Systematic review of interventions aimed at reducing hookah pipe use: Implications for practitioners and clinicians

Z Kader, N V Roman, R Crutzen


Background. Globally, tobacco ranks as one of the major risk factors for death, disease and disability. While strong measures have been implemented to reduce cigarette use, there are alternative ways to smoke tobacco, such as the hookah pipe. Hookah pipe use appears to pose a significant public health concern and has serious short- and long-term health consequences for users and those exposed to second-hand smoke. To date, few studies have reviewed hookah pipe interventions beyond the efficacy-based paradigm.

Objectives. To systematically review interventions aimed at reducing hookah pipe use through the RE-AIM framework (reach, efficacy, adoption, implementation and maintenance of results) in order to provide a practical means of evaluating interventions.

Methods. A systematic review spanning 12 databases identified studies aimed at reducing hookah pipe use. All methodological types of intervention studies that were peer reviewed and in the English language were considered for inclusion. The quality of each study was assessed. Ten studies were deemed eligible. For each study, data were extracted using the RE-AIM framework.

Results. All studies focused solely on the smoker, and their recruitment strategies were described. Eight studies reported meeting their objectives. Overall, the studies presented limited information regarding adoption success. The interventions were mainly supportive, educational or counselling sessions. Only five studies reported on the maintenance of results post intervention.

Conclusions. Interventions focusing on reducing hookah pipe use are limited. Counselling and educational support sessions seem to be the most feasible and potentially successful approaches for intervention.


Authors' affiliations

Z Kader, Child and Family Studies Unit, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa

N V Roman, Child and Family Studies Unit, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa

R Crutzen, Department of Health Promotion, Faculty of Health, Medicine and Life Sciences, Maastricht University/CAPHRI (Care and Public Health Research Institute), The Netherlands

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Tobacco; Hookah pipe; Implications; Interventions; Systematic review; Practitioners

Cite this article

South African Medical Journal 2019;109(6):392-406. DOI:10.7196/SAMJ.2019.v109i6.013892

Article History

Date submitted: 2019-05-31
Date published: 2019-05-31

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