Social and behavioural determinants of nargila (waterpipe) smoking among Israeli youth: Findings from the 2002 HBSC survey

Background: Nargila is a device for smoking, which works by water-filtration and indirect heat. The use of substances, such as tobacco, herbs, and even hard drugs in the device, is common. Over the past decade, nargila smoking using mainly tobacco, is an accepted behaviour among teenagers in Israel. This study examines nargila smoking among teenagers in relation to family and school problems, and risk behaviours, such as cigarette smoking and alcohol use in their background. Methods: This article presents findings from the international study data of the HBSC (Health Behaviour in School-aged Children), conducted by the World Health Organization. The Israeli representative sample consists of data collected from 6681, 6th, 8th and 10th grade school children. Sampling consists of data from the Jewish and Arab state, secular and religious, school systems. Results: This study shows a statistically significant association between nargila smoking and involvement with other health risk behaviours. Strong predictors in the use of nargila as a one-time experience, as well as weekly use, correlate with a history of cigarette smoking, drunkenness and violence. Conclusions: These findings suggest that causes that influence nargila smoking also influence other risk behaviours, which in turn, effect this pastime occupation. There is need for a State prevention programme and protocol that consists of educating students, parents, teachers, and public representatives about the risks of this accepted behaviour and habit.