Factors contributing to the initiation of waterpipe tobacco smoking among Iranian women

Background: Using waterpipe is the most common method of tobacco consumption among Iranian females and the rate has significantly increased over the past few decades. Aims: The purpose of this study was to determine the factors that contribute to the initiation of waterpipe tobacco smoking among females in Gorgan, Islamic Republic of Iran. Methods: This cross-sectional study was conducted between March and June 2016 in Gorgan. Two hundred and six females who smoked waterpipe tobacco were recruited as participants using convenience and snowball sampling methods. Data were collected using a questionnaire examining the factors that facilitate initiation of waterpipe smoking among females. Results: Positive attitudes towards waterpipe smoking and its availability were the most frequently reported factors contributing to its initiation among females (87.9%). Curiosity (80.1%) and waterpipe smoking among family members (70.9%) were also significant. The least frequently reported factor was "attracting other's attention and cooperation". Conclusion: A positive opinion, availability, curiosity and presence of waterpipe smoking among family members and relatives were the most signifcant factors that facilitated initiation of waterpipe smoking among females. To reduce its prevalence, it is recommended that intervention strategies be implemented to change attitudes and reduce access to waterpipe tobacco at family and social gatherings.