An Ethnographic Study of Hookah Consumption Among Adolescents in Shiraz
Subject Areas : Research on Iranian social issuesrouhola mozafari 1 , sedighe alborzi 2 , Yaser Rastegar 3
1 - Ph.D. Student of Sociology, Faculty of Literature and Humanities, Yasouj University and Expert of the Organizational Performance Evaluation Department in Shiraz Municipality.
2 - Ph.D. in Sociology of Shiraz University and Scientific Staff of Academic Center for Culture, Education and Research Fars Branch. Shiraz. Iran.
3 - Associate Professor in Sociology, Department of Social Sciences, University of Hormozgan, Bandar Abbas, Iran.
Keywords: Adolescents, Ethnographic Study, Hookah Consumption, Risky Behaviors, Smoking.,
Abstract :
Smoking is a health hazard and its harmful consequences threaten people's health and lives; cigarette is killing 8 million people every year (WHO, 2019). While in 2007, multiple reports show that the global pattern of tobacco use has changed, smoking has decreased and other forms, especially hookah, have increased (Danaei et al., 2017; 73). This has caused concern of the subject to relevant officials; Because tobacco contains more than 4000 chemical substances, which are often produced during the burning process and are combined with more than 40 carcinogenic substances (Feli O et al., 2020; 185). Evidence also shows that hookah is addictive and can be a gateway to smoking (Maziak et al., 2015; 51). While hookah is considered as dangerous and harmful to the people’s health, it provides a hidden platform for the other social problems and disorders as well as other risky behaviors. Therefore, it is considered a hidden social problem (Afrasiabi and Amirmohammadi, 2017: 2). Some studies have confirmed the relationship between hookah use and high-risk sexual behaviors, drug and alcohol usages (Alborzi, 2018: 36). Many experts in the field of addiction studies, believe that hookah can be a gateway to drugs and other risky behaviors (Kanyaji, 2003, 418). Hookah use had a historical background in Iran. According to the various studies, at the present time, there is increasing trend of hookah consumption. (Kalan and Taleb, 2018: 267). Related research indicates an increase in consumption of hookah among teenagers and young people (Dugas et al., 2013; 1184). While adolescence and youth are vital periods in life and the habits and behaviors that people get used to during this period will most likely continue until adulthood and become their lifestyle. At this stage of life, people’s experience, choices and behaviors are based on their emotions. For this reason, hookah consumption and its consequence in this period of life can be dangerous and harm a person for the rest of his life. Therefore, the present study focused on adolescent’s hookah consumers and tries to ethnographic study of the phenomenon with emphasis to socio- psychological aspects.
Keywords: Adolescents, Ethnographic Study, Hookah Consumption, Risky Behaviors, Smoking.
Methods
The present research applied the ethnographic among qualitative method to study of hookah consumption among adolescent in Shiraz city. The issue was examined in several stages (theoretical and exploratory studies, entering the field of research and experimental study, data interpretation). In order to achieve the above goals, the researcher talked to the available informants, monitored the sites and virtual social networks, made several references to the relevant guilds in order to build trust, and made preliminary field observations. After the exploratory study, the researcher entered the research field to collect data, formal conversations, visual documents and field notes are very important in this part of the study. Designing interview questions, choosing a place, deciding who, when and where to observe, trying to access the field, establishing communication and trust, choosing a research role, interacting with informants, recording observations and doing demographic interviews were conducted in the field of study. The statistical population includes adolescents aged 12-18 years old in Shiraz and the sample size was 29 people according to the theoretical saturation. Also, purposeful sampling based on maximum diversity. Thematic data analysis was done at two levels. In the first level, it was tried to analyze and examine all types of data, including field notes as well as from official interviews. In the second level, all the data were analyzed together and in general.
Results
The key categories that were extracted from the data analysis are:
Hookah, friendship and harmony with the friendship group: The main actors in the use of hookah both in the beginning and in its continuation are the teenagers themselves along with their friends and peers, who are referred to as "friends".
Supporting actors: Hookah suppliers (hookah renters in public places like parks, coffee shops, gardens, restaurants, and canteens, etc…) are complementary actors who provides consumers with access to hot charcoals and a ready-made fire for consumption of hookah. The providers are responsible for making and facilitating this process and providing the necessities of consumption.
Fruit tobacco hookah is a fundamental proposition: The type of tobacco has a special place among the adolescent hookah users. In the present study, fruit tobacco is a fundamental proposition. In other words, the variety in taste, aroma, and color has strengthened the attractiveness of this type of tobacco, and most of them use only fruit hookahs, and the fruitiness of tobacco is the fundamental part of process.
Hookah; Escaping from problems, Identification and spending leisure time:
Escaping from problems, Identification and spending leisure time are three important and key concepts in this study. Hookah consumption gives instant pleasure to the consumer and makes them forget their problems, and it is also a mediator of fun and satisfactorily fills free time as one of the permitted leisure tools. Hookah is understood as a tool to avoid problems, spend free time and find identity.
Hookah Fun tool: Some of the respondents whom interviewed in this research understate their economic status and consider hookah as a cheap and accessible tool for recreation and leisure time specific to this class base.
Hookah and risky behaviors: In numerous interviews, the association and correlation between hookah use and risky behaviors such as smoking, drugs, alcohol, and sexual relations were observed. In such a way that many of them considered these things necessary and mandatory and did not accept one without the another. In the case of cigarettes, it is rare to find a hookah but no trace of cigarette smoking.
Conclusion
The important concepts extracted from the data are: friendship and collective nature of hookah, suppliers as supporting actors, fruit hookah as a fundamental proposition, escape from problems, identification and leisure, hookah as tools. Hookah as a means of entertainment for the lower class, hookah and association with drugs, cigarettes, alcohol and sexual relations. The vital trinity was manifested in hookah consumption hangouts in the present study. Friendship and collective nature of hookah, suppliers as supporting actors and fruit hookah as a fundamental proposition. It is as if one of these pillars is not fulfilled, the table is not spread and the hookah is not used. Because it is rarely occurring for a teenager to smoke hookah alone, to use a personal hookah, and to use traditional tobacco. Here the originality of "group" as a very important and key concept is visible. As mentioned before, hookah consumption has a collective nature, and this issue is especially prominent when it comes to teenagers. The association of hookah with the use of drugs, cigarettes, alcohol and sexual relations is another concept derived from the present research. This finding indicates that not only hookah use considered a risky behavior in itself, but also, it can also provide the basis for the formation of social harms and other risky behaviors; In such a way that many experts in the field of addiction believe that because hookah consumption can be a start to drug use and other risky behaviors, it is one of the important social issues. In addition to empirical evidence and with a review of several theories in the field of social deviations such as differential association or the influence of delinquent subculture, it can be claimed that due to the collective nature of hookah use, this group behavior, by involving the individual in the relevant sub-culture, it provides the basis for social deviations. The subculture theory of delinquency believes that the group of friends is very attractive to teenagers and young people, especially when the emotional atmosphere dominates it, they prefer to spend more time with each other. This causes more attachment and commitment to the group, in parallel with being involved in it, it can weaken the individual's commitment to the values and norms of the larger society, and if delinquent and abnormal patterns affect the group, is dominant, the probability that a person will tend towards these patterns increases (zangene,2004: 98). Differential bonding theory also believes that deviant behavior is learnable and is learned through interaction with others in a process of communication. Especially, the main part of learning such behaviors takes place in intimate groups (Williams, 2013: 98). In the end, considering the importance of leisure time and the role of peers during adolescence, it is suggested that policymakers should pay more attention to creating collective entertainment and leisure programs that match the characteristics of adolescence. Also, considering the role of suppliers as facilitators of hookah consumption among teenagers, it is suggested that an effective policy be made to reduce the supply and rental of hookah.
Reference
Afrasiabi, H; Amirmohammadi, Z. (2018) Qualitative study of hookah consumption among young boys in Jiroft city. Strategic Research of Iran's Social Issues, 7 (1), 65-80. (Persian)
Alborzi, S. (2019) Sociological study of health-based behaviors of young people in Shiraz. PhD Thesis, Department of Sociology, Shiraz University. (Persian)
Danaei, M., Jabbarinejad-Kermani, A., Mohebbi, E., Momeni, M. (2017) Waterpipe tobacco smoking prevalence and associated factors in the southeast of Iran. Addiction & health, 9 (2), 72-80.
Dugas, E., Tremblay, M., Low, N C., Cournoyer, D., & O'Loughlin, J. (2013) Water-pipe smoking among North American youths. Pediatrics, 125 (6),1184-9.
Feliu A, Fu M, Russo M, Martinez C, Sureda X, Lopez MJ, et al. (2020) Exposure to second-hand tobacco smoke in waterpipe cafes in Barcelona, Spain: An assessment of airborne nicotine and PM2.5. Environmental research. 2020;184:109347. https://doi.org /10.1016/j.envres.2020.109347 PMid:32179267.
Kalan ME, Taleb ZB. (2018) Waterpipe tobacco smoking: A reality or hidden iceberg for Iranian women. Health Promotion Perspectives, 8(4): 252-267.
Kanyajit, S. (2003) An Analysis of Causes of Deviant Juvenile Behaviors
during Current Globalization. PhD thesis in Criminology and Criminal Justice, Man idol University, http://mulinet10.li.mahidol.ac.th/ethesis/4137938.pdf.
Maziak, W., Taleb, Z B., Bahelah, R., Islam, F., Jaber, R., Auf, R., & Salloum, R G. (2015) The global epidemiology of waterpipe smoking. Tobacco control, 24(1), 3-12.
Williams, F,. McShane, P and Marie, L. (2004) Theories of criminology, translated by Hamid Reza Malek Mohammadi. Tehran: Mizan Publishing. (In Persian)
World Health Organization (2019) Tobacco Breaks Hearts: choose health not Tobercco. beat NCDS, Federation, FCTC, WHO.
Zangane, M. (2004) Investigating the factors affecting students' delinquent behavior. Tehran: Allameh Tabatabai Publications. (In Persian)
افراسیابی، حسین و ضیاء الله امیرمحمدی (1397) مطالعه کيفي مصرف قليان در ميان پسران جوان شهر جيرفت، پژوهش راهبردی مسائل اجتماعی ایران، 7 (1)، صص 65-80.
افشانی، سیدعلیرضا و علی روحانی، و سعیده ابراهیمی نیا (1400) واکاوی بسترها و پیامدهای اجتماعی شدن قلیان در میان جوانان، نشریه بررسی مسائل اجتماعی ایران، 1، صص 369- 397.
البرزی، صدیقه (1398) مطالعه جامعه¬شناختی رفتارهای مبتنی بر سلامت جوانان شهر شیراز، رساله دکتری، رشته جامعه¬شناسی دانشگاه شیراز.
رضایی، مصطفی (1389) سبکهای زندگی و چالشها هویتی، زمانه (جامعه و علوم اجتماعی)، شماره 95، صص 44-45.
زنجری، نسیبه (1390) مطالعه تعیین¬کننده¬های اجتماعی روان¬شناختی سبک زندگی ارتقاءدهنده سلامت سالمندان مطالعه موردی: سالمندان شهر شیراز، پایان¬نامه کارشناسی ارشد، رشته جامعه¬شناسی دانشگاه شیراز.
زنگنه، محمد (1383) بررسی عوامل مؤثر بر رفتار بزهکارانه دانش¬آموزان، تهران، علامه طباطبایی.
قاسمی، محمود و لیلا سبزمکان (1394) تجارب دانش¬آموزان دبیرستانی در مورد پیشبینیکنندههای مصرف دخانیات: یک تحلیل محتوی کیفی نظریه¬محور، مجله آموزش و سلامت جامعه، ۲ (۳)، صص 11-۱.
كلي، هارولد (1377) دو عملكرد گروههاي مرجع، در روانشناسي اجتماعي متون اساسي انگليسي و آمريكايي، نوشته جمعي از روانشناسان اجتماعي، ترجمه پرويز سرندي، تبريز، دانشگاه تبريز، صص 180-187.
ویلیامز، فرانک و پی، مک شین و ماري، لین ري (1383) نظریه¬هاي جرم شناسی (ترجمه حمید رضا ملک محمدي) تهران، میزان.
Alborzi, S., Movahhed, M., Mozafari, R. (2022) A Sociological Study on Hookah Consumption Among the Youth of Shiraz. Tobacco and Health. 1(1).36-42.
AlMulla A, Kouyoumjian S, Maisonneuve P, Cheema S, & Mamtani R. (2024) Waterpipe smoking: Results from a population-based study in Qatar. Tob Induc Dis. 20(1), 20-61.
Al Sabbah H, Assaf E & Taha Z. (2022) Impact of COVID-19 lockdown on smoking (waterpipe and cigarette) and participants' BMI across various sociodemographic groups in Arab countries in the Mediterranean Region. Tob Induc Dis.20, 20-98.
Bandura, A. (1997) Self-efficacy: the exercise of control. New York: W.H, Freeman.
Bandura, A. & Walters, R.H. (1964) Social Learning and Personalty Development, Holt Rinehart & Winston, Inc. New Jersey, Prentice Hall, Inc. Englewood Cliffs.
Cobb C, Ward KD, Maziak W, Shihadeh AL, Eissenberg T. (2010) Waterpipe tobacco smoking: an emerging health crisis in the United States. American journal of health behavior, 34 (3), 275-85.
Cockerham, W C. (1999) Health and Social Change in Russia and Eastern Europe. London: Routledge.
---------------------- (2000) Health Lifestyles in Russia, Social Science & Medicine Disease. London: Polity Press.
---------------------- (2004) The Sociology of Health Behavior and Health Lifestyle. London: Prentice Hall College.
--------------------- (2008) Social Causes of Health and Disease. London: Polity Press.
--------------------- (2013) Social Causes Of Health and Disease. United states of America: Polity Press.
--------------------- (2015) Medical Sociology on the Move : New Directions in Theory. Dordrecht, Netherlands. Springer.
Cockerham, W. C & Ritchey, F. J. (1997) Dictionary of Medical Sociology. United states of America: Greenwood Press.
Danaei, M., Jabbarinejad-Kermani, A., Mohebbi, E., Momeni, M. (2017) Waterpipe tobacco smoking prevalence and associated factors in the southeast of Iran. Addiction & health, 9 (2), 72-80.
Demers, A., Sylvia, K., Edward, M., Adlaf, L., Glickman, B., Newton, T. & Alain, M. (2002) Multilevel analysis of situational drinking among Canadian undergraduates. Social Science and Medicine, 55, 415–24.
Dugas, E., Tremblay, M., Low, N C., Cournoyer, D., & O'Loughlin, J. (2013) Water-pipe smoking among North American youths. Pediatrics, 125 (6),1184-9.
Elizabeth R. Stevens, Erin L. Mead-Morse (2024) Prevalence and factors associated with second hand smoke exposure among a sample of pregnant women in Cairo, Egypt. BMC Women's Health. 24, 24-45.
Feliu A, Fu M, Russo M, Martinez C, Sureda X, Lopez MJ, et al. (2020) Exposure to second-hand tobacco smoke in waterpipe cafes in Barcelona, Spain: An assessment of airborne nicotine and PM2.5. Environmental research. 2020;184:109347. https://doi.org /10.1016/j.envres.2020.109347 PMid:32179267.
Kalan ME, Taleb ZB. (2018) Waterpipe tobacco smoking: A reality or hidden iceberg for Iranian women. Health Promotion Perspectives, 8(4): 252-267.
Kanyajit, S. (2003) An Analysis of Causes of Deviant Juvenile Behaviors during Current Globalization. PhD thesis in Criminology and Criminal Justice, Man idol University, http://mulinet10.li.mahidol.ac.th/ethesis/4137938.pdf.
Keller, A P. (2000) An Ethnographic study of substance – dependent women in Residential treatment, requirement. Degree of Doctor of Nursing science, Louisiana state university.
Kelly, H. (1998) Two functions of reference groups. English and American basic texts in social psychology, written by a group of social psychologists, translated by Parviz Sarandi, Tabriz, Tabriz University Press, pp. 180-187.
Khatib, M., Sheikh, M A., Hadid S. (2022) Correlates of Hookah Smoking among Arab Adults in Israel Identified by a Machine Learning Algorithm. Isr Med Assoc J. 24(4):246-252.
Levy, D., Rodríguez-Buño, R L., Hu, T W., & Moran, A E. (2016) The potential effects of tobacco control in China: projections from the China SimSmoke simulation model. In Economics of Tobacco Control in China: From Policy Research to Practice, pp. 189-213.
Makvandi, Z., Mostafavi, F., Bashirian, S., Zamani-Alavijeh, F., & Kelishadi, R. (2021) Sociocultural factors contributing to waterpipe tobacco smoking among adolescents and young adult women: a qualitative study in Iran. International Journal of Qualitative Studies on Health and Well-being, 16 (1), 1857043.
Mathers , C. D , & Loncar, D. (2006) Projections of global mortality and burden of disease from 2002 to 2030. Plos med, 3 (11), 1-12.
Maziak, W., Taleb, Z B., Bahelah, R., Islam, F., Jaber, R., Auf, R., & Salloum, R G. (2015) The global epidemiology of waterpipe smoking. Tobacco control, 24(1), 3-12.
Pronina, T. (2023) The prevalence of hookah smokers among Belarussian children and adolescents. Tobacco prevention & Cessation. 9: 1-5. & Sergei Sychik.
Sadeghieh S, Hoseinpour H, Aghamohammadi M. (2022) Knowledge of the Role of Cigarette and Hookah Consumption in COVID-19 Disease among the Businesspeople of Ardabil City. Journal of Health,14(3).367-378.
Soule, E K., Lipato, T., & Eissenberg, T. (2015). Waterpipe tobacco-smoking: a new smoking epidemic among the young?. Current pulmonology reports, 4 (4), 163-172.
Swartz, D. (1997) Culture and Power: The Sociology of Pierre Bourdieu. Chicago: University of Chicago Press.P. 104.
Turner, B. S. (2004) The New Medical Sociology: Social Forms of Health and Illness. London: Norton.
Williams, F,. McShane, P and Marie, L. (2004) Theories of criminology, translated by Hamid Reza Malek Mohammadi. Tehran: Mizan Publishing.
World Health Organization (2018) Noncommunicable Diseases (NCD). Country Profiles.
World Health Organization (2019) Tobacco Breaks Hearts: choose health not Tobercco. beat NCDS, Federation, FCTC, WHO.
World Health Organization. (2015) WHO global report on trends in prevalence of tobacco smoking 2015. http://apps.who.int/iris/bitstream/10.