Water Pipe Tobacco Smoking Among University Students in Oman: A Cross-sectional Study

Tobacco smoking and water pipe tobacco smoking (WTS) are common in the Middle East and have now spread to other parts of the world. The aim of this study was to explore the behavior, attitude, beliefs and intentions associated with WTS among university students in Oman. This is a cross-sectional, descriptive study, which was carried out at Sultan Qaboos University (SQU) and the High Technology College, both in Muscat, Oman, from August 2015 to April 2016. Participants were requested to answer an electronic or paper-based survey, which was adapted from a validated survey constructed by the American University of Beirut, adapted for WTS users. Of the 188 participants, 51.1% were younger than 23-years-old. The vast majority (85.6%) smoked WTS in a cafe, while 11.2% smoked at home and only 3.2% at a university accommodation. A higher proportion of WTS products were purchased from cafes (64.4%), followed by supermarkets, friends and purchased online. The most commonly used flavor was “double apple” (59.0%). Around 47.3% of the participants thought WTS was less addictive and less harmful than cigarette smoking. This study highlighted the need for a better understanding of the contributing factors and the attitudes towards WTS, which will in turn lead to prevention, as well as interventional policies, to address this emerging public health threat in Oman.