'When I smoked it, it was like a slap in the face but it felt really good': exploring determinants of midwakh use among young adults in Lebanon.

摘要: Background Dokha (‘dizziness’ in English) is a type of alternative tobacco product (ATP) increasing popularity the Arab world; and smoked pipe called midwakh. Midwakh use common among nationals United Emirates (UAE); yet, evidence indicates its spread expats UAE as well beyond UAE. Research on midwakh nascent, no qualitative research has been published. This paper explored context determinants young adults Lebanon using methods. Methods We conducted four focus group discussions with 18 ever smokers aged 18–25 years Lebanon. Discussions were recorded, transcribed thematically analysed Pragmatics, Attraction, Communication, Expectations framework. Results ‘Pragmatics’ was evident participants’ comments about availability supply dokha. For ‘attraction’, participants described why they prefer smoking compared it to other ATPs. Regarding communication, shared terms used describe their (eg, ‘buzz’/taking hit). Participants also expectations from midwakh, including stress relief. Conclusion appealing due factors such ‘buzz’, perceived harm reduction, relief ability satisfy nicotine craving small amounts tobacco. As result, despite experiencing negative effects first use, choose continue find hard quit. These results have implications for prevention control adults. Framework Convention Tobacco Control guidance documents address ATPs are critically needed prevent global yet another product.