Prevalence and factors associated with shisha smoking by youth In tertiary institutions, Kisumu county, Kenya

Abstract

The tobacco epidemic has a significant public health challenge worldwide, affecting approximately 1.1 billion smokers, with a particularly high prevalence in low- and middle- income countries, with over 7 million deaths annually; a figure projected to rise. shisha smoking has rapidly gained popularity among youth, often surpassing traditional cigarette use. This trend was attributed to social acceptance and the appealing flavours of shisha, despite the severe health risks associated with its use, which are frequently underestimated. In Kenya, 37% of university students in Nairobi County were engaging in shisha smoking, coupled with a widespread lack of awareness regarding its health implications. Despite the growing prevalence of shisha smoking among the youth, data specifically focusing on its use in Kenya remains limited. Consequently, this study aimed to assess the prevalence and factors influencing shisha smoking among youth in tertiary institutions in Kisumu County. The study set out to determine the prevalence of shisha use, to explore individual and environmental factors influencing its consumption among students in tertiary institutions. A cross-sectional study design with a sample of 398 students from a target population of 26,384 students aged 18 - 24 years reflecting a known prevalence of 37% was drawn from institutions: Maseno University, Uzima University College, Great Lakes University, Kenya Medical Training College-Kisumu, and the Kisumu National Polytechnic. Institutions were purposely sampled, and each sample was determined using population proportionate to size, stratified sampling was employed to obtain students across all academic years and simple random sampling was used to achieve the sample size. Reliability of the questionnaires was assessed using a Cronbach’s Alpha with a score of 0.718, and data collection was conducted by trained research assistants using pre-tested questionnaires. Data analysis was conducted using SPSS version 25. Frequencies and percentages were used to determine prevalence and reasons for shisha smoking. Cramer’s V and Chi-square p-value <0.05 were used to establish associations. Twenty-nine percent of students had smoked Shisha in the past one year, with current smokers at 32.3%. Curiosity (26.6%), pleasure-seeking (21.8%), the appeal of flavours (19.4%) and peer pressure influenced (33.9%) of the students to smoke shisha. There was no significant association between self-esteem and shisha smoking (p-value 0.407). In conclusion high prevalence of shisha smoking among tertiary students was significantly driven by social dynamics, peer pressure, and misconceptions about its safety compared to cigarettes. Psychological peer counsellors should educate the youth population on the health effects associated with shisha smoking.