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Background and purpose: Substance abuse is one of the main social problems among young adults. This study aimed at evaluating the prevalence of substance abuse and associated factors in hookah users in Zahedan, Iran.

Materials and methods: This cross-sectional study was carried out on 600 hookah users in Zahedan, 2015.The city was divided into 5 districts (north, south, east, west and center) according to the maps. Then a start point was randomly selected and all individuals in first hookah place were entered into the study. Other cases were studied by referring to next nearest hookah places. The study questionnaires were completed in each districts. Data analyses were performed in Stata.12 using Chi-square, Independent T test and multiple logistic regression. 

Results: The subjects’ mean age was 26.1±5.1 years old. About 53% of the participants used hookah in groups. The ages of first hookah experience in males and females were 17.1±6.13 and 21.2±5.6 years old, respectively (P=0.04). Total prevalence of substance abuse was 70.4%. Using hookah in groups (OR=2.03, P=0.05), using hookah every other days (OR=2.2, P=0.042), living alone (OR=2.27, P=0.046), being university student (OR=3.7, P=0.01), and being male (OR=3, P=0.032) significantly increased the chance of substance abuse among hookah users.

Conclusion: The prevalence of substance abuse in hookah users was found to be more than that in general population.  Use of hookah can play a role in initiation of substance abuse. Also, the situation of hookah use and pattern or levels of consumption are the most important predictors in tendency of hookah users to other tobacco products and addictive industrial materials.

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Background and purpose: Irrational beliefs are among the factors affecting the tendency to use tobacco. Today, there is a growing trend of waterpipe (hookah) smoking among the youth in Iran. This study aimed at comparing irrational beliefs among young adult hookah smokers and young athletes.

Materials and methods: This descriptive study was conducted in 600 individuals who were selected using stratified random sampling, in Zahedan, Iran, 2015. The participants included 300 hookah smokers in traditional teahouses and 300 individuals attending bodybuilding gyms. Data collection was performed using the Jones’ Irrational Beliefs Test (IBT).

Results: The mean ages of the young hookah smokers and athletes were 23±6 and 22±2 years, respectively. The results of MANOVA test indicated a statistically significant difference between the two groups in terms of all irrational beliefs. Accordingly, the mean score of irrational beliefs score in the hookah smokers was much higher than that of the young athletes (F=71.42, Wilks lambda=0.452, P=0.00).

Conclusion: Irrational beliefs are believed to be amongst the main factors affecting the tendency of young people to smoke hookah.

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 Background and purpose: Excessive intake of heavy metals has adverse health effects and smoking is one of the sources of these elements. The aim of this study was to investigate the concentrations of 11 heavy metals in tobacco of different widely-consumed brands of cigarettes and hookahs in Iran.
Materials and methods: Concentrations of nine types of cigarettes and four types of hookah tobacco were measured using inductively coupled plasma mass spectrometry (ICP-MS). Statistical analyses were performed using Shapiro-Wilk pre-test, independent t-test, one-way analysis of variance, and Tukey Post Hoc Test.
Results: Manganese and selenium had the highest and the lowest concentrations in cigarette and hookah tobacco, respectively. One-way analysis of variance showed significant differences in concentrations of manganese, barium, and antimony between tobacco of different types of cigarettes (P<0.05). The mean concentrations of the elements in cigarettes were higher than the hookah. Tukey and Mann-Whitney test showed that the mean concentrations of all elements were not significantly different between different types of tobacco in cigarette and hookah (P> 0.05).
Conclusion: High levels of heavy metals were found in cigarette and hookah tobacco in Iranian market. The dangers of these elements to human health, requires enforcing strict regulations to reduce consumption and informing people about their harmful effects.