statement that shisha causes

addiction. Other major proportion (38%) of the respondents strongly agreed with

the statement.

Major proportion (53%) of the sample agreed that shisha causes chronic diseases.

Other major (25%) of the proportion disagreed with the statement that shisha

smoking causes chronic diseases.

Major proportion (46%) agreed that shisha smoking is totally wastage of money.

Other major proportion (33%) of the respondents disagreed with the statement.

Majority (44%) of the respondents disagreed that shisha smoking is wastage of

precious time. Other major proportion (38%) agreed with the statement.

Majority (39%) of the respondents disagreed that shisha smoking leads to

immorality. While with a little difference (38%) of the respondents agreed that

shisha smoking leads to immorality.

Major proportion (46%) of the respondents agreed that education is given less

priority because of shisha smoking.

Majority (40%) of the respondents agreed that shisha smoking disturbs other

activities of life. Other (30%) of the respondents disagreed that shisha smoking

disturbs other activities of life.

Majority (60%) of the respondents never had been addicted to other drugs

previously.

Major proportion (58%) of the sample was addicted to cigarettes among those

who had been addicted to other drugs previously.

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Majority (42%) of the respondents answered that shisha didn’t affect much on the

people in their surroundings.

Data show that same percentage (43%) of the respondents faced objection

“sometimes” and “never” while smoking shisha at public places.

Majority (50%) of the respondents believed that toxins are produced to some

extent when shisha is heated up.

Majority (33%) of the respondents believed that shisha smoking can cause all of

the health hazards which were listed such as lungs cancer, heart diseases, tumors

on lips and mouth, periodontal (gum tissues) diseases.

Majority (66%) of the respondents answered that their partners complained about

their changing behavior.

Majority (35%) of the respondents found it fairly easy to go without shisha

smoking for the whole day.

Majority (62%) of the sample had no fear of failure regarding their efforts to quit

shisha smoking.

Majority (56%) of the respondents had no fear of being bad-tempered regarding

their efforts to quit shisha smoking.

Majority of the respondents (65%) had no fear of being nervous regarding their

efforts to quit shisha smoking.

Majority (64%) of the respondents had no fear to be tensed regarding their efforts

to quit shisha smoking.

Majority (63%) of the respondents had no fear of having difficulty in

concentrating on other activities regarding their efforts to quit shisha smoking.

73

Majority (49%) of the respondents had some fear of missing or desiring shisha

their efforts to quit shisha smoking.

Majority (43%) of the respondents had some fear of losing a pleasure regarding

their efforts to quit shisha smoking.

Majority (56%) of the respondents had no fear of gaining weight regarding their

efforts to quit shisha smoking.

Majority (48%) of the respondents had some fear not t be around other smokers

regarding their efforts to quit shisha smoking.

Majority (54%) of the respondents sometimes thought about quitting shisha.

Major proportion (42%) of the respondents felt satisfied to think themselves as

non smokers.

Majority (55%) of the respondents knew about the governments act against

shisha bar.

Majority (49%) of the respondents were in favor of government’s efforts against

shisha bar.

Majority (55%) of the respondents somehow regretted to be a shisha smoker.

Major proportion (17%) of the respondents rated their motivation as 10 on the

scale of 1-10 to quit shisha smoking.

Conclusion

74

During the research which was conducted in twin cities (Islamabad and Rawalpindi) it

was noticed that a large number of respondents were students and they had very strong

affiliation with shisha. It was revealed that shisha smokers had good relations with their

friends as compare to their family. There were a large number of people who were

introduced to shisha by their friends; they spend a lot of time at shisha bars while they

prefer to accompany their friends. Respondents preferred to go to shisha bars depending

on their mood. Respondents had doubts about the other shisha smokers of their family.

They were not aware about the activities and practices of other members of their family.

It shows that they had less interaction with other family members.

Education was given less importance than shisha smoking. Students of colleges and

universities were found at shisha bars during the day time which shows that they didn’t

attend their classes. Instead of getting education students are more involved in other

activities. With shisha smoking respondents get lot more chances to have other drugs too.

Not only other drugs but many more activities which are not socially appreciated are

adopted. Shisha smoking is the starting with goes with a lot more bad habits that ruins the

educational experience of the respondents.

Most of the respondents were unaware about the harms of shisha and never wanted to

quit that. This new trend has got a lot of attraction in it because of the smoke rings and

the way friends sit together and share it with one another. People like to share the mouth

piece with one another which causes several diseases. Respondents had fear of losing a

pleasure and missing shisha regarding their efforts to quit shisha smoking. It shows that

shisha smokers had pleasure while smoking shisha and they missed/desired shisha.

Research shows that favorite flavors of shisha were double apple mint and blue mist.

75

These flavors of shisha are very famous among youngsters and they preferred these

flavors over other flavors.

Shisha smokers faced very less objection while having shisha in public places which

shows that this trend is getting acceptance in society. People had fewer obstacles in

smoking shisha at home or telling it to their parents. A large number of the respondents

knew how to prepare shisha and it was available to them at their homes. They had fewer

objections on shisha smoking from their family where as majority mothers of the

respondents stopped them from shisha smoking. Major proportion of the sample had

complaints about their changing behavior made by their partner and mothers, most

prominently.

Suggestions

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Considering the results of the research some of the suggestions are made. These

suggestions are as follows.

It is suggested to make people more aware about the dangers of shisha smoking.

People should be aware of the health hazards related to shisha smoking. Different

researches proved that shisha can cause lungs cancer, heart diseases, periodontal

(gum tissues) diseases and tumors on lips, mouth and other parts of the body.

It is revealed through the research that family involvement in the shisha smoking

is seen quite prominently where brothers, sisters, cousins, uncles and wives were

used to smoke shisha with the respondents. This issue must be addressed in such a

way that it must help the family to get rid of this addiction. Family should get

education about having an alternate activity in order to bring healthy living style.

Students must be given proper information about the dangerous nature of shisha

and the effects of shisha on their lives. Students mostly go to shisha bars during

the college/university timings which not only affect their routine but also cause

great loss in educational attainment. In order to save the future of Pakistan, it is

needed to save the young generation from such unhealthy activities.

Shisha smoking can be avoided by avoiding such gatherings where shisha

smoking is preferred. People must involve themselves in healthy activities.

References:

77

“An Emerging Deadly Trend: Waterpipe Tobacco Use”, American Lung

Association February 2007

Al-Saleh I, Coate L. (1993) Cadmium exposure in Saudi Arabia and its

relationship to smoking. Trace Elem Med; 10:129–133.

American Lung Association, “Tobacco Policy Trend Alert: 2000”

Bergstrom J. 2005 Tobacco smoking and periodontal health in a Saudi Arabian

population.Periodontology;76 (11): 1919-1926(doi:10.1902/jop.2005.76.11.1919)

Doyle, L. (2008). Psychiatric Mental Health Nursing. Dekker. p. 289. ISBN 978-

0-7171-4459-4.

Eissenberg T and Shihadeh A. (2006) Waterpipe tobacco and cigarette smoking.

Direct comparison of toxicant exposure; 37(6): 518-523

Global Youth Tobacco Survey Collaborating Group. (2003) Research conducted

worldwide based on tobacco use: findings from the global youth tobacco survey. J

Sch Health; 73:207-15.

Joe, C, Kauai, K—“The Marketing of Candy-Flavored Cigarettes” May 2006.

Knishkowy, B and Amitai, Y. (2005 July) “Water-Pipe (Narghile) Smoking: An

Emerging Health Risk Behavior,” Pediatrics; 116(1): e113-119 “Waterpipe

Tobacco Smoking: Health Effects, Research Needs and Recommended Actions by

Regulators” WHO Study Group on Tobacco Product Regulation  2005

Mohamed, M (27th March 2007) “Shisha 200 times worse than a cigarette”, ASH

news release:  Embargo: 00:01

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Maziak, W, Soweid, A, Eissenberg, T (2004) “Tobacco smoking using a

waterpipe: a re-emerging strain in a global epidemic”, Tobacco Control; 13:327-

333 doi:10.1136/tc.2004.008169.

Peter, H (14 Mar 10) “Addiction expert warns over ignorance of shisha smoke

dangers” 13:24 CET

Safdar, H (April 3rd, 2009). Shisha: A serious risk for health

Shihadeh, A. (2003) “Investigation of mainstream smoke aerosol of the narghile

water pipe.” Food Chem Toxicol, Jan; 41(1):143-52.

Taylor, C.Z. (March 2002). "Religious Addiction: Obsession with Spirituality".

Pastoral Psychology (Springer Netherlands) 50 (4): 291–315

Wiley liss, Inc. (2000) Toxic and trace elements in tobacco and tobacco smoke

Questionnaire

Shisha smoking among youngsters in twin cities (Islamabad, Rawalpindi)

79

11. What is your rank among your brothers and sisters?

______________________

12. How many of your family members smoke shisha? (If none, go to Q.14)

i) None ii) 1 iii) 2 iv) 3 v) More than 3

13. What is your relation with them along with their ages?

________________________

________________________

________________________

________________________

________________________

________________________

14. When did you smoke shisha for the first time?

i) Been years ii) Less than year iii) Few months iv) Few weeks v) First time

15. How did you feel when you tried it for the first time?

i) felt bad ii) Started to cough iii) Irritated by smell iv) Quiet unusual

v) Relaxed vi) Mind blockage vii) Any other ______________

16. Who introduced shisha to you?

i) Family ii) Relatives iii) Friends iv) College/ University fellows

v) Colleagues vi) Found it myself vii) partner

17. What is your favorite flavor of shisha?

i) Double Apple ii) Cola iii) Vanilla iv) Cherry v) Double Apple Mint

vi) Blue Mist vii) Any other ______________

18. How does shisha influence you?

i) Relaxation ii) Break from hectic life iii) Stress-relief iv) Friend to me

v) Fun and enjoyment vi) A habit

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19. What attracts you towards shisha?

i) Flavored tobacco ii) Smoke rings iii) Sharing with friends iv) Urge to smoke

v) Any other (mention) ____________________

20. How many times do you smoke in a week?

i) 1 – 2

ii) 3 - 4

iii) 5 – 6

iv) 7 – 8

v) more than 8

21. Whom do you prefer to accompany while visiting shisha bar?

i) Family

ii) Relatives (cousins etc)

iii) University/college friends

iv) Alone

v) Street fellows

vi) Partner

vii) Any other ____________

22. Who normally pays for the shisha at shisha bar?

i) Family

ii) Relatives

iii) Friends

iv) Own self

v) Partner

vi) Any other_______

23. Which type of shisha bar do you prefer to go?

i) With a lot of girls/boys

ii) With a lot of crowd (for both)

iii) Only for girls/boys

iv) few people

24. How distant shisha bar do you prefer to visit?

i) At a long distance

ii) At a short drive

iii) Closest one

iv) Depends on mood

25. How much of the time do you spend at shisha bar?

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i) 15 – 30 minutes ii) 30 – 60 minutes iii) 1 – 2 hours iv) Longer than 2 hours

26. What do you like the most about shisha smoking at shisha bar?

i) New friends ii) Romance iii) Shisha smoking only iv) Loud music

v) Escape from worries vi) Any other ___________

27. Do you know how to prepare shisha? (If no, go to Q.29)

i) Yes ii) No

28. Did you ever try to prepare it?

i) Many times ii) A few times iii) never

29. Do you smoke shisha at your home?

i) Frequently ii) Sometimes iii) Not at all

30. Do your parents know that you smoke shisha?

i) Yes ii) Maybe iii) No

31. What is your reaction when parents show anger when you smoke shisha?

i) Anger ii) Annoying iii) Normal iv) Irritating v) Fear vi) Arguing

32. Did anybody ever stop you from shisha smoking?

i) Mother ii) Father iii) Grandparents iv) Sisters v) Brothers vi) Friends

vii) Teachers viii) None ix) Any other _____________

33. Up to what extent do you know shisha is harmful?

Strongly agreed

agreed disagreed Strongly disagreed

Shisha causes addiction

It can cause chronic diseasesIt is totally wastage of moneyIt is the wastage of precious time

82

It may lead to immoralityEducation is given less priorityIt disturbs other activities of daily life34. Do you think shisha smoking is harmful than cigarettes?

i) To great extent ii) To some extent iii) Some how iv) No

35. Have you ever been told or found yourself addicted to other drugs previously?

(If never then go to Q.37)

i) Quiet frequently ii) Sometimes iii) A very few times iv) Never

36. What are those drugs?

i) Cigarettes

iv) Heroin

ii) Cigar

v) Chars

iii) Alcoholic drinks

vi) Any other _______

37. Do you think shisha smoke affects the people in the surroundings?

i) Yes ii) Not much iii) Maybe iv) No

38. Do you face any objection while smoking it in public place?

i) Often ii) Sometimes iii) never

39. To what extent toxins are produced when shisha is heated up?

i) To great extent ii) Some extent iii) Very less iv) Not at all

40. Do you think shisha smoking has any of the health hazards?

i) Lungs cancer ii) Heart disease iii) Tumors on lips and mouth

iv) Periodontal (gum tissue) disease v) All above vi) None of them

41. Did any of the following complain about your changing behavior with them?

i) Mother ii) Father iii) Grandparents iv) Sisters v) Brothers vi) Friends

vii) Teachers viii) None ix) Any other ______________

83

42. How easy or difficult would you find it to go without smoking it for a whole day?

i) Very easy ii) Fairly easy iii) Fairly difficult iv) Very difficult

43. What fears do you have about your efforts to quit?

none some a lot

Fear of failure

Being bad-tempered

Fear of being nervous

To be tensed

Difficult to concentrate on other activities

Missing or desiring shisha

Losing a pleasure

Gaining weight

Being around other smokers

44. Have you ever thought about quitting?

i) Often ii) Sometimes iii) Never

45. How do you feel thinking yourself being a non smoker?

i) Comfortable ii) Satisfaction iii) Never thought iv) Dissatisfaction v) Uncomfortable

46. Do you know about government’s act against shisha bar? (If No, go to Q. 48)

i) Yes ii) No

47. To what extent are you in favor of those efforts?

i) To great extent ii) To some extent iii) Not much iv) Not at all

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48. Do you regret being a shisha smoker?

i) Yes ii) Somehow iii) No

49. On a scale of 1-10, how would you rate your motivation today to quit shisha smoking?

1 = very low motivation,

10 = very high

1, 2, 3, 4, 5, 6, 7, 8, 9, 10

Thank you!!