Knowledge and Attitudes Toward Smoking Hookah and Exacerbation of COVID-19 Symptoms Among Women: A Web-Based Cross-sectional Study

Smoking hookah during the coronavirus disease 19 (COVID-19) pandemic is a dangerous factor which could exacerbate the symptoms of the illness. The present study aimed at determining the relationship between knowledge and attitudes toward the negative effects of smoking hookah on the exacerbation of COVID-19 symptoms and the role of some effective socio-demographic factors.

This descriptive-analytical study was conducted (February 2021 to April 2021) among 933 women over the age of 15 who smoked hookah in Hormozgan province. A self-made questionnaire was completed by women after its preparation and online checking of its validity and reliability.

The mean and standard deviation of knowledge and attitude scores were 5.13 ± 2.19 and 25.20 ± 4.75, respectively. In this study, 65% of the subjects had adequate knowledge and 48.7% had a positive attitude. However, the predictors of adequate knowledge were: subjects aged over 50 compared to those aged 35-50 years [1.975 (1.029-3.794)], subjects with university degrees compared to those with primary school, high school or diploma degrees [2.445 (1.476-4.049)], [5.508 (3.305-9.178)], [3.991 (1.981-8.042)], subjects with good economic status compared to those with poor economic status [1.966 (1.218-3.175)], and age of onset of smoking hookah after 30 compared to the onset age between 15 and 30 as well as below 15 [2.563 (1.030-6.379)], [6.308 (2.249-17.693)]. There was no statistically significant relationship between any of the demographic factors and attitudes.

In general, increasing knowledge and changing attitudes about the relationship between smoking hookah and exacerbation of the COVID-19 symptoms can be an effective step in reducing hookah use during the COVID-19 pandemic. These findings can provide policymakers with valuable insights and information on the importance of community-wide training programs.