Reza Sadeghi - Department of Public Health, Sirjan School of Medical Sciences, Sirjan, Iran

Background: Hookah smoking has become prevalent, especially among the Iranianpopulation. Knowing the associated factors is essential in designing preventive interventions.This systematic review was conducted to consolidate the factors linked to hookah smoking inthe Iranian people.Materials and Methods: This study searched ۳ Iranian databases—Magiran, SID, andIranMedex—for articles in Persian and ۴ international databases—Scopus, PubMed, Web ofScience, and Google Scholar, for articles in English. The search spanned from April ۲۳, ۲۰۲۳,using the keywords “waterpipe,” “hookah,” “goza,” “shisha,” “hubble bubble,” “narghileor smoking,” and “predictive factors or predictors.” This review followed the PRISMA (thepreferred reporting items for systematic reviews and meta-analyses) framework.Results: The review included ۱۶ studies (۷ English papers and ۸ Persian articles). Based onthese studies, positive attitudes towards hookah smoking, subjective norms, self-efficacy,perceived threat, socializing with friends, passing leisure time, entertainment, unemployment,pleasant feeling, reducing anxiety and fatigue, and easy access to hookah were related tohookah smoking.Conclusion: The synthesized evidence from this systematic review highlights the influenceof social, cultural, and contextual factors, such as unemployment, anxiety, fatigue, andeasy access, on hookah smoking in Iran. Incorporating the above factors in designing and implementing public health interventions might effectively deter hookah use among Iranians.

Hookah smoking, Predictive factors, Iranian population