title: Knowledge, attitude and perception of water pipe smoking (Shisha) among adolescents aged 14-19 years.
abstract: OBJECTIVE
  To study the impact of educational intervention on knowledge, attitude and practices with regard to water pipe smoking among adolescents (14-19 years old) in Karachi.
  
  
  METHODS
  A cross-sectional survey of adolescents aged 14-19 years studying at different educational institutions of Karachi, Pakistan was conducted through multistage sampling on a pre-tested self-administered questionnaire. They were divided into high, middle and lower socioeconomic strata on the basis of monthly fee structure. The impact of health messages was assessed two months after education sessions through post-test of only high and middle socioeconomic strata.
  
  
  RESULTS
  A total of 646 students were surveyed for the pre test and 250 students for the post test. A significant association was found for water pipe smoking among the socioeconomic class (p < 0.001). Water pipe is more addictive as compared to cigarettes was marked by more students after the sessions (54% vs 68%; p < 0.001). A significant difference was seen for water pipe being more socially acceptable (58% vs 80%; p < 0.001), it is part of our cultural heritage (29% vs 58%; p < 0.001).
  
  
  CONCLUSIONS
  Shisha smoking was more prevalent among the high socio economic group, which might be because of the cost, accessibility and availability. The knowledge of the students regarding water pipe smoking improved after the health awareness sessions.
authors.affiliation: Department of Community Health Sciences, Ziauddin University, Karachi.
authors.forename: Qudsia
authors.initials: Q
authors.lastname: Anjum
authors.forename: Farah
authors.initials: F
authors.lastname: Ahmed
authors.forename: Tabinda
authors.initials: T
authors.lastname: Ashfaq
mesh_terms: D000293:Adolescent; D000367:Age Factors; D003430:Cross-Sectional Studies; D005260:Female; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D008297:Male; D010154:Pakistan / Q000453:epidemiology; D015995:Prevalence; D012309:Risk-Taking; D012907:Smoking / Q000453:epidemiology*; D012938:Social Perception; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult