The Geography of Water Pipe Use: A Case Study in Tabriz City, Northwestern Iran

Water pipe smoking, or hookah smoking, is a growing public health concern ingrained in urban leisure cultures. Even though hookah smoking is common, the localized spatial drivers of this activity are still poorly understood. In order to close this gap, this study examined the locations of 273 hookah cafés in the Tabriz metropolis in Iran, modeling the distribution of these cafés against eight urban predictors: population density, road networks, and six distinct land use categories, such as commercial, administrative, educational, industrial, religious, and recreational land use. We combined Kernel Density Estimation (KDE) with Local Bivariate Relationships (LBR) using a high-resolution spatial approach. The findings indicate a non-random and spatially clustered pattern, using entropy-based measures of local relationship complexity. With the highest mean entropy value (0.84) and percentage of significant relationships (87.7%), educational land use density was found to be the best predictor. Additionally, there was a robust and consistent correlation with commercial land use density. Relationships with administrative and recreational land uses, on the other hand, showed lower entropy and were weaker and more dispersed. According to this study’s findings, the distribution of hookah cafés is spatially correlated to youth concentration and commercial activity patterns. Entropy analysis reveals substantial neighborhood-level variation in predictor influence, highlighting the value of local spatial analysis for identifying place-specific exposure.