Chapter # 1

Introduction

Introduction

Historically, addiction has been defined as physical and psychological dependence on

psychoactive substances for example alcohol, tobacco, heroin and other drugs. Addiction
is a term used for a complex behavioral disorder. The most obvious symptom is that
addicts reach a point where they cannot control their own actions. Even when they can
see the harm, they continue the uncontrollable behavior. They are unable to stop; their
desire for that particular thing goes to extreme where there is no sense of right and
wrong. (Doyle, 2008)
(Taylor, 2002) Addiction was first described as a failure of will power. We now know this
is incorrect. Addiction is a real disease with psychological, genetic, and psychosocial
aspects. It is not a character flaw or a failure of morality. There are actual changes that
occur in the brains of addicts and treatments for addiction must address the reason behind
the behavior.
2

(Peter, 2010) Shisha (Also called hookah, hooka, huka, nargile, narghile, shisha, shesha,
sheesha, nargila, or shishah and even Hubbly Bubbly) is known by many names. Shisha
is most commonly referred to as goza and narghile, although most of the people know it
as hookah. Originating in Turkey over 500 years ago, this smoking culture has been the
standard for centuries in the Middle East and was smoked by royalty and people alike to
smoke away the days stress. Today this experience is shared across the world as many
people prefer Shisha smoking to cigarettes and cigars because of the smooth, flavorful,
and cool taste of the smoke. Shisha is a tobacco waterpipe that was first used in Asia and
the Middle East but has gained popularity in many countries. Shisha essentially is a
waterpipe used for smoking purposes, originating about is a unique waterpipe device that
is used as a smoking tool and has been the standard of smoking for centuries. Shisha
Tobacco (Also called tabac, tombako, tumbak, gouza, guza, moassel, sheesha) tobacco is
available in a variety of flavors including apple, apricot, strawberry, cappuccino, mint,
peach, mixed fruits and plenty of others. Shisha is quickly becoming very fashionable
and popular amongst this new generation of smokers.
(Eissenberg, 2006) Waterpipe smoking is often a social activity and two or more people
may share the same pipe. In some cultures, children may smoke with their parents.
Although their usage appeared to be declining by the mid 1980s, more recently there has
been an upturn in their popularity in the eastern Mediterranean region and hookah cafes
and bars are also beginning to appear in North America, Brazil and Europe.
(Motarreb, 2001) The tobacco is heated by coals and the smoke comes through the water
after which it emerges through the suction tube, from where it is smoked. The water filter
is a gimmick. Most of the toxic chemicals and nicotine are not water-soluble. Hence, they

pass through the filter and are inhaled by a smoker. Shisha smoking can lead to physical
addiction and can also create psychological and habitual dependence to the user. Smokers
have been advised to stop immediately, because it damages the body by causing wrinkled
skin and many chronic diseases. The reason behind the increase in the shisha smoking
phenomenon is that people do not take the health risks seriously. Carbon monoxide
absorption is greatly increased when shisha is smoked just prior to sleeping. Even
minimal exposure to carbon monoxide is known to be harmful and people who smoke
shisha as little as once a day put themselves at risk.
(Eissenberg, 2006) According to the U.S. News & World Report, shisha also carries
strong risks of addiction. Shisha is a danger to health because it can lead to daily
waterpipe use. One of the most serious concerns of shisha is cancer. The smoke increases
the risk of various cancers such as lung cancer and cancer of the mouth. In addition to
cancer, there are various gum diseases that are linked to shisha. Shisha has dangerous
effects on the body because it exposes the smoker to a much larger volume of smoke than
what would be inhaled from a cigarette. The tobacco smoke has high levels of toxins,
including carbon monoxide. Smoking cigarette is said to be haram because of its harmful
affects on our health, and hookah smoking is even worse than cigarette. So it is not wrong
to say that shisha addiction is not a good thing and whoever is thinking that they are safe
with hookahs as opposed to cigarettes is only fooling them. It is sad to see this trend
catching on fire in the Muslim world. Most prominently in Pakistan, it is noticed how this
has become the cool alternative thing to do. Especially among young generation, said
to be the future of Pakistan.

Although it is traditionally very common in rural areas of Pakistan for generations but
now hookahs have become very popular in the cities. Many clubs and cafes are offering
them and it has become quite popular amongst the youth and students in Pakistan. This
form of smoking has become very popular for social gatherings, functions, and events.
There are a large number of cafes and restaurants offering a variety of hookahs. Karachi
has seen a growth in this business. Now Islamabad also prospers by this trade.
(Khan, 2006) Water pipe smoking appears to be particularly popular among students and
young people who enjoy the novelty and conviviality of sharing the waterpipe, although
in some countries many young people appear to be even unaware that it contains tobacco.
Young women, in particular, are being targeted in some Middle Eastern countries with
custom-made flavored tobacco for use with waterpipes. Another factor that attracts the
young people towards shisha is that it offers a mixture of crude types of tobacco
fermented with molasses and fruits and the sweet odor of fruits conceals the natural smell
of tobaccos tar and nicotine. A large number of school and college students of both
genders hang at Shisha houses for smoking as they dont face any hurdle there to satisfy
their desire. Among women in many countries, there is less of a stigma associated with
Shisha than with cigarette smoking and therefore more and more women are taking up
this habit as a fashion
(Safdar, 2009) scientific studies done to see the adverse health consequences of shisha
smoking point to dangers that are similar to those associated with cigarette smoking. The
research conducted on Shisha use has clearly shown that it has particularly serious health
consequences on 2 vital organs of body namely the lungs and heart. Lung Cancer,
Cancers of the Food Pipe, Chronic Obstructive Lung Disease, Emphysema, low birth

weight, precipitation of Asthma attacks and pneumonia are some of the health hazards
associated with shisha smoking. Nicotine dependence may also result from repeated
inhalation of tobacco smoke from Shisha. Besides Lung Cancer Shisha use is also linked
with increased risk of, Mouth and Urinary Bladder Cancer. Research published in the
Journal of Periodontology (Nov. 2005) found that the effects of waterpipe smoking are
the same as that of cigarette smoking. Additional dangers not encountered with cigarette
smoking are infectious diseases resulting from pipe sharing and the frequent addition of
alcohol or psychoactive drugs to the tobacco.

Objectives
Some of the objectives of the study are discussed under:
1. To study the socio-economic conditions of correspondents.
2. To study/explore the consequences of shisha addiction on young generation.
3. To study the behavioral changes of shisha addicts and attraction towards other
drugs due to shisha smoking.
4. To study policy measures to minimize the affect of shisha addiction on young
generation.

Significance of the study

The study focuses on the affects of shisha smoking among youngsters in twin cities. This
trend is not new in Pakistan as a matter of fact it has been a popular practice in rural areas
since very long. It has been given more attention as an up coming trend, becoming
popular among young people in Pakistan. People are adopting such practices without

thinking about the negative impacts of shisha smoking on their health. Researches have
proved that shisha smoking is worse than cigarette smoking. Its not just affecting their
health but it also disturbs the social life of the youngsters. Young people are adopting this
new trend more often as compare to the elders. Shisha smoking has brought a lot more
hazards to the social setup as it has got hype in urban society too. People have adopted
this trend with much strong acceptance of it than before. There are a couple of researches
held in different countries, addressing the dangerous affects of shisha smoking. It is
necessary to make people know why they should quit shisha smoking and how to save
themselves from such a risky thing which not only affects their health but also their
education. Other social activities are also disturbed because of their addiction to shisha
smoking.

Hypothesis

More attraction towards shisha leads to acceptance of other drugs.

More involvement in shisha smoking, less importance is given to education.

Chapter # 2
Literature review

Literature review

In todays context, Shisha refers to the flavored tobacco used in the smoking process
using a hookah, also commonly known as Hubble bubble and narghile. The
composition of the tobacco used in waterpipe smoking is not well standardized and thus
can be a great risk to the lives of the shisha smokers. (Barrawy, 2005)
9

(Mohamed, 2007) Heat sources that are commonly used in Shisha pipes to burn the
tobacco are likely to increase the health risks because when they burn they produce their
own toxins. Shisha smokers and those around them are put at greater risk. Center of
Tobacco Studies added a great amount of work in this combine research. The new study
stresses that it is the very social nature of shisha smoking that makes the problem worse.
(Knishkowy, 2005) The latest study makes clear that the clean air policies should include
the water pipe, as it can be responsible for the buildup of toxic levels of indoor air
pollutants similar to what is seen in cigarettes. The social nature of this tobacco use
method makes such regulations more needed, but perhaps more difficult to implement as
well. The public health community in the meantime must wake up to the hazardous
nature of this emerging tobacco use method, both to users and those exposed. Existing
evidence on waterpipe smoking shows that it carries many of the same health risks and
has been linked to many of the same diseases caused by cigarette smoking. Access to this
new form of tobacco use continues to grow, especially in hookah cafes targeting 18-to24-year olds.
(Maziak et-al, 2004) A typical hour long shisha session involves inhaling 100 to 200
times the volume of smoke inhaled when smoking a cigarette and there is no proof that
any adaptation can make waterpipes safer. The latest study provides evidence about the
potential hazards of exposure to waterpipe-associated secondhand smoke. Hazardous
particles of various sizes can build up gradually during waterpipe use to reach
dangerously high levels presenting a risk to non-smokers.
It is said that the problem was only recently being addressed by western scientists and
that had lead to dangerous misconceptions. The historical lack of evidence has

10

unfortunately allowed many shisha users to believe that the practice was safe, or at least
safer than other forms of tobacco use. This is certainly not true. Researchers went on
stress that it was the shisha smoker who is at risk and warned that the tobacco industry
will try to undermine the science; every recent study has found that shisha smoke
contains large quantities of the chemicals that lead to heart disease, cancer, and addiction
in cigarette smokers. (Shidaheh et-al, 2005)
According to a research conducted by Mark OMalley and Bachman most trends
emerging among youngsters are followed with some sequences. They dont directly get
addicted to serious drugs; instead they get some interest in minor drugs, including
cigarettes and use of flavors in their drugs to make it more thrilling and exciting. Intake
of tobacco through waterpipe adds more dangers to health. Sharing the mouth piece is
also a dangerous thing. Passing the shisha from person to person is unhygienic and may
result in transmission of communicable diseases. (Johnston et-al, 2005)
International organization ASH working in different areas around the world in order to
protect the new generation from the injurious effects of smoking shisha/hookah. In their
report to the WHO the researchers stressed, Waterpipes should be subjected to the same
regulations as cigarettes and other tobacco products. Waterpipes and waterpipe tobacco
should contain health warnings. Claims of harm reduction and safety should be
prohibited. It would help in reduction of shisha addicts. Study concluded that regular
shisha smokers carry a risk of deforming their teeth. It is also suggested that shisha
smoking may be responsible for abnormal changes in their chromosomes.
(Bergstrom, 2005) Although research into the health impacts of prolonged waterpipe
usage is still in its infancy, there is now enough evidence of its harm to include waterpipe

11

smoking in public smoking bans. In countries where there is a tradition of using

waterpipes, work to change cultural norms and attitudes will be required alongside any
proscriptive laws and regulations. However in countries where waterpipe usage is still a
novelty, public health advocates should seize the opportunity to limit its spread through a
combination of education and legal measures. Laws to ban or restrict smoking in public
places should be drafted to ensure that waterpipes are covered by the relevant legislation.
According to the recent publication by the American Lung Association (February 2007)
An emerging Deadly Trend: Waterpipe Tobacco Use
This new research suggests that the waterpipes have three additional lethal risks
over the risks of smoking cigarettes:
Flavored tobacco is smoked over coals and fumes from these fuels add new toxins to the
already dangerous smoke.
Shisha smokers inhale up to 200 times more smoke in a single shisha session that they
would from a cigarette.
Caf owners have stress the social importance of their product but researchers say it is
exactly that social aspect that results in high level of highly dangerous secondhand
smoke.
(Wiley, 2000) Most of the young people who smoke water pipe regularly are already
addicted to nicotine. In fact, they have the same kind of addiction as adult smokers.
Almost 3 out of every 4 regular smokers in young age have already tried to quit but
failed. Yet out of 100 young smokers, only 3 think they will still be smoking in 5 years.
Studies show that about 60 of them will still be smoking 7 to 9 years later. Most teen
shisha smokers say that they would like to quit and many have tried to do so without

12

success. Those who try to quit shisha smoking report withdrawal symptoms much like
those reported by adults.
(Saleh et al, 1993) Waterpipe use may increase exposure to carcinogens because smokers
use a water pipe over a much longer period of time, often 40 to 45 minutes, rather than
the 5 to 10 minutes it takes to smoke a cigarette. Due to the longer, more sustained period
of inhalation and exposure, a waterpipe smoker may inhale as much smoke as consuming
100 or more cigarettes during a single session. The younger you are when you begin to
smoke, the more likely you are to be an adult smoker. Almost 90% of adults who are
regular smokers started at or before the age 19. And people who start smoking at younger
ages are more likely to develop long-term nicotine addiction than people who start later
in life.
An international researcher added that every second young person knows that waterpipe
smoke is damaging their health. The tobacco in shisha pipes is not directly inhaled, he
explained. Instead the tobacco being originally served, it is added with the smells such as
strawberry and apple, these are heated up on charcoal and then sucked through water.
This means that during smoking, there is not this uncomfortable, scratchy feeling, he
said. Many believe that therefore smoking from a water pipe is even healthy, which is
certainly not true. Further more he added the fact that the tobacco is under lower
temperatures than when set alight, means that more poison is released this way. And the
fact that the smoke coming out of the water pipe is cooler means smokers inhale it more
heavily. Heavy metals like chrome, nickel or lead are sucked more deeply into the lungs.
In the long term this increases the danger of lung cancer as well as tumors on the lips and
mouth. And it is among younger people that the shisha pipes are increasingly popular

13

many do not even rate themselves as smokers if they have a water pipe a couple of times
a month, although many smoke them more frequently. (Lang et al, 2007)
Research published in the Journal of Periodontology (Nov. 2005) found that the effects of
water pipe smoking are the same as that of cigarette smoking and sometimes even worse
than that. The occurrence of periodontal (gum tissue) diseases in the study was 30 percent
among shisha smokers, 24 percent in cigarette smokers and eight percent in nonsmokers. Research from this study shows that the relative risk for periodontal disease
increased five-fold in water pipe and 3.8-fold in cigarette smokers, compared to nonsmokers.
(Kenneth et al, 2004) Even though the smoke is filtered out by water, inhalation of toxic
substances is similar to or even greater than that of cigarette smoking. Many people are
misled in believing that water filters out the toxins and that nicotine is reduced in
waterpipe smoking. Not only does water pipe smoking include the same substances as
cigarette smoke such as carbon monoxide and tar, tobacco used for water pipe smoking
contains two to four percent nicotine, as opposed to the one to three percent for
cigarettes. Researchers found increased levels of nicotine and cotinine (a by product of
nicotine) in the blood plasma, saliva and urine of shisha smokers, which is further
evidence that waterpipe smoking affects the periodontal tissues in the same way as
cigarette smoking. Abdel-Hafiz al-Khameri, a professor of psychology and the head of
the Human Development Foundation, said that stress is a major psychological factor
driving people to smoke the shisha.
Hookahs are marketed as a safe alternative to cigarettes. This claim is false. The water
does not filter out many of the toxins. In fact, hookah smoke has been shown to contain

14

concentrations of toxins, such as carbon monoxide, nicotine, tar, and heavy metals that
are high or higher than those that are seen with cigarette smoke. Several types of cancer,
including lung cancer, have been linked to hookah smoking. Hookah is also linked to
other unique risks not associated with cigarette smoking. For example, infectious diseases
including tuberculosis (which can infect the lungs or other parts of the body), aspergillus
(a fungus that can cause serious lung infections), and helicobacter (which can cause
stomach ulcers) may be spread by sharing the pipe or through the way the tobacco is
prepared.
(American Lung Association, 2006) Existing evidence on waterpipe smoking shows that
it carries many of the same health risks and has been linked to many of the same diseases
caused by cigarette smoking. Access to this new form of tobacco use continues to grow,
especially in hookah cafes targeting 18-to-24-year olds. Water pipes can become yet
another inducement to smoking that appeal particularly to a younger audience attracted
by the reportedly sweeter, smoother smoke. They may have an appeal similar to the
sweeter, candy-flavored cigarettes and tobacco products that the tobacco industry has
begun to market to young adults and youth who appear to be more attracted to these
flavors than adults.
(Soweid et al, 2004) The global tobacco epidemic may kill 10 million people annually in
the next 20-30 years, with 70% of these deaths occurring in developing countries. Current
research, treatment, and policy efforts focus on cigarettes, while many people in
developing regions (Asia, Indian subcontinent, Eastern Mediterranean) smoke tobacco
using waterpipes. Waterpipes are increasing in popularity, and more must be learned
about them so that we can understand their effects on public health, restrict their spread,

15

and help their users quit. This integrative review paper suggests that perceptions
regarding health effects and traditional values may facilitate waterpipe use among women
and children. Waterpipe smoke contains harmful constituents and there is preliminary
evidence linking waterpipe smoking to a variety of life threatening conditions, including
cancer, pulmonary disease, and coronary heart disease. More scientific documentation
and careful analysis is required before the spread of waterpipe use and its health effects
can be understood, and the necessary empirically guided treatment and public policy
strategies can be implemented.

16

Chapter # 3

Methodology

17

Methodology

Methodology may be a description of process to include a philosophically coherent

collection of theories, concepts or ideas as they relate to a particular discipline or field of
inquiry. Methodology may refer to nothing more than a simple set of methods or
procedures, or it may refer to the rationale and the philosophical assumptions that
underlie a particular study relative to scientific method. Methodology guides the
researcher how and what steps need to be followed to the collect relevant data.
Methodology is complete frame work of the whole research activity.
This chapter highlights the methodology strategy under which present research had been
carried out. The methodology to find out answers to questions depends upon the nature of
question.
The current research addresses the, shisha addiction among youngsters in twin cities.

Topic
Shisha addiction among youngsters .

Research design

18

In order to conduct the present research, quantitative research method was used to get the
proposed information from the respondents.

Universe
In research, the target group to be studied is called population of study (Henlin, 1997).
The entire group from which a sample is known as the population or universe. In other
words, any set of individuals or objects having some common observable characteristics
under study constitutes a population or universe.
The study was conducted in the twin cities; Islamabad and Rawalpindi. Keeping in view
the significance of the topic and the problems, I restricted my study only to the shisha
smokers. The research topic under consideration required working with the shisha
smokers and the shisha bars in twin cities.

Sample
A sample is a small part of population, which represents the characteristics of the whole
population. Time and cost are usually limited factors in research. The study aim to know
the addiction of shisha smoking among youngsters, therefore shisha smokers in the
research local was the population out of which the researcher picks the sample randomly.

Sample Size
A sample of 260 respondents selected from the universe.

Data collection
The procedure a researcher follows together relevant data (Ferranti, 2006). In this study
questionnaire was used to collect data, having different kinds of questions to get the

19

required information in most appropriate manner. Different types of questions were asked
such as matrix, open ended and close ended questions.

Tools of data collection

The success of research depends upon how carefully data was collected. The validity of
research mostly depends upon the tool of the data collection. In the present study, the data
was collected with the help of questionnaire. Questionnaire is a set of

questions, which

are asked from the respondents in face -to-face interaction.

Pre-testing
It is always useful to make a test of the tool, formulated before giving it final shape, so
that a researcher may come to know the acceptability of questions. Pre-testing not only
provides ways to modify the interviewing schedule but it also discovers new aspects of
the problem under study.
Ten respondents were selected by researcher for pre-testing. Many important issues were
highlighted during field-testing of the instruments. These main issues were related to the
sequence and phrasing of questions and interviewing techniques. After field test, some
modifications were made, based on the information received.

Editing
Editing is the process of checking and adjusting the data for omissions, legibility and
consistency. Editing may be differentiated from coding, which is the assignment of
numerical scales or classifying symbols to previously edited data. The purpose of editing
is to ensure the completeness, consistency and readability of the data to be transferred to

20

data storage. The editors task is to check errors and omissions in the questionnaires or
other data collection forms.

Coding
Coding involves assigning numbers or other symbols to answers so the responses can be
grouped into limited number of categories. The classifying of data into limited categories
sacrifices some data detail but is necessary for efficient analysis. Codes are generally
considered to be numerical symbols; they are more broadly defined as the rules for
interpreting, classifying and recording data. Codes allow data to be processed in
computer. Researches organize data into fields, records, and files. A field is a collection
of characters (a character is a single number, letter of alphabet, or special symbol such as
the question mark) that represent a single type of data. A record is collection of related
fields. A file is collection of related records. File, records, and fields are stored on
magnetic tapes, floppy disks, or hard drives.

Conceptualization
The process through which we specify what we mean when we use particular terms in
research is called conceptualization. Conceptualization gives definite meaning to a
concept by specifying one or more indicator of what we have in our mind. An indicator is
a sign of the presence of the concept we are studying. The clarification of concept is a
continuing process in social research. Conceptualization is the refinement and
specification of abstract concepts, and operationalization is the development of specific
research procedures (operations) that will result in empirical observations representing
those concepts in the real world.

Perception
21

Perception is defined as the process of attaining understanding or acquiring basic

information or knowledge about any aspect or phenomenon. It is referred to an
understanding of trainees.

Socioeconomic characteristics
According to Chapin (1978) the prevalent average standard of cultural processions,
effective income, material procession and the participation in the group activities of
community determine the persons socio-economic status. For the present study the
indicators identifying socio-economic characteristics were respondents age, education,
family, occupation, income, type and size of family etc.
1. Age
Age is one of important variables in any social research which affects the attitude and
behavior of person at different stages of life. Age is defined as the total number of years
completed by the respondents since their birth to the time of interviews. Such as 18, 19
etc.
2. Education
According to Francis (1970), education is a consciously controlled process whereby
changes in behavior are produced and through the person within the group. Education is
considered one of the most important factors for variation in knowledge. Being an
educated person means you have access to optimal state of mind regardless of the
situation you are in. Education plays an influential role and is considered to be very
22

important sociological indicator in understanding and defining respondents behavior.

Mostly, various researches described and measured education under the categories of
illiterate, primary, middle, secondary, intermediate, graduation, and post graduation but
here in study respondents educational attainments were asked in completed years of
schooling question was asked What is your level of education (in complete years)? and
options were given:
1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 16+
It indicates that how many years cover respondents educational achievement.

3. Family structure
Family defined as a relatively permanent group of people related by ancestry, marriage,
or adoption, who live together, from an economic unit, and undertake of their young
(Robertson, 1987). It is one of the basic institutions of human society. The family
structure has important demographic, economic, and social consequences. According to
the structure there are three types of family.

Nuclear family
Nuclear family consists of a father, mother and their children. This kind of family is
common where families are relatively mobile, as in modern industrialized societies.

Joint family
In a joint family, parents and their childrens families often live under a single roof. This
type of family often includes multiple generations in a family.

Extended family

23

A family consisting of parents and children, along with grandparents, grandchildren,

aunts and uncles etc. A family group consisting of the biological or adoptive parents, their
children, grandparents, and other family members. Who live in close geographic
proximity rather than under the same roof. The extended family is the basic family group
in many societies.

Data analysis
The data was analyzed to draw the conclusions and suitable statistical techniques were
used. The researcher used the widely statistical package for the social science (SPSS).
The analysis data has been presented is tabular forms. For the analysis of the quantitative
data, computer was used which facilitate me more than any ways such as time saving,
reduction of large amount of data to the basic pattern etc.
Data analysis is the process of probing unrefined data with the objective of making key
points or drawing conclusions about the information. Data analysis focuses on
conclusion; it is the process to draw a conclusion based exclusively on what is already
known by the researcher.

Statistical techniques
The data was systematically tabulated and statistically analyzed to bring into equivalent
form. Different statistical tools and techniques were used for the analysis and
interpretation of results.

Percentage
For the attainment of frequency distribution of the personal traits of the respondent,
simple percentages were calculated.

24

The percentages were calculated by using following formula:

F
P=

_______________________ x 100

N
Where
P =Percentage
F = Frequency of class
N = Total number of frequencies

25

Chapter # 4
26

Data analysis and presentation

Data analysis and presentation

27

Table 4.1
Distribution of respondents by their gender, age and current status.
Gender
Sr. no
i
ii

Categories
Male
Female
Total

Age
Sr. no
i
ii
iii
iv

Categories
Less than 20
20-24
25-29
30 and above
Total
Current status
Sr. no
Categories
i
Students
ii
Employed
Total

Frequency
164
96
260

percentage
63.1
36.9
100

Frequency
30
159
44
27
260

percentage
11.5
61.2
16.9
10.4
100

Frequency
190
70
260

Percentage
73.1
26.9
100

Table no 4.1 includes three variable i.e. gender, age (in complete years) and current status
of the respondents.
Gender of the respondents is based on their biological differences. Male and female
respondents keep different positions that determine their roles in the society. It is an
important variable in order to know the involvement of certain gender in particular
activity. In this category male respondents were in majority having 63% of the total
sample. While 37% of the respondents were female.
Age of the respondents is one of the most important variables as it determines the age
group of the respondents which affects other aspects of the individuals life. Majority of
28

the respondents e.g. 61% were in the range of 20-24 years. Whereas 17% of the
respondents belonged to the age group of 25-29. A little more than 11% of the
respondents belonged to the age group of less than 20 years. Remaining 10% of the
respondents belonged to the age group of 30 and above.
This table includes another variable that defines the status of the respondents. This
category consisted of two options such as student and employed. In this category a little
more than 73% of the respondents were students and were dependent. Remaining 27% of
the respondents were employed and were independent to make expenses.

Table 4.2:

29

Frequency distribution of respondents by their city, type of family and marital

status.
City
Sr. no
i
ii

Categories
Islamabad
Rawalpindi
Total
Type of family
Sr. no
Categories
i
Nuclear family
ii
Extended family
iii
Joint family
Total
Marital status
Sr. no
Categories
i
Married
ii
Unmarried
Total

Frequency
142
118
260

percentage
54.6
45.4
100

Frequency
132
82
46
260

percentage
50.8
31.5
17.7
100

Frequency
42
218
260

Percentage
16.2
83.8
100

Table no 4.2 consists of three variables i.e. city, type of family and marital status of the
respondents.
Two cities were selected to be studied in the research including Islamabad and
Rawalpindi. Whereas a little more than 54% of the sample were taken from Islamabad
and the remaining 45% of the sample consists of the people (shisha smokers) from
Rawalpindi.
Type of the family was studied to know the family structure of the respondents.
Respondents who belonged to joint family represented the strong bond among the family
members. Respondents from the extended family also represented good relations among
the family members. Whereas nuclear family system represented less restricted structure
of the family. According to the research a little more than 50% of the respondents
30

belonged to nuclear family system. Other 50% of the sample consisted of extended and
joint family with 32% and 18% respectively.
A person's marital status indicates whether the person is married or not. Questions about
marital status appear on many polls and forms, including censuses and credit card
applications. Its an important element in research to know whether respondents have
those responsibilities that a married person would have. Marital status of the respondents
was studied; according to the table 16% of the respondents were married and 84% of the
respondents were unmarried.

Table 4.3

31

Distribution of respondents by their level of education, mothers and fathers level of

education.

Respondents Level of education

Sr. no
Categories
Frequency
i
Matric
5
ii
Intermediate
28
iii
Graduation
104
iv
Masters and above
123
Total
260
Respondents mothers level of education
Sr. no
Categories
Frequency
i
Primary
19
ii
Middle
10
iii
Matric
39
iv
Intermediate
43
v
Graduation
69
vi
Masters and above
80
Total
260
Respondents fathers level of education
Sr. no
Categories
Frequency
i
Matric
6
ii
Intermediate
21
iii
Graduation
59
iv
Masters and above
174
Total
260

Percentage
2
10.7
40
47.3
100
Percentage
7.3
3.8
15
16.5
26.5
30.7
100
Percentage
2.3
8.0
22.6
66.9
100

Table 4.3 consists of three variables i.e. respondents level of education, their mothers
level of education and their fathers level of education.
Respondents level of education was calculated in completed years which included matric
to masters and above. According to the table 47% of the sample had educational status up
to masters and above where as 40% of the respondents had educational level up to
graduation level. Remaining 13% of the sample consisted of respondents who had
32

educational level up to intermediate and matric level which included 11% and 2%
respectively.
This table also includes mothers level of education of the respondents. This table shows
that 31% of the respondents mothers had educational level up to masters and above
while 27% had educational level up to graduation level. Whereas 17% of the respondents
mothers had educational level up to intermediate. Remaining 26% of the sample had
educational level up to matric, middle and primary, having 15%, 4% and 17%
respectively.
This table also shows the fathers level of education of the respondents. In this table 67%
of the fathers had educational level up to masters and above while 27% of the fathers
completed their education up to graduation level. Remaining 10% of the sample indicates
that the fathers of respondents had educational level up to intermediate and matric level,
having 8% and 2% respectively.

Table 4.4

33

Distribution of respondents by their rank among their sisters and brother, family
members of the respondents who smoke shisha along with their relation and ages.

Rank of respondents among their brothers and sisters

Sr. no
Categories
Frequency
Percentage
i
Only child
25
9.6
ii
Eldest
70
26.9
iii
Middle
87
33.5
iv
Youngest
78
30.0
Total
260
100
Number of family members of respondents who smoke shisha
Sr. no
Categories
Frequency
Percentage
i
None
199
76.5
ii
One
61
23.5
Total
260
100
Relation of respondents with other shisha smokers in their family
Sr. no
Categories
Frequency
Percentage
i
None
199
76.5
ii
Brother
33
12.7
iii
Sister
11
4.2
iv
Uncle
4
1.5
v
Wife
4
1.5
vi
Cousin
9
3.5
Total
260
100
Age of the family members of respondents who smoke shisha
Sr. no
Categories
Frequency
Percentage
i
16-25
29
47.5
ii
26-35
27
44.2
iii
36-45
3
4.9
iv
46-55
2
3.2
Total
61
100
Table no 4.4 includes four variables i.e. rank of the respondents among their brothers and
sisters, number of family member of respondents who smoke shisha along with their age
and relation with the shisha smokers.
34

This table indicates the rank of the respondents which included only child, eldest, middle
and youngest. According to the table the highest percentage such as 34% of the
respondents had middle rank among there brothers and sisters where as 30% of the
respondents were youngest in rank while 27% of the respondents were eldest and 10% of
the sample were the only child of the family.
This table also indicates the number of family members of the shisha smokers who smoke
shisha. According to the research 77% of the respondents were the only shisha smoker of
the family and no other member had any interest in shisha smoking. Remaining 23% of
the respondents had one family member who smokes shisha other than them.
This table also includes the relation of those family members of the respondents who
smoke shisha. According to the results 13% of the respondents answered that their
brothers smoke shisha while a little more than 4% of the respondents said that their
sisters were also addicted to the shisha. Remaining 6% of the respondents answered
cousin, wife, and uncle as the family members who smoke shisha, having 4%, 1% and
1% respectively.
The final part of the table indicates the frequency of the age group of the family members
of the respondents who smoke shisha. According to the table a little more than 47% of the
family members belonged to the age group of 16-25 years. Whereas 44% of the family
members of the respondents belonged to the age group of 26-35 years. Remaining 8% of
the family members belonged to the age group of 36-45 and 46-55 with 5% and 3% of
the total of sample respectively.
Table 4.5
Distribution of respondents by their mothers and fathers occupation.

35

Respondents mothers occupation

Sr. no
Categories
Frequency
i
Teacher
21
ii
Banker
14
iii
Office job
38
iv
Doctor
25
v
House wife
155
vi
Business
2
vii
Retired personnel 5
Total
260
Respondents fathers occupation
Sr. no
i
ii
iii
iv
v
vi
vii

Categories
Bureaucrat
Army officer
Engineer
Doctor
Retired personnel
Business man
Teacher
Total

Frequency
56
40
38
27
27
60
12
260

Percentage
8.1
5.4
14.6
9.6
59.6
.8
1.9
100
percentage
21.5
51.4
14.6
10.4
10.4
23.1
4.6
100

Table no 4.5 includes two variables i.e. mothers occupation and fathers occupation of
the respondents.
Occupation of the respondents mothers and fathers was studied to know the economic
background of the shisha smokers. Several occupations were included in the
questionnaire to get the appropriate answers from the respondents.
According to the results 59% of the mothers were house wives. A little more than 14% of
the mothers of respondents were engaged in office jobs. Whereas 9% of the mothers were
doctors and 8% of the mothers of respondents were teachers. While a little more than 5%
of the mothers of respondents were bankers. Almost 2% of the mothers were retired
personnel remaining 1% of the mothers were engaged in business.
36

This table also includes the fathers occupation of the respondents and the distribution of
the frequency regarding their occupation. The table indicates that 51% of the fathers were
army officers.23% of the fathers were businessmen. Whereas 22% of the fathers of the
respondents were bureaucrats. A little more than 14% of the fathers of respondents were
engineer. Results indicate that 10% of the fathers were doctors and the same percentage
i.e. 10% were retired personnel. Remaining 5% of the fathers were teachers.

Table 4.6
Respondents having shisha for the first time, their feelings and the relation with the
one who introduced shisha to them.
Shisha smoked for the first time
Sr. no
Categories
i
More than one year

Frequency
172

Percentage
66.2
37

ii
iii
iv
v

A year before
63
Less than one year
20
A few months before
2
A few weeks before
3
Total
260
Feelings when shisha was tried for the first time
Sr. no
Categories
Frequency
i
Felt bad
15
ii
Started to cough
52
iii
Irritated by smell
19
iv
Quiet unusual
34
v
Relaxed
100
vi
Mind blockage
24
vii
Normal
16
Total
260
Relation with those who introduced shisha
Sr. no
Categories
Frequency
i
Family
27
ii
Relatives
18
iii
Friends
145
iv
College/university fellows
27
v
Colleagues
3
vi
Own self
24
vii
Partner
16
Total
260

24.2
7.7
.8
1.2
100
Percentage
5.8
20.0
7.3
13.1
38.5
9.2
6.2
100
Percentage
10.4
6.9
55.8
10.4
1.2
9.2
6.2
100

Table no 4.6 includes three variables i.e. first time when the respondents tried shisha, how
they felt when they tried shisha for the first time and relation with the person who
introduced shisha to them.
This table indicates that 66% of the people tried shisha for the first time more than one
year ago while 24% tried shisha a year before. Whereas a little more than 7% of the
respondents tried shisha less than one year ago. Remaining 2% of the respondents tried
shisha a few months before and a few weeks before having the same percentage which is
1%.
38

This table also includes feelings of respondents when they tried shisha for the first time.
Table indicates that a little more than 38% of the people felt relaxed when they had shisha
for the first time. 20% of the respondents started to cough while 13% of the respondents
felt quiet unusual when they had shisha for the first time. This table indicated that 9% of
the respondents experienced mind blockage when they had shisha for the first time.
Whereas 7.3% of the respondents were irritated by the smell of shisha. Remaining 12%
of the sample felt normal and bad having 6% and a little more than 5% respectively.
This table also indicates the relation of the respondents with the people who introduced
shisha to them. According to the table a little more than 55% of the respondents answered
that their friends introduced shisha to them. Whereas family and college/university
fellows had the same frequency which is 10%. While 9% of the shisha smokers found it
by themselves. A little more than 6% of the respondents were introduced to shisha by
their relatives. Remaining 7% of the respondents were introduced shisha by their partners
and colleagues having 6% and 1% of the sample respectively.

Table 4.7
Distribution of respondents by their favorite flavor, influence and the cause of
attraction towards shisha.
Favorite flavor of shisha
Sr. no
Categories
i
Double apple
ii
Cola
iii
Vanilla
iv
Cherry
v
Double apple mint
vi
Blue mist

Frequency
56
21
25
27
69
62

Percentage
21.5
8.1
9.6
10.4
26.5
23.8
39

Total
260
Influence of shisha smoking
Sr. no
Categories
Frequency
i
Relaxation
31
ii
Break from hectic life
51
iii
Stress relief
34
iv
Friend to me
9
v
Fun and enjoyment
117
vi
A habit
18
Total
260
Most attractive thing about shisha smoking
Sr. no
Categories
Frequency
i
Flavored tobacco
50
ii
Smoke rings
84
iii
Sharing with friends
99
iv
Urge to smoke
27
Total
260

100
Percentage
11.9
19.6
13.1
3.5
45.0
6.9
100
Percentage
19.2
32.3
38.1
10.4
100

Table no 4.7 includes three variables i.e. favorite flavors of shisha, influence of shisha on
respondents and the most attractive thing about shisha.
This table indicates that 26% of the respondents liked double apple mint flavor of shisha.
23% of the respondents said that the blue mist is their favorite flavor of shisha. Whereas a
little more than 21% of the respondents liked double apple flavor of shisha. 10% of the
respondents chosen cherry as their favorite flavor of shisha. A little more than 9% of the
respondents liked vanilla flavor of shisha. Remaining 8% of the respondents liked cola
flavor of shisha.
This table includes the influence of shisha smoking on the respondents. Results show that
45% of people answered fun and enjoyment. A little more than 19% of people answered
shisha as break from hectic life while 13% of the respondents found shisha as relief from
stress. 12% of the people found shisha relaxing whereas 7% of the people answered
40

shisha smoking as their habit. Remaining 3% of the respondents answered shisha as a

friend to them.
This table consists of the thing that attracts the shisha smokers towards shisha. It
indicates that 38% of the respondents liked to share shisha with their friends. 32% of the
respondents were attracted towards shisha because of smoke rings while 19% of the
respondents had attraction towards shisha because of flavored tobacco. Remaining 10%
of the respondents had urge to smoke that attracted them towards shisha smoking.

Table 4.8
Distribution of respondents by the time they smoke shisha in a week and the time
spend in shisha bar
Times shisha smoked in a week
Sr. no
Categories
i
1-2
ii
3-4
iii
5-6
iv
7-8
v
More than 8
Total
Time spend at shisha bar
Sr. no
Categories
i
15-30 minutes

Frequency
92
78
49
18
23
260

Percentage
35.4
30.0
18.8
6.9
8.8
100

Frequency
26

Percentage
10.0
41

ii
iii
iv

30-60 minutes
1-2 hours
Longer than 2 hours
Total

94
101
39
260

36.2
38.8
15.0
100

Table no 4.8 includes two variables i.e. how many times respondents smoke shisha in a
week and time they spend at shisha bar.
This table indicates that 35% of the people smoked shisha for 1-2 times in a week. 30%
of the respondents smoked shisha for 3-4 times in a week while 18% of the respondents
smoked shisha for 5-6 times in a week. 9% of the shisha smokers smoked shisha for more
than 8 times in a week. Remaining 7% of the respondents smoked shisha for 7-8 times in
a week.
This table includes the time that shisha smokers spend at shisha bar. Results indicate that
39% of the respondents were used to spend 1-2 hours in the shisha bar where as 36% of
the respondents were used to spend 30-60 minutes at shisha bar. 15% of the respondents
were used to spend longer than 2 hours at shisha bar. Remaining 10% of the respondents
were used to spend 15-30 minutes at shisha bar.
Table 4.9
Preference given to accompany while visiting shisha bar and the payment of shisha
at shisha bar
Preferred to accompany while visiting shisha bar
Sr. no
Categories
Frequency
i
Family
19
ii
Relatives
12
iii
Friends
114
iv
University/college
40
friends
v
Street fellows
19

Percentage
7.3
4.6
43.8
15.4
7.3
42

vi
vii

Alone
Partner
Total
Payment of shisha at shisha bar
Sr. no
Categories
i
Family
ii
Relatives
iii
Friends
iv
Own self
v
Partner
vi
Share the amount
Total

8
48
260

3.1
18.5
100

Frequency
15
5
75
115
17
33
260

Percentage
5.8
1.9
28.8
44.2
6.5
12.7
100

Table no 4.9 consists of two variables i.e. preference given to the people to accompany
while visiting shisha bar and payment of shisha at shisha bar.
This table indicates that 44% of the respondents preferred to accompany by their friends
while visiting shisha bar. While 19% of the respondents preferred to their partners to
accompany them at shisha bar. Family and street fellows had the same frequency which is
7%. While a little more than 4% of the respondents preferred their relatives to accompany
them while visiting shisha bar. Remaining 3% of the respondents preferred to visit shisha
bar alone.
This table includes frequency distribution of the people who normally pay for shisha at
shisha bar. It indicates that 44% of the respondents were used to pay for shisha on their
own. 29% of the respondents answered that their friends used to pay for shisha normally
while 13% of the respondents said that they were used to share the amount. A little more
than 5% of the respondents said that their family was used to pay for shisha normally. A
little more than 6% of the respondents answered that their partners were used to pay for

43

their shisha at shisha bar remaining 2% of the respondents answered that their relatives
were used to pay for shisha for them.

Table 4.10
Distribution of respondents by the types, distance and the most likable thing about
shisha bar.
Type of shisha bar preferred
Sr. no
categories
Frequency
i
With a lot of girls/boys
48
ii
With a lot of crowd
90
iii
Only for girls/boys
26
iv
Few people
96
Total
260
Distance of shisha bar prefer to visit
Sr. no
Categories
Frequency
i
At a long distance
20

Percentage
18.5
34.6
10.0
36.9
100
Percentage
7.7
44

ii
iii
iv

At a short distance
53
Closest one
43
Depends on mood
144
Total
260
Likable thing about shisha smoking at shisha bar
Sr. no
Categories
Frequency
i
New friends
38
ii
Romance
44
iii
Shisha smoking only
54
iv
Loud music
50
v
Escape from worries
74
Total
260

20.4
16.5
55.4
100
Percentage
14.6
16.9
20.8
19.2
28.5
100

Table no 4.10 includes three variables such as types of shisha bar, how distant shisha bar
respondents prefer to visit and respondents like the most about shisha smoking at shisha
bar.
This table indicates that 36% of the respondents preferred to go to shisha bar with the few
people. Whereas 35% of the respondents liked to visit shisha bar with a lot of crowd. A
little more than 18% preferred to visit bar with a lot of girls/boys. Remaining 10% of the
respondents liked to visit shisha bar which is only for girls/boys.
The second variable of the table discuss about the distant shisha bar preferred by the
shisha smokers. Results show that 55% of the respondents preferred to visit shisha bar
depending their mood. Whereas 20% of the respondents liked to visit shisha bar at a short
distance while a little more than 16% of the respondents preferred to visit the closest
shisha bar. 8% of the respondents preferred shisha bar at a long distance.
This table shows what respondents like the most about shisha smoking at the shisha bar.
It indicates that a little more than 28% of the respondents answered for escape from
worries. 21% of the respondents went shisha bar only for shisha smoking. 19% of the

45

respondents liked loud music at shisha bar. A little more than 16% of respondents liked
romance at shisha bar while remaining 15% of the respondents liked to make new friends
while smoking shisha at shisha bar.

Table 4.11
Distribution of respondents by those who prepare shisha and the times they have
tried to prepare shisha.
Knowledge about preparing shisha
Sr. no
categories
Frequency
i
Yes
181
ii
No
79
Total
260
Tried to prepare shisha
Sr. no
categories
Frequency
i
No
79
ii
Many times
137
iii
A few times
36
iv
Never
8

Percentage
69.6
30.4
100
Percentage
30.4
52.7
13.8
3.1
46

Total

260

100

Table no 4.11 includes two variables i.e. shisha smokers know how to prepare shisha and
shisha smokers ever try to prepare shisha.
Shisha has become really popular among youngsters. People learn how to prepare it so
that they can enjoy shisha whenever and wherever they want to. This table also indicates
that 70% of the respondents knew how to prepare shisha. Whereas 30% of the
respondents didnt know how to prepare shisha.
This table also indicates that 53% of the respondents tried to make shisha for many times.
A little more than 13% of the respondents tried to prepare shisha for a few times.
Remaining 3% of the shisha smokers never tried to prepare shisha

Table 4.12
Distribution of respondents by smoking shisha at home, their parents know and
their reaction
Shisha smoking at home
Sr. no
categories
Frequency
i
Frequently
72
ii
Sometimes
83
iii
Not at all
105
Total
260
Parents knowledge about the habit of shisha smoking
Sr. no
categories
Frequency
i
Yes
141
ii
Maybe
49
iii
No
70
Total
260

Percentage
27.7
31.9
40.4
100
Percentage
54.2
18.8
26.9
100
47

Reaction when parents show anger on habit of shisha smoking

Sr. no
categories
Frequency
Percentage
i
Anger
32
12.3
ii
Annoying
42
16.2
iii
Normal
104
40.0
iv
Irritation
15
5.8
v
Fear
45
17.3
vi
Arguing
22
8.5
Total
260
100
Table no 4.12 includes three variables i.e. shisha smoking at home, parents of respondents
know about their habit of shisha smoking and reaction of respondents when parents show
anger on their habit of shisha smoking.
This table indicates that 28% of the respondents frequently smoked shisha at their home.
Whereas 32% of the respondents sometimes smoked shisha at home. Remaining 40% of
the respondents never smoked shisha at home.
This table also includes the variable which shows that the parents know about their
childrens habit of shisha smoking. Result indicates that 54% of the respondents parents
knew that their children smoke shisha. While 27% of the respondents answered that their
parents didnt know about their habit of shisha smoking while 19% of the respondents
answered may be.
This table also includes the reaction of respondents when parents show anger on their
habit of shisha smoking. According to the results 40% of the respondents answered that
they stayed normal on their parents anger. While 17% of the respondents answered fear,
16% of the respondents answered that they were used to get annoyed when their parents
showed anger on their habit of shisha smoking. Whereas 12% of the respondents
answered anger, a little more than 8% of the respondents said that they used to start

48

arguing with their parents when they showed anger on them. Remaining 6% of the
respondents were used to get irritated when their parents showed anger on them.

Table 4.13
Anybody ever stopped the respondents from shisha smoking.
Anybody ever stopped respondents from shisha smoking
Sr. no
Categories
Frequency
Percentage
i
Mother
65
25.0
ii
Father
43
16.5
iii
Grand parents
19
7.3
iv
Sisters
11
4.2
v
Brothers
13
5.0
vi
Friends
49
18.8
vii
Teachers
9
3.5
viii
Partner
50
19.2
ix
None
1
.4
Total
260
100

49

Table no 4.13 includes a variable i.e. anybody ever stopped respondents from shisha
smoking.
This table shows that 25% of the respondents answered that their mothers stopped them
form shisha smoking. While 19% of the respondents answered partners whereas 19% of
the respondents answered that their friends stopped them from shisha smoking. While
16% of the respondents answered that their fathers stopped them from shisha smoking.
7% of the respondents answered grandparents. 5% of the respondents answered brothers
while 4% of the respondents said that their sisters stopped them from smoking. A little
more than 3% of the respondents said that their teachers stopped them from shisha
smoking only 0.4% of the respondents answered that nobody stopped them.

Table no 4.14
Extent to which respondents believe that shisha smoking cause various harms to
them.
shisha smoking cause addiction
Sr. no
Categories
Frequency
i
Strongly agreed
100
ii
Agreed
104
iii
Disagreed
40
iv
Strongly disagreed
16
Total
260
shisha smoking cause chronic diseases
Sr. no
Categories
Frequency
i
Strongly agreed
43
ii
Agreed
139

Percentage
38.5
40.0
15.4
6.2
100
Percentage
16.5
53.5
50

iii
iv

Disagreed
Strongly disagreed
Total

65
13
260

25.0
5.0
100

Table no 4.14 includes two variables i.e. shisha smoking cause addiction and shisha
smoking cause chronic diseases.
This table includes the extent to which the respondents believe that shisha cause
addiction. 40% of the respondents agreed to that whereas a little more than 38% of the
respondents strongly agreed on this. 15% of the respondents disagreed to this statement
while only 6% strongly disagreed that shisha can cause addiction.
This table includes the extent to which respondents believe that shisha can cause chronic
diseases. 54% of the respondents agreed while 25% of the respondents disagreed that
shisha cause chronic diseases. 16% of the respondents strongly agreed with the statement
while only 5% of the respondents strongly disagreed that shisha cause chronic diseases.
Table 4.15
Extent to which respondents believe that shisha smoking cause various harms to
them.
Shisha smoking is totally wastage of money
Sr. no
Categories
Frequency
i
Strongly agreed
37
ii
Agreed
119
iii
Disagreed
86
iv
Strongly disagreed 18
Total
260
Shisha smoking is wastage of precious time
Sr. no
Categories
Frequency
i
Strongly agreed
26
ii
Agreed
99
iii
Disagreed
114

Percentage
14.2
45.8
33.1
6.9
100
Percentage
10.0
38.1
43.8
51

iv

Strongly disagreed
Total

21
260

8.1
100

Table no 4.15 includes two variables i.e. shisha smoking is totally wastage of money and
shisha smoking is wastage of precious time.
This table includes the extent to which respondents believe that shisha smoking is totally
wastage of money. 46% of the respondents agreed that this statement is true. 33% of the
respondents disagreed with this statement. While 14% of the respondents strongly agreed
that shisha smoking is totally wastage of money. Remaining 7% of the respondents
strongly disagreed.
This table includes the extent to which respondents believe that shisha smoking is
wastage of precious time. A little more than 43% of the respondents disagreed with the
statement where as 38% of the respondents agreed. 10% of the respondents strongly
agreed with the statement that shisha smoking is wastage of precious time while
remaining 8% of the respondents strongly disagreed with this.
Table 4.16
Extent to which respondents believe that shisha smoking cause various harms to
them.
Shisha smoking leads to immorality
Sr. no
Categories
Frequency
Percentage
i
Strongly agreed
29
11.2
ii
Agreed
99
38.1
iii
Disagreed
101
38.8
iv
Strongly disagreed
31
11.9
Total
260
100
Education is given less priority because of shisha smoking
Sr. no
Categories
Frequency
Percentage
52

i
ii
iii
iv

Strongly agreed
39
Agreed
120
Disagreed
76
Strongly disagreed
25
Total
260
Shisha smoking disturbs other activities of daily life
Sr. no
Categories
Frequency
i
Strongly agreed
36
ii
Agreed
105
iii
Disagreed
79
iv
Strongly disagreed
40
Total
260

15.0
46.2
29.2
9.6
100
Percentage
13.8
40.4
30.4
15.4
100

Table no 4.16 includes three variables i.e. shisha smoking leads to immorality, education
is given less priority because of shisha smoking and shisha smoking disturbs other
activities of daily life.
This table includes the extent to which respondents believe that shisha smoking leads to
immorality. 39% of the respondents disagreed with the statement whereas 38% of the
respondents strongly agreed with this. A little more than 11% of the respondents strongly
disagreed that shisha smoking leads to immorality while 11% of the respondents strongly
agreed with the statement that shisha smoking leads to immorality.
This table includes the extent to which respondents believe that shisha smoking gets
priority on education. 46% of the respondents agreed that education is given less priority
because of shisha smoking. 29% of the respondents disagreed with the statement whereas
15% of the respondents strongly agreed that education is given less priority as compare to
shisha. Remaining 9% of the respondents strongly disagreed with this statement.
This table also includes the extent to which respondents believe that shisha smoking
disturbs other activities of daily life. 40% of the respondents agreed with the statement

53

whereas 30% of the respondents disagreed with the statement that shisha smoking
disturbs other activities of life. 15% of the respondents strongly disagreed while 14% of
the respondents strongly agreed that shisha smoking disturbs other activities of life.

Table 4.17
Respondents ever told or found addicted to other drugs previously and names of
those drugs.

Addiction to other drugs previously

Sr. no
Categories
Frequency
i
Quiet frequently
17
Ii
Some times
51
Iii
Very few times
35
Iv
Never
157
Total
260
Names of the drugs
Sr. no
Categories
Frequency
I
Cigarettes
60
ii
Cigar
16
Iii
Alcoholic drinks
21
Iv
Heroin
6

Percentage
6.5
19.6
13.5
60.4
100
Percentage
58.2
15.5
20.3
5.8
54

Total

103

100

Table no 4.17 includes two variables i.e. addiction to other drugs and names of those
drugs.
This table includes respondents addiction to other drugs previously. This table shows that
60% of the respondents have never been addicted to other drugs previously. A little more
than 19% of the respondents have been addicted to drugs other than shisha for some
times. 13% of the respondents were addicted to other drugs very few times whereas 7%
of the respondents have been taking drugs quite frequently other than shisha.
This table includes names of those drugs respondents have addicted to previously other
than shisha. 58% of the respondents were addicted to cigarettes where as 20% of the
respondents have been taking alcoholic drinks. 16% of the respondents were addicted to
cigar where as 6% of the respondents were addicted to heroin other than shisha.

Table 4.18
Effects of shisha smoking on the people in surroundings and objections on shisha
smoking in public places.

Shisha smoking affects the people in the surroundings

Sr. no
Categories
Frequency
Percentage
i
Yes
65
25.0
ii
Not much
110
42.3
iii
Maybe
43
16.5
iv
No
42
16.2
Total
260
100
Respondents face any objection while smoking shisha in public
Sr. no
Categories
Frequency
Percentage
i
Often
36
13.8
55

ii
iii

Sometimes
Never
Total

112
112
260

43.1
43.1
100

Table no 4.18 includes two variables i.e. effects of shisha smoking on surroundings and
objections that are faced by shisha smokers while smoking shisha in public.
This table includes the extent to which shisha smoking affects people in the surrounding.
42% of the respondents were having the view that shisha smoking does not affect much
on the people in the surroundings whereas 25% of the respondents said yes. 16% of the
respondents answered maybe while the same percentage i.e. 16% of the respondents
said that shisha smoking does not affect the people in the surroundings.
This table includes the extent to which respondents face objection while smoking shisha
in public. 43% of the respondents said that sometimes they face objection while the same
number of respondents which is 43% answered that they never face any objection while
smoking shisha in public. 14% of the respondents often faced objection while smoking in
public.
Table 4.19
The extent to which respondents believe that toxins are produced when shisha is
heated up and the health hazards of shisha smoking.

Toxins produced when shisha is heated up

Sr. no
Categories
i
To great extent
ii
To some extent
iii
Very less
iv
Not at all
Total
Health hazards of shisha smoking

Frequency
21
131
50
58
260

Percentage
8.1
50.4
19.2
22.3
100

56

Sr. no
i
ii
iii
iv
v
vi

Categories
Lungs cancer
Heart disease
Tumors on lips and mouth
Periodontal(gum tissues) diseases
All above
None of them
Total

Frequency
46
49
23
15
85
42
260

Percentage
17.7
18.8
8.8
5.8
32.7
16.2
100

Table no 4.19 includes two variables i.e. toxins produced when shisha is heated up and
health hazards of shisha smoking.
This table includes the extent to which respondents believe that toxins are produced when
shisha is heated up. This table indicates that 50% of the respondents believed that toxins
are produced to some extent while 22% of the respondents believe that toxins are not
produced at all. 19% of the respondents believed that very less toxins are produced when
shisha is heated up. Whereas 8% of the respondents believe that toxins are produced to
the great extent when shisha is heated up.
This table includes health hazards of shisha smoking. According to the table 33% of the
respondents answered that shisha smoking causes health hazards which are lungs cancer,
heart diseases, tumors on lips and mouth, periodontal (gum tissues) diseases. While 19%
of the respondents believe that shisha smoking cause health diseases whereas 18% of the
respondents believe that shisha causes lungs cancer. 16% of the respondents believe that
shisha has no health hazards. 9% of the respondents believe that shisha can cause tumors
on lips and mouth while 5% of the respondents said that shisha causes periodontal (gum
tissues) diseases.

57

Table 4.20
Complainants of changing behavior of shisha smokers and respondents to go
without smoking shisha for the whole day.

complainant of changing behavior

Sr. no
Categories
Frequency
i
Mother
7
ii
Father
13
iii
Grand parents
11
iv
Sisters
11
v
Brothers
5
vi
Friends
29
vii
Teachers
13
viii
Partner
171
Total
260
To go without smoking shisha for the whole day
Sr. no
Categories
Frequency
i
Very easy
65
ii
Fairly easy
90
iii
Fairly difficult
68

Percentage
2.7
5.0
4.2
4.2
1.9
11.2
5.0
65.8
100
Percentage
25.0
34.6
26.2
58

iv

Very difficult
Total

37
260

14.2
100

Table no 4.20 includes two variables i.e. complainant of shisha smokers changing
behavior and the shisha smokers to go without smoking for the whole day.
This table includes the complainants of changing behavior of shisha smokers. This table
indicates that 66% of the respondents said that their partners complain about their
changing behavior whereas 11% of sample said that their friends complain about their
changing behavior. 5% of the respondents said that their teachers complain about their
behavior while 5% of the respondents said that their father complains. 4% of the
respondents said that their grandparents complains about their changing behavior whereas
the same percentage i.e. 4% of the respondents said that their sisters complaints about
their changing behavior. Remaining 5% of the respondents said that their mothers and
brothers complain about their changing behavior with them having 3% and 2% of the
sample respectively.
This table includes the way shisha smokers go without smoking for the whole day. This
table indicates that 35% of the respondents found it fairly easy. 26% of the respondents
found it fairly difficult to go without smoking for the whole day whereas 25% of the
respondents found it very easy. Remaining 14% of the respondents found it very difficult
to go without smoking shisha for the whole day.

59

Table 4.21
Fears of respondents regarding their efforts to quit shisha smoking.

Fear of failure
Sr. no
Categories
i
None
ii
Some
iii
A lot
Total
Fear of being bad tempered
Sr. no
Categories
i
None
ii
Some
iii
A lot
Total
Fear of being nervous
Sr. no
Categories
i
None
ii
Some
iii
A lot
Total

Frequency
162
92
6
260

Percentage
62.3
35.4
2.3
100

Frequency
145
108
7
260

Percentage
55.8
41.5
2.7
100

Frequency
170
85
5
260

Percentage
65.4
32.7
1.9
100
60

Table no 4.21 includes three variables i.e. fear of failure, fear of being bad tempered, fear
of being nervous regarding their efforts to quit shisha smoking.
This table includes respondents fear of failure regarding their efforts to quit shisha
smoking. 62% of respondents had no fear whereas 35% of the respondents had some fear
of failure while only 2% of the respondents had a lot of fear of failure regarding their
efforts to quit shisha smoking.
This table includes respondents fear of being bad tempered regarding their efforts to quit
shisha smoking. 56% of the respondents said none whereas a little more than 41% of the
respondents had some fear of being bad tempered whereas 3% of the respondents had a
lot of fear of being bad tempered regarding their efforts of quitting shisha smoking.
This table includes respondents fear of being nervous regarding their efforts to quit
shisha smoking. According to the table 65% of the respondents had no fear whereas 33%
of the respondents had some fear and 2% of the respondents had a lot of fear of being
nervous regarding their efforts to quit shisha smoking.

61

Table 4.22
Fears of respondents regarding their efforts to quit shisha smoking.
Fear to be tensed
Sr. no
Categories
Frequency
Percentage
i
None
167
64.2
ii
Some
87
33.5
iii
A lot
6
2.3
Total
260
100
Fear of having difficulty in concentrating on other activities
Sr. no
Categories
Frequency
Percentage
i
None
163
62.7
ii
Some
89
34.2
iii
A lot
8
3.1
Total
260
100
Fear of missing or desiring shisha
Sr. no
Categories
Frequency
Percentage
i
None
56
21.5
ii
Some
128
49.2
iii
A lot
76
29.2
Total
260
100

62

Table no 4.22 includes three variables i.e. fear to be tensed, fear of having difficulty in
concentrating on other activities and fear of missing or desiring shisha regarding their
efforts to quit shisha smoking.
This table includes respondents fear of being tensed regarding their efforts to quit shisha
smoking. Results indicate that 64% of the respondents had no fear. 34% of the
respondents had some fear whereas 2% of the respondents had a lot of fear to be tensed
regarding their efforts to quit shisha smoking.
This table includes respondents fear of having difficulty in concentrating on other
activities as a result of their efforts to quit shisha smoking. Table indicates that 63% of
the respondents had no fear. 34% of the respondents had some fear whereas 3% of the
respondents had a lot of fear of having difficulty in concentrating on other activities
regarding their efforts to quit shisha smoking.
This table includes respondents fear of missing or desiring shisha regarding their efforts
to quit shisha smoking. Table indicates that 49% of the respondents had some fear. 29%
of the respondents had a lot of fear whereas 21% of the respondents had no fear of
desiring or missing shisha regarding their efforts to quit shisha smoking.

63

Table 4.23
Fears of respondents regarding their efforts to quit shisha smoking.
Fear of losing a pleasure
Sr. no
Categories
Frequency
i
None
76
ii
Some
111
iii
A lot
73
Total
260
Fear of gaining weight
Sr. no
Categories
Frequency
i
None
146
ii
Some
92
iii
A lot
22
Total
260
Fear to be not around other smokers
Sr. no
Categories
Frequency
i
None
116
ii
Some
124
iii
A lot
20
Total
260

Percentage
29.2
42.7
28.1
100
Percentage
56.2
35.4
8.5
100
Percentage
44.6
47.7
7.7
100

64

This table includes three variables i.e. fear of losing a pleasure, fear of gaining weight
and fear to be not around other smokers regarding their efforts to quit shisha smoking.
This table includes respondents fear of losing the pleasure regarding their effort to quit
shisha smoking. This table shows that 43% of the respondents had some fear. 29% of the
respondents had no fear whereas 28% of the respondents had a lot of fear of losing the
pleasure regarding their effort to quit shisha smoking.
This table includes respondents fear of gaining weight regarding their efforts to quit
shisha smoking. According to the table 56% of the respondents had no fear. 35% of the
respondents had some fear while 9% of the respondents had a lot of fear of gaining
weight regarding their efforts to quit shisha smoking.
This table includes respondents fear of not to be around other smokers regarding their
efforts to quit shisha smoking. 48% of the respondents had some fear. 45% of the
respondents had no fear whereas 8% of the respondents had a lot of fear not to be around
other smokers regarding their efforts to quit shisha smoking.
Table 4.24
Quitting shisha smoking and respondents feeling of thinking themselves as a non
smoker.
Thought about quitting
Sr. no
Categories
i
Often
ii
Sometimes
iii
never
Total
Feeling as a non smoker
Sr. no
Categories
i
Comfortable

Frequency
44
140
76
260

Percentage
16.9
53.8
29.2
100

Frequency
66

Percentage
25.4
65

ii
iii
iv
v

Satisfied
Never thought
Dissatisfied
Uncomfortable
Total

110
62
12
10
260

42.3
23.8
4.6
3.8
100

Table no 4.24 consists of two variables i.e. quitting shisha smoking and feeling of
respondents of thinking themselves as non smokers.
This table includes thoughts of shisha smokers regarding quitting shisha. Results show
that 54% of the respondents have thought about quitting shisha some times. 29% of the
respondents never thought about quitting shisha whereas 17% of the respondents often
thought about quitting shisha.
This table includes feelings of respondents thinking themselves as non smokers. 42% of
the respondents feel comfortable. 25% of the respondents felt comfortable to think
themselves as non smokers. 24% of the respondents never thought about quitting whereas
5% of the respondents feel dissatisfied, remaining 4% of the respondents feel
uncomfortable to think themselves as a non smoker.
Table no 4.25
Respondents know about the governments act against shisha bar and extent to
which shisha smokers are in favor of those efforts.
Governments act against shisha bars
Sr. no Categories
Frequency
Percentage
i
Yes
143
55.0
ii
No
117
45.0
Total
260
100
In favor of Governments efforts against shisha bars
Sr. no Categories
Frequency
Percentage
i
To great extent
13
9.0
ii
To some extent
70
48.9
iii
Not much
37
25.8
iv
Not at all
23
16.0
66

Total

143

100

Table no 4.25 consists of 2 variables i.e. know about governments act against shisha bar
and the extent to which respondents are in favor of those efforts.
This table includes respondents know how about the governments act against shisha bar.
55% of the respondents had answered yes while 45% of the respondents said no.
This table includes the extent to which the respondents are in favor of those efforts of
government against shisha bar. According to the results 49% of the respondents were in
favor of those efforts to some extent. 26% of the respondents were not much in the favor
of those efforts while 16% of the respondents were not at all in favor of those efforts.
Remaining 9% of the respondents were in favor of governments efforts against shisha
bars to great extent.
Table no 4.26
Respondents regret being a shisha smoker and their motivation to quit shisha
smoking.
Shisha smokers regret being a shisha smoker
Sr. no
Categories
Frequency
Percentage
i
Yes
44
16.9
ii
Some how
143
55.0
iii
No
73
28.1
Total
260
100
Respondents rate of motivation to quit shisha smoking on a scale of 110
Sr. no
Categories
Frequency
Percentage
i
1
30
11.5
ii
2
19
7.3
iii
3
32
12.3
iv
4
26
10.0
v
5
33
12.7
vi
6
33
12.7
67

vii
viii
ix
x

7
8
9
10
Total

14
20
10
43
260

5.4
7.7
3.8
16.5
100

Table no 4.26 consists of two variables i.e. shisha smokers regret being a shisha smoker
and respondents rate of motivation to quit shisha smoking on a scale of 1-10.
The table includes the regret of respondents being a shisha smoker. Table indicates that
55% of the respondents somehow regret to be a shisha smoker. 28% of the respondents
had no regret to be a shisha smoker while 17% of the respondents regret to be a shisha
smoker.
This table includes motivation rate of respondents to quit shisha smoking on a scale of 110. This table shows that majority of the respondents i.e. 16% of the respondents rated
their motivation up to highest level of scale which is 10. Whereas 12% of the respondents
rated their motivation up to 6,5 and 3 having the same ratio of respondents for each level
of scale. A little more than 11% of the respondents rated 1. According to the results 7% of
the respondents rated their motivation up to 8 and 2 on the scale having the same ratio for
each level. Remaining 9% of the respondents rated their motivation up to 9 and 7 having
the ratio of 4% and 5% respectively.

68

69

Chapter # 5
SUMMARY, FINDINGS, CONCLUSIONS &
SUGGESTIONS

70

Summary
Shisha smoking has been a popular trend among the people of Middle East for centuries.
It was originated in turkey over 500 years ago. This culture is now very popular across
the world. People prefer shisha smoking to cigarettes and cigars because it smells good
and it has a soothing affect which is basically because of the flavors that are added to it. If
smoking cigarettes is harmful then hookah smoking is only worse. So those who are
thinking that they are safe with hookahs as opposed to cigarettes are only fooling them.
Shisha is quickly becoming very fashionable and popular amongst this new generation of
smokers.
It is especially sad to see this trend catching on fire in the Muslim world. In Pakistan it is
noticed how this has become the cool alternative thing to do. People in Pakistan
especially the youngsters are attracted towards shisha to great extent. It is needed to halt
this phenomenon, especially in preventing our youth from picking up this harmful habit.
Smoking shisha (Arabic water pipes, sometimes known as hookahs) brings the same risks
or even much severe than smoking cigarettes. It can lead to lungs cancer and many other
health problems. Shisha smoking can also affect your mental health, as it is linked with
anxiety and depression. Shisha smoking must be addressed in order to let the people
know about the dangers of it on their lives.

71

Major findings

Most of the respondents were male (63%) while female respondents were in less

percentage (37%).
Majority of the respondents (61%) belonged to the age group of 20-24 years.
While second highest percentage (17%) of respondents were falling in the age

group of 25-29 years.

More number of respondents (73%) were students where as employed were in less

proportion (27%).
Majority of the respondents (55%) were from Islamabad while a little less
percentage of respondents (45%) from Rawalpindi. Sample was selected from

some famous shisha bars from both of the cities.

Major proportion of the sample (50%) belonged to nuclear family system. The
data indicates that second major proportion of sample belonged to extended
family where as very less of the proportion (17%) belonged to joint family

system.
Majority of the respondents (84%) were unmarried where as less of the proportion

(16%) were married.

The data reveals that the major proportion (47%) of the respondents had
educational level up to masters and above. Whereas other major proportion (40%)

of the respondents were graduate.

Majority of the respondents mothers (31%) had educational level up to masters
and above. While other major proportion (27%) of the respondents mothers had

educational level up to graduation.

According to the research (67%) of the respondents fathers had educational
level up to masters and above. Whereas a little less of the percentage (23%) of the
respondents fathers were graduate.

72

Majority of the respondents (34%) of the respondents had middle rank among
their brothers and sisters. Whereas a little less proportion (30%) of the

respondents were youngest among their brothers and sisters.

Major proportion of the sample (77%) had no other shisha smoker at their home
whereas with a lot of different a very less proportion (23%) had one shisha

smoker at home, other than them.

Among shisha smokers in respondents family, major proportion (13%) of the
respondents brothers were shisha smokers. Majority of the proportion (47%) of

those family members of respondents were falling in the age group of 16-25.
Majority (60%) of the respondents mothers were house wives where as very less

proportion (15%) of the respondents mothers were engaged in office job.

Majority (51%) of the respondents fathers were army officer whereas other

(23%) of the respondents fathers were business man.

Majority of the respondents (66%) had tried shisha more than one year ago for the
first time. While other (24%) of the respondents tried shisha for the first time a

year before.
Major proportion (39%) of the respondents felt relaxed when they had shisha for
the first time. With less proportion (20%) of the respondents started to cough

when they had shisha for first time.

Majority (56%) of respondents friends introduced shisha to them. Whereas other

(10%) respondents were introduced to shisha by their college/university fellows.

Majority (27%) of the respondents liked double apple mint flavor of shisha while
a little less proportion (23%) of the respondents liked blue mist flavor of shisha

the most.
Majority (45%) of the respondents had fun and enjoyment when they had shisha
while other major proportion (20%) of the respondents found shisha as a break
from hectic life.

73

Majority (38%) of the respondents were attracted towards shisha because they
share it with their friends. Other major proportion (32%) of the respondents found

smoke rings as the reason of their attraction towards shisha smoking.

Majority of the respondents (35%) were used to smoke 1-2 times in a week. A
little less of the sample (30%) of the respondents smoke shisha 3-4 times in a

week.
Data displays that majority (39%) of the respondents used to spend 1-2 hours in
the shisha bar. A little less proportion (36%) of the respondents used to spend 30-

60 minutes in shisha bar.

Majority (44%) of the respondents preferred to accompany their friends while
visiting shisha bar. Other (18%) of the respondents preferred to accompany their

partners while visiting shisha bar.

Major proportions (44%) of the respondents were used to pay for shisha on their
own. Whereas other (28%) of the respondents friends were used to pay for shisha

at shisha bar.
Majority of the respondents (37%) preferred to visit shisha bar with few people
while a little less (34%) of the respondents preferred to visit shisha bar with a lot

of crowd.
Major proportion (55%) of the respondents preferred to visit shisha bar depending
on their mood. Other major proportion (20%) of the respondents preferred to visit

shisha bar at a short distance.

Majority of the respondents (28%) said that shisha smoking at shisha bar helped
them in escaping from worries and that is what they liked the most about shisha
smoking. Other (19%) of the respondents answered that they liked loud music at

shisha bar.
Majority of the respondents (70%) knew how to prepare shisha while remaining
(30%) of the respondents didnt know how to prepare shisha.
74

Major proportion (52%) of the respondents had tried to prepare shisha for many

times.
The data indicates that majority (40%) of the respondents never smoked shisha at
home. Other major proportion (32%) of the respondents smoked shisha at home

for some times.

Majority of the respondents (54%) said that their parents knew about their habit of
shisha smoking. While (26%) of the respondents said that their parents didnt

know about their habit of shisha smoking.

Majority of the respondents (40%) reacted normal on their parents anger on

their habit of shisha smoking.

Majority (25%) of the respondents mothers stopped them from shisha smoking
where as other (19%) of the respondents answered that their partners stopped

them from shisha smoking.

Majority (40%) of the respondents agreed with the statement that shisha causes
addiction. Other major proportion (38%) of the respondents strongly agreed with

the statement.
Major proportion (53%) of the sample agreed that shisha causes chronic diseases.
Other major (25%) of the proportion disagreed with the statement that shisha

smoking causes chronic diseases.

Major proportion (46%) agreed that shisha smoking is totally wastage of money.

Other major proportion (33%) of the respondents disagreed with the statement.
Majority (44%) of the respondents disagreed that shisha smoking is wastage of

precious time. Other major proportion (38%) agreed with the statement.
Majority (39%) of the respondents disagreed that shisha smoking leads to
immorality. While with a little difference (38%) of the respondents agreed that

shisha smoking leads to immorality.

Major proportion (46%) of the respondents agreed that education is given less
priority because of shisha smoking.
75

Majority (40%) of the respondents agreed that shisha smoking disturbs other
activities of life. Other (30%) of the respondents disagreed that shisha smoking

disturbs other activities of life.

Majority (60%) of the respondents never had been addicted to other drugs

previously.
Major proportion (58%) of the sample was addicted to cigarettes among those

who had been addicted to other drugs previously.

Majority (42%) of the respondents answered that shisha didnt affect much on the

people in their surroundings.

Data show that same percentage (43%) of the respondents faced objection

sometimes and never while smoking shisha at public places.

Majority (50%) of the respondents believed that toxins are produced to some

extent when shisha is heated up.

Majority (33%) of the respondents believed that shisha smoking can cause all of
the health hazards which were listed such as lungs cancer, heart diseases, tumors

on lips and mouth, periodontal (gum tissues) diseases.

Majority (66%) of the respondents answered that their partners complained about

their changing behavior.

Majority (35%) of the respondents found it fairly easy to go without shisha

smoking for the whole day.

Majority (62%) of the sample had no fear of failure regarding their efforts to quit

shisha smoking.
Majority (56%) of the respondents had no fear of being bad-tempered regarding

their efforts to quit shisha smoking.

Majority of the respondents (65%) had no fear of being nervous regarding their

efforts to quit shisha smoking.

Majority (64%) of the respondents had no fear to be tensed regarding their efforts
to quit shisha smoking.

76

Majority (63%) of the respondents had no fear of having difficulty in

concentrating on other activities regarding their efforts to quit shisha smoking.

Majority (49%) of the respondents had some fear of missing or desiring shisha

their efforts to quit shisha smoking.

Majority (43%) of the respondents had some fear of losing a pleasure regarding

their efforts to quit shisha smoking.

Majority (56%) of the respondents had no fear of gaining weight regarding their

efforts to quit shisha smoking.

Majority (48%) of the respondents had some fear not t be around other smokers

regarding their efforts to quit shisha smoking.

Majority (54%) of the respondents sometimes thought about quitting shisha.
Major proportion (42%) of the respondents felt satisfied to think themselves as

non smokers.
Majority (55%) of the respondents knew about the governments act against

shisha bar.
Majority (49%) of the respondents were in favor of governments efforts against

shisha bar.
Majority (55%) of the respondents somehow regretted to be a shisha smoker.
Major proportion (17%) of the respondents rated their motivation as 10 on the
scale of 1-10 to quit shisha smoking.

Conclusion
During the research which was conducted in twin cities (Islamabad and Rawalpindi) it
was noticed that a large number of respondents were students and they had very strong
affiliation with shisha. It was revealed that shisha smokers had good relations with their
77

friends as compare to their family. There were a large number of people who were
introduced to shisha by their friends; they spend a lot of time at shisha bars while they
prefer to accompany their friends. Respondents preferred to go to shisha bars depending
on their mood. Respondents had doubts about the other shisha smokers of their family.
They were not aware about the activities and practices of other members of their family.
It shows that they had less interaction with other family members.
Education was given less importance than shisha smoking. Students of colleges and
universities were found at shisha bars during the day time which shows that they didnt
attend their classes. Instead of getting education students are more involved in other
activities. With shisha smoking respondents get lot more chances to have other drugs too.
Not only other drugs but many more activities which are not socially appreciated are
adopted. Shisha smoking is the starting with goes with a lot more bad habits that ruins the
educational experience of the respondents.
Most of the respondents were unaware about the harms of shisha and never wanted to
quit that. This new trend has got a lot of attraction in it because of the smoke rings and
the way friends sit together and share it with one another. People like to share the mouth
piece with one another which causes several diseases. Respondents had fear of losing a
pleasure and missing shisha regarding their efforts to quit shisha smoking. It shows that
shisha smokers had pleasure while smoking shisha and they missed/desired shisha.
Research shows that favorite flavors of shisha were double apple mint and blue mist.
These flavors of shisha are very famous among youngsters and they preferred these
flavors over other flavors.

78

Shisha smokers faced very less objection while having shisha in public places which
shows that this trend is getting acceptance in society. People had fewer obstacles in
smoking shisha at home or telling it to their parents. A large number of the respondents
knew how to prepare shisha and it was available to them at their homes. They had fewer
objections on shisha smoking from their family where as majority mothers of the
respondents stopped them from shisha smoking. Major proportion of the sample had
complaints about their changing behavior made by their partner and mothers, most
prominently.

Suggestions

79

Considering the results of the research some of the suggestions are made. These
suggestions are as follows.

It is suggested to make people more aware about the dangers of shisha smoking.
People should be aware of the health hazards related to shisha smoking. Different
researches proved that shisha can cause lungs cancer, heart diseases, periodontal

(gum tissues) diseases and tumors on lips, mouth and other parts of the body.
It is revealed through the research that family involvement in the shisha smoking
is seen quite prominently where brothers, sisters, cousins, uncles and wives were
used to smoke shisha with the respondents. This issue must be addressed in such a
way that it must help the family to get rid of this addiction. Family should get

education about having an alternate activity in order to bring healthy living style.
Students must be given proper information about the dangerous nature of shisha
and the effects of shisha on their lives. Students mostly go to shisha bars during
the college/university timings which not only affect their routine but also cause
great loss in educational attainment. In order to save the future of Pakistan, it is

needed to save the young generation from such unhealthy activities.

Shisha smoking can be avoided by avoiding such gatherings where shisha
smoking is preferred. People must involve themselves in healthy activities.

References:

80

An Emerging Deadly Trend: Waterpipe Tobacco Use, American Lung

Association February 2007

Al-Saleh I, Coate L. (1993) Cadmium exposure in Saudi Arabia and its

relationship to smoking. Trace Elem Med; 10:129133.

American Lung Association, Tobacco Policy Trend Alert: 2000

Bergstrom J. 2005 Tobacco smoking and periodontal health in a Saudi Arabian

population.Periodontology;76 (11): 1919-1926(doi:10.1902/jop.2005.76.11.1919)

Doyle, L. (2008). Psychiatric Mental Health Nursing. Dekker. p. 289. ISBN 9780-7171-4459-4.

Eissenberg T and Shihadeh A. (2006) Waterpipe tobacco and cigarette smoking.

Direct comparison of toxicant exposure; 37(6): 518-523

Global Youth Tobacco Survey Collaborating Group. (2003) Research conducted

worldwide based on tobacco use: findings from the global youth tobacco survey. J
Sch Health; 73:207-15.

Joe, C, Kauai, KThe Marketing of Candy-Flavored Cigarettes May 2006.

Knishkowy, B and Amitai, Y. (2005 July) Water-Pipe (Narghile) Smoking: An

Emerging Health Risk Behavior, Pediatrics; 116(1): e113-119 Waterpipe
Tobacco Smoking: Health Effects, Research Needs and Recommended Actions by
Regulators WHO Study Group on Tobacco Product Regulation 2005

Mohamed, M (27th March 2007) Shisha 200 times worse than a cigarette, ASH
news release: Embargo: 00:01

81

Maziak, W,

Soweid, A, Eissenberg, T (2004) Tobacco smoking using a

waterpipe: a re-emerging strain in a global epidemic, Tobacco Control; 13:327333 doi:10.1136/tc.2004.008169.

Peter, H (14 Mar 10) Addiction expert warns over ignorance of shisha smoke
dangers 13:24 CET

Safdar, H (April 3rd, 2009). Shisha: A serious risk for health

Shihadeh, A. (2003) Investigation of mainstream smoke aerosol of the narghile

water pipe. Food Chem Toxicol, Jan; 41(1):143-52.

Taylor, C.Z. (March 2002). "Religious Addiction: Obsession with Spirituality".

Pastoral Psychology (Springer Netherlands) 50 (4): 291315

Wiley liss, Inc. (2000) Toxic and trace elements in tobacco and tobacco smoke

Questionnaire
Shisha smoking among youngsters in twin cities (Islamabad, Rawalpindi)
82

11. What is your rank among your brothers and sisters?

______________________
12. How many of your family members smoke shisha? (If none, go to Q.14)
i.

i) None
ii.

ii) 1

iii) 2

iv) 3

v) More than 3

13. What is your relation with them along with their ages?

________________________

________________________

________________________

________________________

________________________

________________________

iii.

14. When did you smoke shisha for the first time?

iv.

i) Been years

ii) Less than year

iii) Few months

iv) Few weeks

v)

First time
v.

15. How did you feel when you tried it for the first time?

i.

i) felt bad

ii) Started to cough

iii) Irritated by smell

ii.

v) Relaxed

vi) Mind blockage

vii) Any other ______________

iii.

16. Who introduced shisha to you?

i.

i) Family

ii) Relatives

iii) Friends

iv) Quiet unusual

iv) College/ University

fellows
ii.

v) Colleagues vi) Found it myself

vii) partner

iii.

17. What is your favorite flavor of shisha?

i.

i) Double Apple ii) Cola iii) Vanilla iv) Cherry v) Double Apple Mint

ii.

vi) Blue Mist

iii.

18. How does shisha influence you?

vii) Any other ______________

83

i.

i) Relaxation

ii) Break from hectic life

ii.

v) Fun and enjoyment

iii) Stress-relief

iv) Friend to me

vi) A habit

iii.
iv.

19. What attracts you towards shisha?

i.

i) Flavored tobacco

ii) Smoke rings

iii) Sharing with friends

iv) Urge to

smoke
ii.

v) Any other (mention) ____________________

iii.

20. How many times do you smoke in a week?

i)

12

iii)

56

ii)

3-4

iv)

78

v)

more than 8

i.

21. Whom do you prefer to accompany while visiting shisha bar?

i)

Family

v)

Street fellows

ii)

Relatives (cousins etc)

vi)

Partner

iii)

University/college friends

vii)

Any other ____________

iv)

Alone

viii)

22. Who normally pays for the shisha at shisha bar?

i)

Family

iv)

Own self

ii)

Relatives

v)

Partner

iii)

Friends

vi)

Any other_______

vii)

23. Which type of shisha bar do you prefer to go?

i)

With a lot of girls/boys

iii)

Only for girls/boys

ii)

With a lot of crowd (for both)

iv)

few people

v)

24. How distant shisha bar do you prefer to visit?

84

i)

At a long distance

iii)

Closest one

ii)

At a short drive

iv)

Depends on mood

v)

25. How much of the time do you spend at shisha bar?

i.

i) 15 30 minutes

ii) 30 60 minutes

iii) 1 2 hours

iv) Longer than 2

hours
ii.

26. What do you like the most about shisha smoking at shisha bar?

i)

i) New friends ii) Romance iii) Shisha smoking only

ii)

v) Escape from worries

iii)

27. Do you know how to prepare shisha? (If no, go to Q.29)

i)

vi) Any other ___________

Yes

iii)

iv) Loud music

ii)

No

i)

28. Did you ever try to prepare it?

iv)

Many times

ii)

A few times

iii)

never

i)

iii)

Not at all

iii)

No

29. Do you smoke shisha at your home?

iv)

Frequently

ii)

Sometimes

i)

30. Do your parents know that you smoke shisha?

v)

Yes

ii)

Maybe

31. What is your reaction when parents show anger when you smoke
shisha?
i)

i) Anger

ii) Annoying

iii) Normal

iv) Irritating

v) Fear

vi) Arguing
ii)
i.

32. Did anybody ever stop you from shisha smoking?

i) Mother

ii) Father

iii) Grandparents

Friends vii) Teachers viii) None

iv) Sisters

v) Brothers

vi)

ix) Any other _____________

85

ii.

33. Up to what extent do you know shisha is harmful?

iii.

viii.
xiii.
xviii.
xxiii.
xxviii.
xxxiii.
xxxviii.
xliii.

iv.

Stro
ngly
agre
ed

v.

ag
re
ed

vi.

disag
reed

vii.

Str
ong
ly
disa
gre
ed

Shisha causes
ix.
x.
xi.
xii.
addiction
It can cause
xiv.
xv.
xvi.
xvii.
chronic diseases
It is totally
xix.
xx.
xxi.
xxii.
wastage of
money
It is the wastage xxiv.
xxv.
xxvi.
xxvii.
of precious time
It may lead to
xxix.
xxx.
xxxi.
xxxii.
immorality
Education is
xxxiv.
xxxv.
xxxvi.
xxxvii.
given less
priority
It disturbs other xxxix.
xl.
xli.
xlii.
activities of
daily life
34. Do you think shisha smoking is harmful than cigarettes?

i.

i) To great extent

ii) To some extent

iii) Some how

iv) No

ii.

35. Have you ever been told or found yourself addicted to other drugs
previously? (If never then go to Q.37)

i.

i) Quiet frequently

ii) Sometimes

ii.

36. What are those drugs?

iii) A very few times

i.

i) Cigarettes

iv.

v) Chars

ii.

iv) Heroin

v.

iii) Alcoholic

iii.

ii) Cigar

vii.

37. Do you think shisha smoke affects the people in the surroundings?

i.

vi.

iv) Never

vi) Any other

_______

drinks

i) Yes
86

ii.

ii) Not

iii.

iii)

much
v.
i)

iv) No

Maybe

38. Do you face any objection while smoking it in public place?

Often

iv)

iv.

ii)

Sometimes

iii)

never

39. To what extent toxins are produced when shisha is heated up?

i.

i) To great extent

ii) Some extent

ii.

40. Do you think shisha smoking has any of the health hazards?

i.

i) Lungs cancer

ii.

iv) Periodontal (gum tissue) disease

iii.

41. Did any of the following complain about your changing behavior with

ii) Heart disease

iii) Very less

iv) Not at all

iii) Tumors on lips and mouth

v) All above vi) None of them

them?
iv.

i) Mother

ii) Father

iii) Grandparents

iv) Sisters

v) Brothers

vi)

Friends
v.

vii) Teachers viii) None ix) Any other ______________

vi.
vii.

42. How easy or difficult would you find it to go without smoking it for a
whole day?

i.

i) Very easy

ii) Fairly easy

iii) Fairly difficult

iv) Very

difficult
ii.

43. What fears do you have about your efforts to quit?

iii.

iv.

v.

vi.

87

e
Fear of failure

viii.

ix.

x.

xi.

Being bad-tempered

xii.

xiii.

xiv.

xv.

Fear of being nervous

xvi.

xvii.

xviii.

To be tensed
Difficult to concentrate on other

xx.

xxi.

xxii.

xxiv.

xxv.

xxvi.

activities

i.
ii.
i.

xxvii.

Missing or desiring shisha

xxviii.

xxix.

xxx.

xxxi.

Losing a pleasure

xxxii.

xxxiii.

xxxiv.

xxxv.

Gaining weight

xxxvi.

xxxvii.

xxxviii.

xxxix.
Being around other smokers
xl.
44. Have you ever thought about quitting?

xli.

xlii.

i) Often

ii) Sometimes

iii) Never

45. How do you feel thinking yourself being a non smoker?

i) Comfortable

ii.

vii.

xix.
xxiii.

xliii.

ii) Satisfaction

iii) Never thought

iv) Dissatisfaction

v) Uncomfortable

46. Do you know about governments act against shisha bar? (If No, go to Q.
48)

i)

Yes

ii)

No

iii.

47. To what extent are you in favor of those efforts?

iv.

i) To great extent

ii) To some extent

iii) Not much

iv) Not at all

88

v.

48. Do you regret being a shisha smoker?

vi.

i) Yes

ii) Somehow

iii) No

vii.

49. On a scale of 1-10, how would you rate your motivation today to quit shisha
smoking?

viii.

1 = very low motivation,

ix.

10 = very high

x.

1, 2, 3, 4, 5, 6, 7, 8, 9, 10

xi.
xii.

Thank you!!