title: Cross-sectional study identifying forms of tobacco used by Shisha smokers in Pakistan.
abstract: OBJECTIVE
  To estimate the frequency of different forms of tobacco intake such as smoker's tobacco, chewable tobacco and snuff tobacco among shisha smoker's and to study the patterns and predictors of shisha smoking affecting youth from different cities of Pakistan.
  
  
  METHODS
  A cross-sectional study was conducted including youth from four cities. Participants were asked to fill out a data collection tool at shisha cafes, shopping malls and restaurants. Data was analyzed using SPSSv.18.
  
  
  RESULTS
  A total of 406 participants, 296 (73%) males and 110 (27%) females were included in the study. There were 163 (40%) cigarette smokers; 65 (16%) chewed tobacco and 33 (8%) snuffed it. The median age at initiation of Shisha smoking was 20 years. 280 (69%) considered Shisha smoking to be less deleterious to health than cigarettes. Respiratory disease was the most commonly cited health effect reported. Most 248 (61%) of the participants were infrequent shisha smokers.
  
  
  CONCLUSIONS
  There is high frequency of tobacco usage in the form of cigarettes, chewable tobacco and snuff tobacco among shisha smokers of Pakistan. The highest frequency is for cigarette smoking. The rise in Shisha smoking as a trendy social habit appears to be occurring despite emerging scientific evidence of its potential health risks.
authors: Aga Khan University Medical College, Karachi, Pakistan.
authors: Sameer-ur-Rehman
authors: Mohammed Ali
authors: MA
authors: Sadiq
authors: Maria Adnan
authors: MA
authors: Parekh
authors: Ali Bin Sarwar
authors: AB
authors: Zubairi
authors: Philippe M
authors: PM
authors: Frossard
authors: Javaid Ahmed
authors: JA
authors: Khan
mesh_terms: D000328:Adult; D000367:Age Factors; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D010154:Pakistan; D012140:Respiratory Tract Diseases / Q000453:epidemiology; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology*; D014030:Tobacco, Smokeless; D055815:Young Adult