How Social Media Makes Shisha Smoking Looks Good? A Systematic Review

Agatha Oluwafunmilayo Adu 1, Nurzali Ismail 1 * , Shuhaida Md Noor 1
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1 School of Communication, Universiti Sains Malaysia, Penang, MALAYSIA
* Corresponding Author
Online Journal of Communication and Media Technologies, Volume 12, Issue 4, Article No: e202237.
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Despite the danger of shisha smoking, the freedom provided by social media means, pro-shisha smoking content can be freely shared across the platform. This could have a negative impact on youth who are frequent users of social media. They are often associated with the shisha smoking habit. Hence, this paper systematically synthesized the findings of the earlier literature related to the portrayal of shisha smoking on social media. This was performed to provide insight pertaining to the issue, which contributes to public health intervention and also for future research. Search for relevant literature was conducted using academic search engines including Google Scholar, PubMed, Web of Science, Science Direct, Scopus, and the Cochrane Library. The literature was qualitatively and thematically synthesized. The results of this review indicated that, shisha smoking is commonly portrayed as a social activity that is fun, relaxing, and desirable. At the individual level, it was also found that, social media serves as a platform for youth to express shisha smoking attitude. The findings of this review can enhance the understanding of how the portrayal of shisha smoking on different social media platforms may be interfering with public health cessation intervention. This study adds to the present knowledge with regard to the portrayal of shisha smoking on social media.


Adu, A. O., Ismail, N., & Noor, S. M. (2022). How Social Media Makes Shisha Smoking Looks Good? A Systematic Review. Online Journal of Communication and Media Technologies, 12(4), e202237.


  • Aanyu, C., Kadobera, D., Apolot, R. R., Kisakye, A. N., Nsubuga, P., Bazeyo, W., & Ddamulira, J. B. (2019). Prevalence, knowledge and practices of shisha smoking among youth in Kampala City, Uganda. The Pan African Medical Journal, 32, 61.
  • Abraham, E. A., Egbe, C. O., & Ayo-Yusuf, O. A. (2019). News media coverage of shisha in Nigeria from 2014 to 2018. Tobacco Induced Diseases, 17(April), 1-10.
  • Akl, E. A., Jawad, M., Lam, W. Y., Obeid, R., & Irani, J. (2013). Motives, beliefs and attitudes towards waterpipe tobacco smoking: A systematic review. Harm Reduction Journal, 10(1), 12.
  • Allem, J. P., Chu, K. H., Cruz, T. B., & Unger, J. B. (2017a). Waterpipe promotion and use on Instagram: # hookah. Nicotine & Tobacco Research, 19(10), 1248-1252.
  • Allem, J. P., Dharmapuri, L., Leventhal, A. M., Unger, J. B., & Cruz, T. B. (2018). Hookah-related posts to Twitter from 2017 to 2018: Thematic analysis. Journal of Medical Internet Research, 20(11), e11669.
  • Allem, J. P., Ramanujam, J., Lerman, K., Chu, K. H., Cruz, T. B., & Unger, J. B. (2017b). Identifying sentiment of hookah-related posts on Twitter. JMIR Public Health and Surveillance, 3(4), e74.
  • Alqahtani, M. M., Goodfellow, L. T., Zimmerman, R. D., & Zavorsky, G. S. (2019). Waterpipe smoking in health-care students: Prevalence, knowledge, attitude, and motives. Respiratory Care, 64(3), 321-327.
  • Ben Taleb, Z., Laestadius, L. I., Asfar, T., Primack, B. A., & Maziak, W. (2019). #Hookahlife: The rise of waterpipe promotion on Instagram. Health Education & Behaviour, 46(1), 106-113.
  • Brockman, L. N., Pumper, M. A., Christakis, D. A., & Moreno, M. A. (2012). Hookah’s new popularity among US college students: A pilot study of the characteristics of hookah smokers and their Facebook displays. BMJ Open, 2(6), e001709.
  • Carroll, M. V., Shensa, A., & Primack, B. A. (2013). A comparison of cigarette-and hookah-related videos on YouTube. Tobacco Control, 22(5), 319-323.
  • Combrink, A., Irwin, N., Laudin, G., Naidoo, K., Plagerson, S., & Mathee, A. (2010). High prevalence of hookah smoking among secondary school students in a disadvantaged community in Johannesburg. SAMJ: South African Medical Journal, 100(5), 297-299.
  • Fung, I. C.-H., Blankenship, E. B., Ahweyevu, J. O., Cooper, L. K., Duke, C. H., Carswell, S. L., Jackson, A. M., Jenkins III, J. C., Duncan, E. A., Liang, H., Fu, K.-W., & Tse, Z. T. H. (2019). Public health implications of image-based social media: A systematic review of Instagram, Pinterest, Tumblr, and Flickr. The Permanente Journal, 24, 18307.
  • Gathuru, I. M., Tarter, R. E., & Klein-Fedyshin, M. (2015). Review of hookah tobacco smoking among college students: Policy implications and research recommendations. American Journal of Drug and Alcohol Abuse, 41, 272-280.
  • Grant, A., & O’Mahoney, H. (2016). Portrayal of waterpipe (shisha, hookah, narghile) smoking on Twitter: A qualitative exploration. Public Health, 140, 128-135.
  • Greenhow, C., Chapman, A., Marich, H., & Askari, E. (2017). Social media and social networks. In K. Peppler (Ed.), The SAGE encyclopedia of out-of-school learning. SAGE.
  • Guidry, J. P., Haddad, L. G., Jin, Y., & Zhang, Y. (2017). Of #waterpipe smoking on Instagram. Archivos de Medicina [Medicine Archives], 2(3), 34.
  • Guidry, J., Jin, Y., Haddad, L., Zhang, Y., & Smith, J. (2016). How health risks are pinpointed (or not) on social media: The portrayal of waterpipe smoking on Pinterest. Health Communication, 31(6), 659-667.
  • Haddad, C., Bou Malhab, S., Sacre, H., & Salameh, P. (2021). Smoking and COVID-19: A scoping review. Tobacco Use Insights, 14, 1179173X21994612.
  • Ilakkuvan, V., Johnson, A., Villanti, A. C., Evans, W. D., & Turner, M. (2019). Patterns of social media use and their relationship to health risks among young adults. Journal of Adolescent Health, 64(2), 158-164.
  • Ismail, N., Ahmad, J., Noor, S. M., & Saw, J. (2019). Malaysian youth, social media following, and natural disasters: What matters most to them? Media Watch, 10(3), 508-521.
  • Ismail, N., Jawhar, J., Yusof, D. M., Ismail, A. I., & Naguib, R. M. K. (2022). Understanding Malaysian youth’s social media practices and their attitude towards violent extremism. Intellectual Discourse, 30(1), 5-33.
  • Israel, E., El-Setouhy, M., Gadalla, S., Aoun A., Mikhail, N., & Mohamed, M. K. (2003). Water pipe (shisha) smoking in cafes in Egypt. Egyptian Society of Parasitology, 33(3), 1073-1085.
  • Krauss, M. J., Sowles, S. J., Moreno, M., Zewdie, K., Grucza, R. A., Bierut, L. J., & Cavazos- Rehg, P. A. (2015). Peer reviewed: Hookah-related Twitter chatter: A content analysis. Preventing Chronic Disease, 12, E121.
  • Maziak, W., Taleb, Z. B., Bahelah, R., Islam, F., Jaber, R., Auf, R., & Salloum, R. G. (2015). The global epidemiology of waterpipe smoking. Tobacco Control, 24(1), i3-i12.
  • Middha, D., & Negi, A. (2019). Forensic chemical profiling of flavouring additives in seized mu’assel (shisha) by gas chromatography-mass spectrometry (GC-MS). Egyptian Journal of Forensic Sciences, 9(1), 39.
  • 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), 713.
  • Primack, B. A., Carroll, M. V., Shensa, A., Davis, W., & Levine, M. D. (2016). Sex differences in hookah-related images posted on Tumblr: A content analysis. Journal of Health Communication, 21(3), 366-375.
  • Qasim, H., Alarabi, A. B., Alzoubi, K. H., Karim, Z. A., Alshbool, F. Z., & Khasawneh, F. T. (2019). The effects of hookah/waterpipe smoking on general health and the cardiovascular system. Environmental Health and Preventive Medicine, 24(1), 1-17.
  • Shekhar, S., & Hannah-Shmouni, F. (2020). Hookah smoking and COVID-19: Call for action. CMAJ, 192(17), E462-E462.
  • Singh, S. K., Enzhong, L., Reidpath, D. D., & Allotey, P. (2017). Shisha (waterpipe) smoking initiation among youth in Malaysia and global perspective: A scoping review (2006-2015). Public Health, 144, 78-85.
  • WHO. (2015). Advisory note: Waterpipe tobacco smoking health effects, research needs and recommended actions by regulators. WHO Study Group on Tobacco.
  • Wong, L. P., Alias, H., Aghamohammadi, N., Aghazadeh, S., & Hoe, V. C. W. (2016). Shisha smoking practices, use reasons, attitudes, health effects and intentions to quit among Shisha smokers in Malaysia. International Journal of Environmental Research and Public Health, 13(7), 726.