"If I don't smoke shisha, I won't be able to sleep": Lived experiences of high school students in Ethiopia

Selamawit Hirpa, Fiona Dobbie, Andrew Fogarty, Adamu Addissie, Mirgissa Kaba, Thomas Frese, Susanne Unverzagt, Eva Johanna Kantelhardt, Kamran Siddiqi, Linda Bauld, Wakgari Deressa

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Background: Shisha smoking predisposes the users to cardiovascular diseases, cancer, and infections, such as tuberculosis, hepatitis, and herpes. In Ethiopia, there is little data on the adolescents’ shisha smoking experience. This study aimed to explore the lived experience of high school students and inform ongoing and future prevention and control interventions.
Methods: This study was conducted in Addis Ababa and Adama cities in Ethiopia. Twenty-five sec-ondary school students aged 15-22 years who had shisha smoking experience participated in this study. A topic guide was used to facilitate the in-depth interviews (IDIs) and a digital audio record-er recorded the interviews. Interviews varied between 40-90 minutes and were conducted in pri-vate open-air spaces where only the interviewee and researcher were present. Each transcript was coded using Atlas.ti version 8 software. The analytical approach was iterative, with interview tran-scripts analyzed at the time of coding and re-analyzed after a preliminary result was drafted to search for additional themes.
Results: Students described two key factors that influenced their decision to initiate shisha smok-ing: peer influence and perceiving it as a means to release stress. After initiating shisha use stu-dents maintained the behaviour because of: peer influence, khat chewing, enjoyment of shisha smoking, having prolonged leisure time, and accessibility to shisha. Students regretted the impact shisha use had on their lives, such as conflict with their families, poor academic performance, and spending money on shisha smoking. Female students were also concerned about reproductive health risks related to shisha use.
Conclusion and recommendations: Peer influence played a major role both in initiating and main-taining shisha use. However, students admitted concern over the impact of shisha smoking on ac-ademic performance and their relationship with their families. Since shisha use is associated with khat chewing; shisha smoking control programs cannot be successful without controlling khat. Es-pecially young girls had worries about their reproductive health risks associated with shisha use. This suggests that targeted awareness raising programs highlighting the dangers of shisha use for both health and safety; especially for young women is required.
Original languageEnglish
Article numbere2022016
JournalJournal of Global Health Reports
Publication statusPublished - 25 Apr 2022


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