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Iran J Public Health. 2019 Jul;48(7):1317-1325.

Determinants of Intentions toward Smoking Hookah in Iranian Adolescents Based on the Theory of Planned Behavior.

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Department of Community Health and Geriatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran.



Smoking hookah is considered a health problem among the adolescents, which currently has a high prevalence. The present study aimed to determine the reasons for tendency toward smoking hookah.


Participants of this qualitative study were 24 adolescents from Tehran selected using purposeful sampling method in 2017. Data gathered through individual semi-structured interviews and two focus groups. Using directed content analysis approach 423 primary codes were categorized into 28 subcategories and 9 categories.


Most of the participants were 16 to 18 yr old (64%), male (58%) and had high school degree (58%) and 75% of them were student. In Theory of Planned Behavior, attitude toward smoking hookah contained categories of replacement for cigarette, the pleasurableness of hookah, easy access and spending the leisure times. Subjective norms contained the categories of family, friends and society. The construct of behavioral control contained the categories of personal and social factors.


Our Results could be helpful in policy-making and planning toward improving the awareness and changing the attitude and performance of the adolescents toward smoking hookah.


Adolescent; Smoking water pipe; Theory of planned behavior


Conflict of interest statement

Conflict of interests The authors declare that there is no conflict of interests.

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