Article In Press | Published on: August 18, 2026
Volume: 2, Issue: 1
1. Department of Public Health, Faculty of Allied Medical Sciences, University of Calabar, Calabar, Nigeria.
2. College of Health Technology Calabar, Cross River State, Nigeria.
3. Department of Public Health, Chitechma University, Buea, Cameroon.
DOI: null
Corresponding Author: Favour Achi Inyang-Ogim, Department of Public Health, Faculty of Allied Medical Sciences, University of Calabar, Calabar, Nigeria.
Citation: Favour A. I. O, Okoi I. Ubi, Oyama V. Ofuka, Ngeniform S. Atanga, Ngala M. Talah. (2026). Knowledge, Risk Perceptions and Pattens of Hookah/Water Pipe Smokers in Calabar Metropolis, Cross River State, Journal of Biomedical Research and Clinical Reviews, RPC Publisher, 3(1); DOI: https://www.doi.org/rpc/2026/rpc.jbrcr/00564
Copyright: © 2026 Inyang-Ogim Favour Achi, this is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: Frequent consumption of hookah has now gained popularity among young urban populations despite contribution on its general health effect.
Aim: This study aimed to assess the knowledge, Risk perception, and Patterns of hookah smokers in Calabar Metropolis, Cross River State, Nigeria.
Methodology: A comparative cross-sectional descriptive design, using two-stage sampling method and snowball sampling technique was used to select respondents in selected bars, lounges, and nightclubs, with a sample size of 90 participants. Data were collected via a semi-structured interviewer-administered questionnaire, data were analyzed using SPSS version 25. Data were summarized using descriptive statistics
Results: Majority of respondents 79(87.8%) are knowledgeable about the health effects of hookah smoking, 62 % had high perceived risk of respiratory outcome and64% of the respondents had increased frequency and longer duration of hookah sessions
Conclusion: The study recommends enforcing strict government regulations on hookah use in public places, and providing regular respiratory health screenings and counseling for smokers to support early detection and informed health decisions.
1. Patil S, Mahuli A. V, & Warnakulasuriya, S. (2022). Effects of smoking shisha, cancer risk, and strategies for prevention of shisha habit. Journal of oral biology and craniofacial research, 12(4):439-443.
2. Otakhoigbogie U, Osagbemiro B. B, Akaji E. A. (2022). Knowledge and sociodemographic predictors of shisha smoking among students in a Nigerian university. Nigerian Journal of Clinical Practice, 25(6):779-785.
3. El-Zaatari Z. M, Chami H. A, Zaatari G. S. (2015). Health effects associated with waterpipe smoking. Tobacco Control, 24(S1):i31-i43.
4. Bigna J. J, Noubiap J. J. (2019). The rising burden of non-communicable diseases in sub-Saharan Africa. The Lancet Global Health, 7(10):e1295-e1296.
5. Eissenberg T. (2019). Now is the time for effective regulation regarding tobacco smoking using a Waterpipe (hookah). Journal of Adolescent Health, 64(6):685-686.
6. Qasim H, Alarabi A. B, Alzoubi K. H, Karim Z. A, Alshbool F. Z, et al. (2019). The effects of hookah/waterpipe smoking on general health and the cardiovascular system. Environmental health and preventive medicine, 24:1-17.
7. Omotehinwa O. J, Japheths O, Damascene I. J, Habtu M. (2018). Shisha use among students in a private university in Kigali city, Rwanda: prevalence and associated factors. BMC public health, 18:1-10.
8. Maziak W, Ward K. D, Afifi Soweid R. A, Eissenberg T. (2014). Tobacco smoking using a waterpipe: A re-emerging strain in a global epidemic. Tobacco Control, 13(4):327-333.
9. Adetona O, Mok S, Rajczyk J, Brinkman M. C, Ferketich A. K. (2021). The adverse health effects of waterpipe smoking in adolescents and young adults: A narrative review. Tobacco Induced Diseases, 19:81.
10. Sighaldeh S. S, Baheiraei A, Dehghan S, Charkazi A. (2018). Persistent use of hookah smoking among Iranian women: A qualitative study. Tobacco Prevention & Cessation, 4:38.
11. Mdege N. D, Ekpo R, Ogolla S, Ali S. J, Camara A, et al. (2024). Reasons for shisha smoking: Findings from a mixed methods study among adult shisha smokers in Nigeria. PLOS Global Public Health, 4(2):e0002853
12. Patil S, Awan K. H, Arakeri G, Aljabab A, Ferrari M, et al. (2019). The relationship of “shisha” (water pipe) smoking to the risk of head and neck cancer. Journal of Oral Pathology & Medicine, 48(4):278-283.
13. (2023). World Health Organization. Non communicable diseases.
14. (2019). World Health Organization. WHO highlights huge scale of tobacco-related lung disease deaths.
15. Akl E. A, Gaddam S, Gunukula S. K, Honeine R, Jaoude P. A, et al. (2010). The effects of waterpipe tobacco smoking on health outcomes: A systematic review. International Journal of Epidemiology, 39(3):834-857.
16. Primack B. A, Shensa A, Kim K. H, Carroll M. V, Hoban M. T, et al. (2016). Social media use and perceived social isolation among young adults in the U.S. American Journal of Preventive Medicine, 53(1):1-8.
17. Abua M. A, Igelle E. I, Eneyo V. B, Abali T. P, Akpan N. A, et al. (2023). Predicting sediment yield on different landuse surfaces in Calabar River Catchment, Nigeria. Heliyon, 9(8).
18. (2021). Center for Disease Control. Smoking & Tobacco use.
19. Lasebikan V. O, Ola B. A, Lasebikan T. O. (2019). Shisha smoking in selected nightclubs in Nigeria. Pan African Medical Journal, 33(1):136.
20. Arisa D, Fawzia B, Regina M. (2018). Knowledge and attitude on effects of Hookah smoking in a Kenyan population. IOSR Journal of Dental and Medical Sciences, 17(7).
21. Al Asmari D. S, Al Rethaiaa A. S, Al Mutairi A. S, Al Rashidi T. H, Al Rasheedi H. A, et al. (2019). Prevalence and perception of shisha smoking among university students: A cross-sectional study. Journal of International Society of Preventive and Community Dentistry, 9(3):275-281.
22. Darawshy F, Rmeileh A. A, Kuint R, Berkman N. (2021). Waterpipe smoking: a review of pulmonary and health effects. European Respiratory Review, 30(160).
23. (2022). World Health Organization. Deaths from noncommunicable diseases on the rise in Africa.
24. Macrotrends. (2024). Calabar, Nigeria Metro Area Population 1950-2024.
25. Oladepo O, Adeoye O. A, Ibitoye O. O. (2018). Prevalence and determinants of waterpipe smoking among undergraduate students in Ibadan, Nigeria. Tobacco Prevention & Cessation, 4:6.
26. Inah E. O, Eneyo V. B, Odey S. A, Ushie M. A, Udonwa R. E, et al. (2022). Anthropogenic Impacts on Water Quality of Kedong Stream in Idomi, Yakurr, Nigeria. Environment and Ecology Research, 10(6):738-748.
27. Odunyemi A, Rahman T, Alam K. (2023). Economic burden of non-communicable diseases on households in Nigeria: evidence from the Nigeria living standard survey 2018-19. BMC Public Health, 23(1):1563.
28. Ngahane B. H. M, Magouanet T, Bitchong E. C, Endale L. M, Barche B, et al. (2023). Prevalence, knowledge and factors associated with shisha smoking among university students in Cameroon. The international journal of tuberculosis and lung disease: the official journal of the International Union against Tuberculosis and Lung Disease, 27(8):606-611.
29. Alzyoud S, Weglicki L. S, Kheirallah K. A, Haddad L, Alhawamdeh K. A, et al. (2015). Waterpipe smoking among middle and high school Jordanian students: Patterns and predictors. International Journal of Environmental Research and Public Health, 12(11):14028-14040.
30. Nazzal Z, Odeh D, Haddad F. A, Berawi M, Rahhal B, Yamin H. (2020). Effects of Waterpipe Tobacco Smoking on the Spirometric Profile of University Students in Palestine: A Cross‐Sectional Study. Canadian Respiratory Journal, 2020(1):5949834.
31. Jha P, MacLennan M, Chaloupka F. J, Yurekli A, Ramasundarahettige C, et al. (2015). Global hazards of tobacco and the benefits of smoking cessation and tobacco taxes. Disease Control Priorities. The World Bank, 3:175-194.
32. Eneyo V. B, Edward J. E. (2018). The Contribution of Tourist Support Services in the Socio-Economic Development of Uyo Urban, Nigeria. Multi-Disciplinary Journal of Research and Development Perspectives, 7(2):28-44
33. Akindele O. R, Adewuyi P. A, Adedoyin R. A. (2020). Health effects of shisha use among young adults: A cross-sectional study. Journal of Community Health, 45(3):451-458
34. Cobb C, Ward K. D, Maziak W, Shihadeh A. L, Eissenberg T. (2010). Waterpipe tobacco smoking: An emerging health crisis in the United States. American Journal of Health Behavior, 34(3):275-285.
35. Ayodapo A, Ibisola B. (2021). Smoking and Non-Communicable Diseases in Sub-Saharan Africa: The Nigeria Scenario. Intech Open.
36. Logo D. D, Kyei-Faried S, Oppong F. B, Ansong J, Amenyaglo S, et al. (2020). Waterpipe use among the youth in Ghana: Lessons from the Global Youth Tobacco Survey (GYTS) 2017. Tobacco induced diseases, 18:47.