Factors affecting hookah tobacco smoking among females in the Islamic Republic of Iran: a qualitative study

Background: The prevalence of hookah smoking in the Islamic Republic of Iran is increasing among females, especially in the southern cities. Aims: The aim of this study was to investigate the factors influencing hookah tobacco smoking among females in the Islamic Republic of Iran. Methods: In this qualitative study, 52 females who use hookah were selected (25-71 years old) from the cities of Evaz and Gerash and were interviewed. The participants were selected using purposive sampling and the data were gathered using semi-structured interviews. Data analysis was performed using the conventional approach of qualitative content analysis. Results: Most participants were aged between 25 and 35 years old and 55.8% were married. Three main themes were identified from the qualitative data including: personal factors, family factors and social factors. Conclusions: The findings of this study indicate that the reasons for hookah smoking were based on complex interactions between individual, family, and social factors. In order to successfully reduce hookah smoking in females it is necessary to consider an approach that uses these social factors.