Knowledge, practices and beliefs of students regarding health effects of shisha use in Ouagadougou, Burkina Faso: A cross‑sectional study

BACKGROUND: The tobacco epidemic is one of the biggest public health threats the world has ever faced. Shisha use has recently been gaining increased popularity in many developed and developing countries. OBJECTIVES: To determine the prevalence of shisha use among students in Ouagadougou, Burkina Faso, and associated knowledge, smoking practices and beliefs about health effects. METHODS: A total of 443 students were selected for this cross-sectional study, using a stratified sampling method. Data on shisha use, knowledge about shisha, shisha smoking practices, and factors associated with use of shisha were collected via a questionnaire. The association between the independent variables and shisha use was assessed using a χ² test (p<0.05). Binary logistic regression analysis was used to determine variables that were independently associated with shisha smoking. RESULTS: Of the 421 respondents, 162 (38.5%) indicated that they had smoked shisha; 14.0% were regular smokers. We found that 183 students (43.5%) had poor knowledge about the health effects of shisha. The main reasons for shisha smoking were being in the company of friends who were users (57.4%), the pleasant flavour and fragrance of shisha (25.9%), and fashion (22.2%). Ninety-nine shisha smokers (61.1%) also consumed alcohol. Factors associated with shisha smoking included age <20 years (p<0.001), gender (p=0.034), and educational level of the respondent’s father (p=0.0001) and mother (p=0.0004). CONCLUSION: We found a relatively high prevalence of shisha smoking among the students, and that 43.5% of them had poor knowledge about its effects on health. Developing surveillance, intervention and regulatory/policy frameworks specific to shisha has become a public health priority. STUDY SYNOPSIS: What the study adds. The study provides additional data from resource-poor settings such as Burkia Faso, where there is an overall high prevalence of Sisha smoking, and also among students who are poorly informed about the health effects of smoking. Implications of the findings. The data informs advocacy and intervention strategies to combat smoking and decrease overall tobacco use in an African setting.