KUWAIT MEDICAL JOURNAL June 2006 ABSTRACT Objective: To assess the prevalence of sheesha smoking and the personal, social and environmental factors associated with it. Subjects and Methods: A convenience sample of 761 students (261 male, 500 female) in the teacher training program of the Public Authority for Applied Education and Training in Kuwait City answered a 70-question survey regarding sheesha use. Data were analyzed using SPSS version 10. Results: 24.6% of males and 5.5% of the females smoked sheesha. 49.2% of the male sheesha smokers smoked at least one bowl a day, as did 26.9% of the female sheesha smokers. The majority of sheesha smokers first started smoking sheesha at age 18 or older. Almost half were encouraged to smoke sheesha the first time by their friends. The majority of sheesha non-smokers had sheesha non-smokers as friends. Among the sheesha smokers, 59.2% of females and 61.3% of males said all or most of their friends smoked sheesha. Sheesha smokers were more likely than sheesha non-smokers to live in a home where there are other sheesha smokers. Half of the males and one-third of the females who smoked sheesha wanted to quit. The majority of sheesha smokers also smoked cigarettes. Teachers, including female teachers, were frequently seen smoking in their schools. As expected, sheesha smokers had more positive attitudes towards sheesha smoking and were less likely to believe in its harmful effects. Conclusions: This is the first known study of sheesha use among college students in Kuwait. Results suggest efforts to reduce sheesha smoking in this young population should: 1) help young people address pressures from peers, 2) reduce sheesha smoking at home and school environment, 3) counteract personal beliefs and attitudes that contribute to sheesha smoking, and 4) reinforce beliefs about the health risks of sheesha smoking. KEYWORDS: attitude, behavior, belief, tobacco survey Original Article Sheesha Smoking among a Sample of Future Teachers in Kuwait Address correspondence to: Professor Ian Newman PhD, University of Nebraska-Lincoln, Department of Educational Psychology, P. O. Box 880345, Lincoln, NE 68588-0345 USA. Tel: 402 472 3844, Fax: 402 472 8319, E-mail: inewman1@unl.edu Kuwait Medical Journal 2006, 38 (2): 107-113 Heyam R A Mohammed 1 , Ian M Newman 2 , Raja Tayeh 3 1 Department of Curriculum and Instruction, Kuwait University, Kuwait 2 Department of Educational Psychology, University of Nebraska-Lincoln, USA 3 Department of Teaching, Learning and Teacher EducationUniversity of Nebraska-Lincoln, USA INTRODUCTION The water pipe, known in Arabic as nargile or sheesha and in English as hookah, is a traditional Arab method of smoking tobacco, especially for men. In this article the term sheesha refers to all types of water pipe, nargile, or hookah used for inhaling tobacco smoke. Water pipes present an especially attractive means of smoking tobacco. They are frequently beautiful works of art representing an exotic tradition and the promise of relaxation and pleasure. They can be used by several people at the same time contributing to friendship and camaraderie. The mix of rolled tobacco leaf, molasses and flavouring used to produce jurak allows for many taste preferences. When inhaled, the sound of the smoke bubbling through the water adds an auditory pleasure. The water cools the smoke allowing deep inhalation, maximizing the opportunity to appreciate the smoking sensation. These aesthetic and social qualities of sheesha smoking have likely contributed to the recent spread of sheesha use around the world. This study assessed the prevalence of sheesha smoking and the personal, social and environmental factors associated with it in a student population. Studies of Tobacco Use in Kuwait Data on sheesha smoking in Kuwait and other Arab countries are limited. Cigarette smoking, however, has been described quite extensively, suggesting possible patterns of sheesha use. Cigarette smoking in Kuwait is increasing, especially among young males, and the age of