Posts with hashtags, such as #hookah or #shisha, on social media platforms may portray its use in an overwhelmingly positive manner despite its serious health risks, a new study suggests.
The findings, published in the journal Health Education and Behavior, suggested that the portrayal and promotion of hookah smoking on social media can normalise its use and pose public health challenges.
A team of researchers from Florida International University, the University of Wisconsin, the University of Miami, the Syrian Centre for Tobacco Studies, and the University of Pittsburgh selected 279 posts from 11,517 posts tagged hookah or shisha within a four-day period.
They found that 99.6 per cent indicated positive sentiments towards hookah use and only one post (0.4 per cent) mentioned its negative health effects.
"A growing body of evidence suggests that smoking hookah can lead to nicotine dependence and many other known smoking-related illnesses such as cancer, cardiovascular disease, and respiratory disease," the researchers said.
"This study represents an important step in identifying hookah-related themes on Instagram and demonstrates the value in using data from this social platform to complement and extend our understanding of health behaviours," they added.
The researchers also found that 10 per cent of all posts used the hashtag #HookahAddiction, signalling that nicotine addiction is not perceived as a health risk that would discourage potential users but instead is referred to ironically or as a badge of honour.
The researchers commented that policymakers and others should explore approaches for reducing the number of promotional posts, for example, by creating campaigns to counter-market positive themes presented on social media.
"These findings can inform the design of future tobacco control media campaigns aimed at countering the normalization of hookah use on social media," the researchers noted.