Tobacco use in shisha: Studies on waterpipe smoking

4
Epidemiology of waterpipe smok<strong>in</strong>g
<strong>in</strong> the rural areas of the Nile Delta
4.1 Introduction
Globally, 4.9 million deaths each year are attributed to tobacco <strong>use</strong>,
and this annual toll may <strong>in</strong>crease to 10 million with<strong>in</strong> the next 20 to 30
years. Of these deaths, 70% are likely to occur <strong>in</strong> develop<strong>in</strong>g countries.
[1]
The waterpipe is an old smok<strong>in</strong>g method that is attract<strong>in</strong>g new
customers. In the countries of the Eastern Mediterranean Region, waterpipe
smok<strong>in</strong>g is spread<strong>in</strong>g. In Egypt, early <strong>in</strong> the 1970s, a chest professor
conducted some studies on this phenomenon [2,3,4] and predicted an
<strong>in</strong>crease <strong>in</strong> this smok<strong>in</strong>g method <strong>in</strong> Egypt. [5]
Syrians reported the upward <strong>in</strong>crease <strong>in</strong> its consumption from the
early 1990s. [6] In Asia, where—traditionally—the waterpipe was born,
an <strong>in</strong>crease <strong>in</strong> its popularity has also been reported. [7] Waterpipe smok<strong>in</strong>g
is also <strong>in</strong>creas<strong>in</strong>g <strong>in</strong> Egypt with a progressively wider distribution of cafés
attract<strong>in</strong>g new customers, yet the epidemiology of waterpipe smok<strong>in</strong>g has
never been studied precisely <strong>in</strong> Egypt. Public health authorities lack basic
<strong>in</strong>formation on which to base <strong>in</strong>terventions, regulations, laws, and other
forms of tobacco control policies for waterpipes.
The aim of this study is to study the prevalence of waterpipe
smok<strong>in</strong>g (<strong>shisha</strong>, as named <strong>in</strong> Egypt) among rural Egyptians and to def<strong>in</strong>e
the determ<strong>in</strong>ants of <strong>shisha</strong> smok<strong>in</strong>g <strong>in</strong> these areas.
4.2 Methods and participants
Selection of villages
Qalyubiyah governorate is the closest rural governorate to Cairo and
very similar to all rural areas <strong>in</strong> lower Egypt and thus was selected to be
surveyed. All villages <strong>in</strong> the Qalyubiyah governorate <strong>in</strong> the Nile Delta
were identified. N<strong>in</strong>e villages were selected randomly.
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