Student perspectives on smoking and second-hand smoke in Qatar: a participatory photovoice study in a multicultural university context.

backgroundTobacco use among university students presents a persistent public health challenge, particularly in settings where smoking is socially normalized despite strong regulatory frameworks. Qatar, with its multicultural population and progressive tobacco laws, offers a unique context for exploring these dynamics. However, little research has examined how young adults in the region experience and navigate smoking behaviours in everyday life. The study explores how university students’ perception and experience of smoking and second-hand smoke exposure, and examined barriers and facilitators to cessation within their academic and social environments.

methodsA qualitative study using photovoice methodology was conducted within a community-based participatory research framework. Undergraduate students aged 18–24 at a large national university in Qatar were recruited via purposive and snowball sampling. After a preparatory workshop, participants captured photographs representing their experiences with smoking or second-hand smoke, followed by semi-structured, photo-elicitation interviews. Data were analysed using thematic analysis of interview transcripts and photographs using a collaborative coding process. Credibility was strengthened through triangulation of visual and narrative data, member checking, and peer debriefing.

resultsTwenty-two students (12 females, 10 males; 9 smokers, 13 non-smokers) participated. Thematic analysis revealed five interrelated themes: (1) health awareness and personal triggers (2), social and cultural influences (3), environmental and economic consequences (4), prevention, cessation, and support, and (5) policy and behavioural regulation. Although students were aware of the health risks of tobacco use, many continued to smoke due to stress relief, peer influence, and cultural normalization. Environmental concerns such as litter and second-hand smoke exposure were widespread but inconsistently acted upon. Most participants expressed interest in quitting but reported limited awareness or trust in available cessation resources. Institutional policies were inconsistently enforced and undermined by contradictory role modelling from faculty and peers.

conclusionsUniversity students in Qatar described smoking behaviours shaped by emotional triggers, academic stress, peer influence, and cultural normalization. Despite awareness of health risks, smoking persisted. Participants reported widespread exposure to second-hand smoke, limited trust in cessation resources, and inconsistent enforcement of institutional policies across campus settings.

trial registrationNot applicable.