Carroll Mary V, Chang Judy, Sidani Jaime E, Barnett Tracey E, Soule Eric, Balbach Edith, Primack Brian A
Program for Research on Media and Health, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA; Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA;
Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA; Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA;
Nicotine Tob Res. 2014 Dec;16(12):1549-58. doi: 10.1093/ntr/ntu101. Epub 2014 Jun 27.
Waterpipe tobacco smoking (WTS) is an increasingly prevalent form of tobacco use in the United States. Its appeal may stem from its social, ritualistic, and aesthetic nature. Our aim in this study was to understand WTS as a social ritual with the goal of informing prevention efforts.
We conducted a covert observational study consisting of 38 observation sessions in 11 WTS establishments in 3 U.S. cities. Data collection was based on an established conceptual framework describing ritualistic elements of tobacco use. Iterative codebook development and qualitative thematic synthesis were used to analyze data.
Atmospheres ranged from quiet coffee shop to boisterous bar party environments. While some children and older adults were present, the majority of clientele were young adults. Men and women were evenly represented. However, there were 19 occurrences of a male smoking by himself, but no women smoked alone. The vast majority (94%) of the clientele were actively smoking waterpipes. All 83 observed groups manifested at least 1 of the ritual elements of our conceptual framework, while 41 of the 83 observed groups (49%) demonstrated all 4 ritual elements.
Despite its heterogeneity, WTS is often characterized by 1 or more established elements of a tobacco-related social ritual. It may be valuable for clinical and public health interventions to acknowledge and address the ritualistic elements and social function of WTS.
在美国，水烟吸食是一种日益普遍的烟草使用形式。其吸引力可能源于其社交、仪式和美学性质。我们开展这项研究的目的是将水烟吸食理解为一种社会仪式，以便为预防工作提供信息。
我们在美国3个城市的11家水烟吸食场所进行了一项隐蔽观察研究，共进行了38次观察。数据收集基于一个描述烟草使用仪式元素的既定概念框架。采用迭代式编码手册开发和定性主题综合分析数据。
场所氛围从安静的咖啡店到喧闹的酒吧派对环境不等。虽然有一些儿童和老年人在场，但大多数顾客是年轻人。男女比例均衡。然而，有19次是男性独自吸烟，没有女性独自吸烟。绝大多数（94%）顾客在积极吸食水烟。所有83个观察到的群体都至少表现出我们概念框架中的1个仪式元素，而83个观察到的群体中有41个（49%）表现出所有4个仪式元素。
尽管水烟吸食具有异质性，但它通常具有与烟草相关的社会仪式的1个或多个既定元素。临床和公共卫生干预措施承认并解决水烟吸食的仪式元素和社会功能可能具有重要价值。
