Abstract
IntroductionAlthough hookah smoking is becoming a source of tobacco use among college students in the United States, little is known of the students’ knowledge, attitudes, and practices regarding hookah use. This cross-sectional study was aimed at determining the prevalence of hookah use and describing social and behavioral factors associated with hookah smoking among university students in a large urban university in Florida.MethodsA convenience sample of 478 undergraduate and graduate students was recruited. Lifetime use and current use was evaluated. Logistic regression modeling was used to assess the independent association between study covariates and hookah use.ResultsPrevalence among students of having ever used hookah during their lifetime was 54.4%. Hookah use within the past 30 days was 16.3%. Hookah use was significantly associated with cigarette smoking (odds ratio [OR], 4.52; 95% confidence interval [CI], 2.13–9.60) and hookah ownership (OR, 10.67; 95% CI, 4.83–23.66) but not with alcohol use (OR, 1.73; 95% CI, 0.74–4.04). Findings also suggest hookah is perceived as a safer alternative to cigarette smoking. Almost 30% of those who never smoked hookah reported they would consider smoking hookah in the future.ConclusionHookah smoking is popular among college students. Misperceptions associated with hookah use indicate a starting point for developing health behavior change interventions. Future studies should investigate social and behavioral determinants of hookah use and determine the incidence of hookah use among college and high school students. Tobacco control activities should include prevention of hookah tobacco use in university settings.
Highlights
Hookah smoking is becoming a source of tobacco use among college students in the United States, little is known of the students’ knowledge, attitudes, and practices regarding hookah use
Hookah use was significantly associated with cigarette smoking and hookah ownership (OR, 10.67; 95% confidence interval (CI), 4.83–23.66) but not with alcohol use (OR, 1.73; 95% CI, 0.74–4.04)
Findings suggest hookah is perceived as a safer alternative to cigarette smoking
Summary
Hookah smoking is becoming a source of tobacco use among college students in the United States, little is known of the students’ knowledge, attitudes, and practices regarding hookah use. This cross-sectional study was aimed at determining the prevalence of hookah use and describing social and behavioral factors associated with hookah smoking among university students in a large urban university in Florida. One session of hookah use contains approximately 200 puffs of smoke, which exposes users to 3- to 6-fold higher levels of carbon monoxide and 46-fold higher levels of tar than from a single cigarette [6,7]
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