Religiosity and the practice of religion constitute a vital part of the lives of many people around the world (Mathur, 2012). It is not only viewed as the core of a culture’s belief system, but religiosity is also known to influence people’s behaviour in all aspects of life, especially regarding life satisfaction and well-being (Tiliouineand Belgoumidi, 2009; Mathur, 2012).
Although studies on the concept of religiosity date back to the early twentieth century (Durkheim, 1912), studies have still not settled on a unified agreement about the conceptualisation of religiosity. The variances in the characterisation of religiosity and the ambiguity in definition is due to the existence of different faiths and belief systems around the world. Each spiritual group defines religiosity from their point of view, both conceptually and operationally (one-dimensional vs. multi-dimensional) (Mathur, 2012). Moreover, when academics approach the concept of religiosity within research, each would address religiosity from different perspectives, making the concept harder to define (Cardwell, 1980).
H2b: Parental Influence affects attitudes towards water-pipe tobacco smoking
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Religion is commonly defined as an integrated system of beliefs and practices relative to sacred elements (Delener, 1990). Magill (1992) detailed that personal religiosity provides a background against which the ethical nature of behaviour is construed. Glock and Stark (1965) defined religiosity as a value-based approach that provides a person with a system of norms and values.
They identified five dimensions of religiosity: experiential (religious feelings), intellectual (knowledge about religion), ideological (beliefs), ritual (religious behaviour), and result-oriented (influences of religion) (Fisherman, 2011).
Allport and Ross (1967) identified two dimensions of religiosity: intrinsic and extrinsic.
According to prior research, the: “extrinsically motivated person uses his religion whereas the intrinsically motivated lives his religion’’ (Allport and Ross, 1967: p. 434). Intrinsic religiosity is living one’s religion with sincerity and intentionality and seems to be related to the private, emotional aspects of religiosity (Cohen et al., 2005). On the other hand, the main idea of extrinsic religiosity is using religion for instrumental purposes or social achievement, such as using religion to gain status or for self-justification (Allport and Ross, 1967). Simply, extrinsic religiosity is what individuals show externally through religious behaviour, for example attending mosque or church. Intrinsic religiosity has been interpreted as being more normative than extrinsic religiosity (Cohen et al., 2005; Hunt and King, 1971). According to Cohen et al.
(2005), measures of intrinsic and extrinsic religiosity are commonly used in psychology.
Weaver and Agle (2002) stated that religiosity influences human attitudes and behaviour. Some research showed that religiously active people are reportedly healthier physically and live longer (Levin and Schiller, 1987; McIntosh and Spilka, 1990; Williams and Sternthal, 2007). This suggestion has been clarified by the fact that religious people tend to have healthier smokingand consumption habits (Tiliouine and Belgoumidi, 2009). Different religions have different behavioural restrictions. For example, eating pork is forbidden in both Islamic and Jewish faiths, but it is acceptable in the Christian faith.
When examining WTS in the EMR, research found religion to play an imperative role in the citizens’ lives. Some previous research on smoking cessation has indicated that religion has sometimes influenced adult smokers to quit (Saeed, Khoja and Khan, 1996; Swaddiwudhipong, Chaovakiratipong, Nguntra, Khumklam, and Silarug, 1993). However, the effect of religion on the major population is slightly indefinite (Ugen, 2003), except for followers of religions that
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strongly condemn the use of tobacco. Nevertheless, all religions stress valuing human well-being, and therefore do not approve of anything that might jeopardise it, including tobacco smoking. However, it is important to note that most disapproved behaviours are not prohibited entirely (El Awa, 2004).
The Holy Quran is the primary source of all life’s teachings and rules to Muslims. In the Quran, it states: “Do not with your own hands, cast yourself to destruction” (2:195) and “do not be wasteful” (7:31) (WHO, 2004). The cited verses ask individuals not to be self-destructive, and not harm themselves in any way, including being wasteful. Bearing in mind that smoking damages one’s health and causes monetary loss as well, most religious scholars view smoking as
“Haram” (“prohibited”) or “Makrouh” (“reprehensible”) (Ghouri, Atcha, and Sheikh, 2006).
Other religious scholars of different faiths view smoking as undesirable behaviour. In Christianity, some Christian scholars argued that smoking is part of the evil that Satan challenges to spread. Smoking may deteriorate a Christian’s spiritual association with the Lord (Marcus, 2008). In Judasim, preserving one’s health is considered a “mitzvah” (“good deed”) (Siegel, 1986); while the Jewish law “Halakha” prohibits the smoking of tobacco and its products. It is also prohibited to smoke during the Sabbath day. According to Hindu principles, tobacco consumption is a violation to Hinduism values, with its dangerous effect on one’s health (Shafey et al., 2009). Buddhism considers that whatever harms the body or the mind must be refrained from (WHO, 2008). Since tobacco is considered a harmful substance, “all tobacco marketing should be banned” and monks should abstain from tobacco (WHO, 2002).
In Egypt, Islam is the national religion. Almost 90% of Egyptians are Muslim and around 10%
are of Christian faith (CAPMAS, 2016; US embassy report, 2017). As mentioned, Islam has religious principles that forbid and discourage the use of addictive substances, and considers anything that would harm health to be forbidden or haram (Yong, Hamann, Borland, Fong, and Omar, 2009); while others have argued that it is merely advised against or makruh (Ghouri et al., 2006). A study that took place in Malaysia and Thailand by Yong and colleagues (2009) examined the role of religion and religious leadership on smoking and association with quitting.
They found out that religious factors had a clear dependent association with making quitting attempts with Muslim Malaysians, but not for Thai Buddhists. Other studies have also linked
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religion to WTS especially within respondents in Egypt. These studies saw an increase in smoking as a consequence of decreasing religious belief (Afifi et al., 2013).
A prior study found that Egyptian Muslim men believed that WTS was sinful, owning to adverse health outcomes (Jawad, Nakkash et al., 2015). On the contrary, a study on US Muslim college students found that religious beliefs on water-pipe and religiosity were not defensive factors against WTS (Arfken, Abu-Ras and Ahmed, 2015). Singh et al. (2012) supported this view.
They investigated the connection between health and religious beliefs about WTS among rural males in Egypt. Their findings indicated that smokers were more likely to believe that cigarette smoking is a sin than WTS. The research presumed that smokers perceived water-pipes as not being as harmful as cigarette smoking due to the filtration process within water-pipe smoking.
Accordingly, Singh et al. (2012) argued that water-pipe smokers maybe less susceptible to faith-based tobacco interventions.
When discussing WTS in the EMR, religion plays a vital part in society. Previous research on smoking cessation indicated that religion has sometimes influenced adult smokers to quit (Saeed et al., 1996; Swaddiwudhipong et al., 1993). However, in this study, the concern is how religious an individual is, i.e. the level of religiosity, and believes that it influences the attitudes of individuals towards WTS. Thus, the following hypothesis is stated: