Unconventional materials and substances used in water pipe (narghile) by smokers in central western region of Saudi Arabia

OBJECTIVES: To investigate the use of unconventional substances and materials in water pipe among café water pipe smokers.

METHODS: This was a questionnaire-based survey among subjects attending coffee shops in the region of Al Madinah, Saudi Arabia between February and March 2013.

RESULTS: We invited 110 subjects, only 90 consented to participate in the study. A percentage of 1.1% used fluids other than water in the water pipe tank, 18.9% added other soft drinks to the tank, and 7.8% added flowers, spices or drugs to the tobacco mix placed in the head of the water pipe. A proportion of participants used fruits to replace the water pipe head (12.2%), or to replace water pipe tank (4.4%). Higher number of children the smokers had and cafe smoking were all significantly associated with unconventional practices.

CONCLUSION: A substantial percentage of sample of water pipe smokers in Al Madinah, Saudi Arabia use unusual materials and/or substances in the water pipe and this is probably encouraged by cafe smoking.