title: Knowledge, attitudes and practice of university students regarding waterpipe smoking in Pakistan.
abstract: OBJECTIVE
  To study the awareness, perceptions and practice of university students in Karachi, Pakistan, with regard to shisha (waterpipe) smoking.
  
  
  METHODS
  Cross-sectional survey conducted among students at four different universities of Karachi, selected through random cluster sampling.
  
  
  RESULTS
  A total of 450 participants, 59.6% males (n=268) and 40.4% females (n=182), were included in the study. About half of the participants reported having ever smoked shisha (n=241, 53.6%). On examining factors associated with starting shisha smoking, curiosity was found to be the most common reason (n=148, 61.4%), followed by pleasure-seeking (n=113, 46.9%), peer pressure (n=55, 22.8%), boredom (n=43, 17.8%) and stress (n=26, 10.8%). Of 241 participants who had ever smoked waterpipes, the majority (n=149, 61.8%) were current smokers. A vast majority of participants (n=269, 60%) considered waterpipe smoking to be less unhealthy than cigarette smoking. Boredom in youth, use of waterpipe in leisure activities and peer pressure were identified as the most common reasons for the escalating popularity of waterpipe smoking in Pakistan.
  
  
  CONCLUSIONS
  Waterpipe smoking is very popular among Pakistani university students, and knowledge among university students about the dangers of waterpipe smoking is alarmingly low.
authors: Section of Pulmonary and Critical Care Medicine, Aga Khan University, Karachi, Pakistan. alijawaid84@gmail.com
authors: A
authors: A
authors: Jawaid
authors: A M
authors: AM
authors: Zafar
authors: T-U
authors: TU
authors: Rehman
authors: M R
authors: MR
authors: Nazir
authors: Z A
authors: ZA
authors: Ghafoor
authors: O
authors: O
authors: Afzal
authors: J A
authors: JA
authors: Khan
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008297:Male; D010154:Pakistan / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*; D013334:Students / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014495:Universities; D014867:Water
chemical_list: D014867:Water