Hookah Bars Research Articles

Temporal and Thematic Analysis of Promotional Waterpipe-Related Posts on Twitter/X in the US.

Waterpipe tobacco smoking (WTS), also known as hookah, shisha, or narghile, is particularly popular among young people in the United States (US). WTS poses serious health risks similar to those of cigarette smoking. Using the Twitter/X streaming API (Application Programming Interface), we collected 4,853,562 tweets between March 9, 2021, and March 14, 2023, using waterpipe-related keywords, such as "hookah" and "waterpipe". After geographical filtering to identify tweets from the US and keyword filtering for the promotional content, we identified 23,803 promotional waterpipe-related tweets. We examined trends in the posting time of these promotional waterpipe-related tweets and identified prevalent topics from these tweets using the BERTopic (Bidirectional Encoder Representations from Transformers) modeling. The number of promotional waterpipe-related tweets showed an overall decreasing trend during the study period. The posting of promotional waterpipe-related tweets was more active later in the day. Major topics in the promotional tweets included "Promotion from hookah lounges and online hookah business" (63.97%, 15,227/23,803), "promoting hookah parties and events" (32.26%, 7,679/23,803), and "promoting engineered and durable hookah products" (3.77%, 897/23,803). Twitter/X accounts posting waterpipe-related promotional content have substantial variations in the number of relevant tweets (mean = 2.28, SD = 12.22) and followers (mean = 5,937, SD = 76,770). This study demonstrates a significant social media activity in promoting waterpipe tobacco smoking. Our findings underscore the urgent need to regulate the promotional content of WTS on social media and promote public health education messages on social media to counteract the promotion of WTS.

Identifying the Determinants of Hookah Smoking Among the Youth; A Mixed-Methods Study.

Hookahs have been rising in popularity in the United States (U.S.) especially among the youth yet not much research has been carried out to understand the various predictors of hookah use among youth. We have thus conducted a cross-sectional study with a mixed-methods triangulation design to identify the hookah use determinants at different levels of the Social Ecological Model among youth. Participants between the ages of 18-24 years were sampled purposively, between April to November 2023, following a snowballing technique from various communities in Virginia and California, United States. Data were collected via a survey, one-on-one interviews, and focus groups. The study had a total sample size of 20. We found that participants smoked for a median of 5 times in the past 30 days. The main determinants of hookah smoking included the limited knowledge of health effects and addiction, positive attitude, family and peer influence, use as a means to socially connect with others, culture, social acceptability, lack of education at school and work place, access to hookah bars and smoke shops, and lack of strict enforcement of laws to ban smoking of youth. Educational interventions should be implemented by public health authorities to target the youth, their social and communities to provide education on hookah harm and addictiveness and to restrict access to- and the production, distribution, marketing and sales of hookahs.

‘I Don’t Play Games’: Migrant Workers and Digital Media in Bengaluru

The great impact of media technologies in reordering almost every facet of modern life has been noted by theorists for over a century now, particularly since the idea of the ‘global village’ imagined by media theorists, and enabled by globalisation and digital technology has become an inescapable reality. The new experience of time and space bears upon various dimensions of life, including the nature of work, the organisation of time and the place of leisure within these rhythms. This article attempts to engage with this very weighty body of scholarship in a modest way, through ethnographic research, to understand how mobile phones and internet technologies structure the experience of ‘everyday life’ for low-income migrant workers in Bengaluru. The sites include a construction site and a hookah bar, and the study focuses on mobile gaming and the structuring of migrant social networks.

Peculiarities of the Operation оf Optical Communication in case of emergencies

Today, in connection with the beginning of the full-scale armed invasion of the RF on the territory of Ukraine, questions related to fire safety and stable electricity supply have arisen before our state. It. in turn, led to numerous problems in the communication system. Against this background, after damage to power supply lines and strategic objects, the search and deployment of power supplies independent of the usual supply sources became urgent. After all, under the conditions of emergency and planned power outages, only the presence of such means of power supply as fuel generators and batteries make it possible to provide work and training for a huge number of people. Thanks to the fact that people, without wasting time and wasting energy on unnecessary things and affairs, began to work on the issue that is associated with a sudden or planned power outage for known or not entirely known reasons, work for most people resumed. Autonomous power sources were fuel generators. Small shopping centers and shopping and entertainment centers have installed powerful diesel generators on their premises to power large premises. Some installed one diesel generator on each individual wing. This was done if the room was too large for one diesel generator. Small establishments, for example: cafes, restaurants, bars, pubs, hookah bars, small offices, offices, workshops, etc. installed gasoline generators if the premises were the size of a garage, a three-room apartment with an area of 92 m2 or the size of a small two-story country house with walls 8 meters long each and ceilings up to 2 meters high. Powerful diesel generators were installed in the premises, which were more than 100 m2 in area. Most generators had an automatic start feature. Some generators had an installed automatic start function, and some did not have this function, and therefore had to install this function separately. Telecommunications companies and mobile communication service companies and provider companies that sell and service cable Internet also did not waste time and effort and also installed generators on their territories. Provider companies and mobile communication service companies were the first to decide to install autonomous emergency power supplies in their territories. This was done on purpose, since the equipment that provided and monitored wireless and cable Internet services and mobile communications services was powered by network electricity, and during the absence of network electricity, the equipment obviously stopped working. Because of this, cable Internet and mobile communications were lost, which had a negative impact on some citizens of Ukraine. It had a negative impact on them, since some citizens, as mentioned above, could work or study remotely. Someone lost their job, someone lost their business due to power outages. Also in connection with this, huge accounting gaps appeared. The introduction and use of emergency power helps solve this problem.

Potential Impact of the COVID-19 Pandemic on Public Perception of Water Pipes on Reddit: Observational Study.

Socializing is one of the main motivations for water pipe smoking. Restrictions on social gatherings during the COVID-19 pandemic might have influenced water pipe smokers' behaviors. As one of the most popular social media platforms, Reddit has been used to study public opinions and user experiences. In this study, we aimed to examine the influence of the COVID-19 pandemic on public perception and discussion of water pipe tobacco smoking using Reddit data. We collected Reddit posts between December 1, 2018, and June 30, 2021, from a Reddit archive (PushShift) using keywords such as "waterpipe," "hookah," and "shisha." We examined the temporal trend in Reddit posts mentioning water pipes and different locations (such as homes and lounges or bars). The temporal trend was further tested using interrupted time series analysis. Sentiment analysis was performed to study the change in sentiment of water pipe-related posts before and during the pandemic. Topic modeling using latent Dirichlet allocation (LDA) was used to examine major topics discussed in water pipe-related posts before and during the pandemic. A total of 45,765 nonpromotion water pipe-related Reddit posts were collected and used for data analysis. We found that the weekly number of Reddit posts mentioning water pipes significantly increased at the beginning of the COVID-19 pandemic (P<.001), and gradually decreased afterward (P<.001). In contrast, Reddit posts mentioning water pipes and lounges or bars showed an opposite trend. Compared to the period before the COVID-19 pandemic, the average number of Reddit posts mentioning lounges or bars was lower at the beginning of the pandemic but gradually increased afterward, while the average number of Reddit posts mentioning the word "home" remained similar during the COVID-19 pandemic (P=.29). While water pipe-related posts with a positive sentiment were dominant (12,526/21,182, 59.14% before the pandemic; 14,686/24,583, 59.74% after the pandemic), there was no change in the proportion of water pipe-related posts with different sentiments before and during the pandemic (P=.19, P=.26, and P=.65 for positive, negative, and neutral posts, respectively). Most topics related to water pipes on Reddit were similar before and during the pandemic. There were more discussions about the opening and closing of hookah lounges or bars during the pandemic. This study provides a first evaluation of the possible impact of the COVID-19 pandemic on public perceptions of and discussions about water pipes on Reddit.

Indoor Carbon Monoxide Levels of Hookah Lounges

Objective: Waterpipe tobacco smoking results in the inhalation of carcinogens, bacteria and heavy metals; however, despite the negative health effects, waterpipe tobacco smoking or hookah smoking continues to be a favored social smoking behavior for young adults. High levels of carbon monoxide can impair normal brain function and put individuals at increased health risk. The purpose of this study was to measure the carbon monoxide levels in the ambient air of 10 hookah lounges surrounding college campuses in the metropolitan area of Tampa, Florida. Methods: The study consisted of repeated measurements of ambient air carbon monoxide inside the hookah lounges over 4 hours during peak times of use. Results: Of the 10 hookah bars, 7 had levels above what is considered harmful to human health. These data provide evidence of high levels of CO produced in indoor hookah lounges that varied and were not predictable based on cigarette smoking allowed, ventilation systems, and whether doors were opened or closed. Conclusions: Stricter regulation is needed in hookah lounges to avoid toxic exposures by patrons.

Relationship between Exposure to Hookah Smoke and Lung Capacity of Hookah Cafe Employees

Background: The aim of the present study was to investigate the effect of exposure to hookah smoke on the respiratory capacity of employees working in hookah cafes in Bandar Abbas. Methods: A total of 75 employees of hookah cafes and 64 people in the control group were the target population. Participants without a history of smoking, diabetes, and hypertension were included in the study. First, the height and weight of subjects were measured and then a respiratory test was performed by an occupational medicine specialist. At the same time, a checklist was completed, which contained demographic characteristics, history of working in hookah cafes, pulmonary diseases, hypertension, smoking, exercising, and a second job. Results: The mean age of the case and control groups was found to be 31.41 and 30.73 years, respectively. The mean values of the indices in the case and the control groups were as follows: forced expiratory volume (FEV1): 84.4% and 89.9%, forced vital capacity (FVC): 91.5% and 91.1%, forced expiratory flow 25-75 (FEF25-75): 78.7% and 75.9%, and peak expiratory flow (PEF): 87.2% and 95.2%, respectively. A significant relationship was found between exposure to hookah smoke and the lung capacity of employees working in hookah cafes (P &lt;0.001). Conclusion: Based on the findings of the study and in order to reduce passive exposure to hookah smoke and its negative consequences, officials should review and apply strict rules on hookah use and monitor and control the air quality inside hookah cafes.

Discussion of waterpipe tobacco smoking on reddit

ObjectivesThis study aimed to examine public discussions of waterpipe tobacco smoking, as well as the potential associations of different waterpipe flavors with health symptoms, using Reddit data. Study designThis is an observational infodemiology study. MethodsUsing keywords such as “waterpipe”, “hookah”, and “shisha”, Reddit posts were extracted from Reddit Archive (pushshift.io) between February 1, 2016, and December 31, 2020. Temporal analysis was used to understand the longitudinal trend of the discussions about waterpipe tobacco smoking. Topic modeling using the Latent Dirichlet Allocation (LDA) model was performed to examine the topics on waterpipe tobacco. We estimated the conditional probability of having each health problem for each given waterpipe flavor. ResultsThe discussion of waterpipe on Reddit was slowly decreasing from 2016 to 2018 and surged until May 2020. The fruit was the most popular waterpipe flavor and the neurological symptom was the most mentioned health category in waterpipe-related Reddit posts. The most popular topics included “Friends spending time together at night with waterpipe smoking”, “Playing games and smoking waterpipe at a hookah bar”, and “Discussing waterpipe flavors and related products”. Some waterpipe flavors were more associated with certain health problems than others. For example, mint/menthol flavor had a high probability to be associated with symptoms related to throat and mouth. ConclusionThis study provided longitudinal surveillance of waterpipe tobacco smoking discussed on Reddit. We showed the potential relationship between waterpipe flavors and health symptoms, which provides preliminary evidence about the potential health effects of waterpipe tobacco smoking.

2021 Year in Review: E-Cigarettes, Hookah Use, and Vaping Lung Injuries During the COVID-19 Pandemic.

Electronic cigarettes (e-cigarettes) and hookah smoking have gained tremendous popularity over the past decade. With the constantly evolving e-cigarette market and potential impact of the COVID-19 pandemic on users of these tobacco products, research is needed to assess the prevalence and safety of these devices as well as potential public health implications and cessation tools. For this year in review, PubMed was searched from January 2021-December 14, 2021, for articles related to e-cigarettes, vaping-related lung injury, and hookah smoking. Relevant articles addressing the objectives were included in this review. This review focused primarily on articles based on United States populations. Gray literature and nonpublished articles were not included in this review. The 2020 pandemic resulted in a decline in e-cigarette usage among youth (potentially due to the COVID-19 pandemic); however, recent research in 2021 suggests that e-cigarette usage is increasing again among youth. Conflicting evidence exists for e-cigarettes and the risk of COVID-19 infection, but biological plausibility suggests that e-cigarette users are more susceptible to COVID-19 infection and more severe COVID-19 infection compared to non-e-cigarette users. Hookah smoking has remained stable across the past several years and remains a primarily social activity among youth. New e-cigarette devices are constantly emerging, resulting in an increased demand to understand the safety of these devices. Additionally, hookah smoking continues to be a concerning public health issue with the increase in hookah bars and venues coupled with lack of policy regulations for hookah smoking.

Spatial Clustering of Hookah Lounges, Vape Shops, and All Tobacco Retailers Near Colleges.

US college students smoke hookah and vape nicotine at higher rates than other young adults. Density and/or proximity of hookah lounges and vape shops near colleges has been described, but this study is the first to test whether tobacco retailers spatially cluster near college campuses. We created and linked spatial shapefiles for community colleges and 4-year colleges in California with lists of hookah lounges, vape shops, and licensed tobacco retailers. We simulated 100 datasets, placing hookah lounges, vape shops, and tobacco retailers randomly in census tracts in proportion to population density. A modified version of Ripley's K-function was computed using the radius (r) from each retailer within retail category. In 2018-2019, 50.5% of hookah lounges (n = 479), 42.5% of vape shops (n = 2467), and 42.0% of all tobacco retailers (n = 31 100) were located within 3 miles of a community college. Spatial clustering was significant (p < .05) from at least 0.4 miles for hookah lounges, 0.1 mile for vape shops, and 0.3 miles for all tobacco retailers. For 4-year colleges, approximately 46.8% of hookah lounges, 31.3% of vape shops, and 31.6% of all tobacco retailers were located within 3 miles. Clustering was significant from 0.2 miles for hookah lounges and 1.3 miles for all tobacco retailers but was not significant for vape shops. Evidence that some types of tobacco retailers cluster near community colleges and 4-year colleges implies greater accessibility and exposure to advertising for students. It is also concerning because a higher probability of underage tobacco sales presumably exists near colleges. Prior studies infer that hookah lounges and vape shops cluster near colleges from the density and closer proximity to campuses. This study modified a traditional test of spatial clustering and considered community colleges separately from 4-year universities. Spatial clustering of hookah lounges and all licensed tobacco retailers was evident near both types of campuses, but vape shops clustered only near community colleges. Place-based strategies to limit tobacco retail density could expand state and local laws that prohibit tobacco sales near schools to include retailers near college campuses. In addition, college environments should be a target for reducing hookah smoking and nicotine vaping.

Particulate matter pollution in Hookah lounges in Palestine

Hookahs, or water pipes, are ornate glass bowl structures used to smoke tobacco products, often in private or public social settings. Hookah smoking is believed to have originated in ancient India in the 16th century; however, it has seen rapid global expansion over the last two decades. A number of studies using high-cost, regulatory or research grade instruments have found respirable particulate concentrations in hookah lounges up to several hundred micrograms per cubic meter. In the summer of 2018, a study was initiated examining the PM2.5 concentrations in several hookah lounges in Nablus and Tulkarm, Palestine (West Bank). However, rather than using the typical high-cost system, low-cost laser light scattering and detection systems were used. Observed PM2.5 concentrations ranged from 84 to 371 μg/m3, concentrations considered to be of notable health concerns in the indoor environment and well within the range of hookah-related particulate matter reported in the literature. Further, examination of the 10-min average temporal PM2.5 concentrations showed variable correlation with the number of active smokers and a seeming dependency on the type of building ventilation. The employed low-cost particulate systems proved capable of reliably quantifying PM2.5 levels in a variety of hookah lounges, as well as being able to characterize the temporal nature of the PM2.5 concentration changes. The results of this study suggest that these systems may be an economic and reliable alternative for particulate studies.

HOOKAH AND B&amp;H YOUTH: TOWARDS A SUBCULTURE?

The basic role of this paper is the representation of the new emerging subculture among the Bosnian youth population, and that is hookah bars. This paper presents some theoretical depictions of hookahs in popular culture, definitions of subcultural trends and the connections formulated between hookahs and subcultures, but this paper also relied on a descriptive research, a survey which analyzed the notion of whether or not hookah bars are the new subculture in Bosnia. The paper concludes that hookahs can be perceived as a phenomenon heading towards a subculture, as well as the idea that hookah bars remain a fashionable part of young people’s lives in Bosnia and Herzegovina.

Little Arabia: A California Ethnoanchor

Tucked into strip malls along Brookhurst Street are the scattered agglomeration of restaurants, markets, bakeries, butcher shops, hookah lounges, educational centers, hair salons, and clothing stores catering to groups who come from the Middle East and North Africa. Proliferating over the last twenty-five years, this Anaheim thoroughfare is colloquially known as Little Arabia. The small strip of commerce is supported by the nation’s largest Arab population residing throughout Southern California. The emergence of Little Arabia is similar to what scholars refer to as “ethnoburbs,” “invisiburbs,” and “design assimilated suburbs.” Little Arabia, however, represents something different: what this paper refers to as an “ethnoanchor.” To illustrate the descriptive utility of the ethnoanchor typology, this paper unpacks the historical, spatial, social, and political dynamics of Little Arabia to illustrate how contemporary migration patterns are influencing suburban regions, collectively illustrating the constitution of a new kind of American dream.

Compliance of Public Places in Bangalore to Anti-Smoking Laws - A CrossSectional Study

Background Killing more than eight million people per year tobacco stands as one of the greatest public health threats mankind has faced. Out of the eight million seven million are due to direct tobacco use while 1.2 million are due to second-hand exposure. According to GATS 2016-17 267 million adults in India that is 29 of all adults are tobacco users. Every fourth adult who works indoors is exposed to second-hand smoke. As per COTPA smoking is not allowed in any public place. Any hotel bar and restaurants having more than 30 rooms seats should provide a designated smoking area to allow smoking. Though COTPA mentions these rules many of the restaurantshotels are violating these putting non-smokers at greater risk by exposing them to second-hand smoke. Therefore this study was conducted to assess the compliance of DSA to the COTPA rules.Methodology A cross- sectional study was conducted from July 2021 to August 2021 in two selected areas in Bangalore ndash Jayanagara and Indiranagara. These areas were selected keeping in mind the density of population and public places in Bangalore as a greater number of required sampling units were consolidated in these two zones. After getting the required number of sampling units Bar Restaurant ClubPub Hookah Bar the field investigator was instructed to observe each of the selected unit by the transect walk method. Each field investigator identified a fixed central point in each zone and followed a survey pathway - Observing compliance to DSA and filling the applicable checklist through mobile application. This process was continued until the recommended number was obtained.Results In our study 67.1 of the surveyed facilities were restaurants followed by bars hookah bars and clubs. The no smoking signage was seen in only 29.4 of the surveyed sites. Only 9.5 of the eligible facilities had DSA among the surveyed sites. Out of these only 20 of the indoor DSA fulfilled the recommended criteria.Conclusion The survey was conducted in predominant commercial areas of Bangalore city with more specifically public places and densely populated areas. Study revealed that majority of the sites were not following COTPA recommended signages and guidelines allowing indoor smoking. Compliance to DSA was observed in only 9.5 of the eligible facilities and among this only 20 followed recommended DSA criteria. Though the COTPA legislations are present since almost two decades significant number of breaches in law were observed during the survey.

A Naturalistic Study of Carbon Monoxide, Heart Rate, Oxygen Saturation, and Perfusion Index in Hookah Lounge Patrons.

Waterpipe (also known as hookah) smokers are exposed to several toxicants, heavy metals, and carcinogens. This study assessed physiologic data from hookah bar participants in an urban area in Florida. We hypothesized that hookah lounge patrons would have a decreased [Formula: see text] and perfusion index, as well as an increased heart rate and exhaled carbon monoxide (CO) levels upon exiting the bars. Exhaled CO levels, heart rate, pulse oximetry for carboxyhemoglobin, and perfusion index were obtained immediately before entering the hookah lounges and after exiting hookah lounges on a sample size of 200 patrons attending hookah lounges. Averages were then used for Wilcoxon signed-rank tests to assess differences across means. Combining data from both hookah smokers and concurrent smokers, the mean CO measurements went from 5.7 ppm prior to lounge entry to 66.5 ppm after the lounge visit (P < .001). Conversion to carboxyhemoglobin for all hookah smokers represents an increase from 1.5% to 10.6% (P < .001). Carboxyhemoglobin mean values as measured with pulse oximetry increased from 1.4% prior to the lounge visit to 7.2% after the lounge visit (P < .001). The mean heart rate for the subjects also increased from 90.3 beats/min to 94.2 beats/min (P < .001). [Formula: see text] levels decreased from 98.4% to 97.8% (P < .001). Similarly, the mean perfusion index decreased from 3.1% to 2.7% (P = .002). Hookah lounge smokers in the United States are exposed to high levels of CO that have the potential for detrimental health effects, as evidenced by rapid negative changes in physiological parameters. Respiratory therapists should be aware of potential cardiovascular changes in hookah lounge patrons who enter emergency rooms and health facilities due to recent exposures.

An Evaluation About Hookah Lounges: Düzce Province Example

Türkiye’de artan nargile kullanımı ile birlikte nargile salonları ve nargile kafe adıyla işletmeler hızla çoğalmakta, ancak bunların tabi olduğu yasal mevzuat sebebiyle özellikle pek çok kurumun ve belediyelerin görev alanına girdiğinden tam bir koordinasyon sağlanamamaktadır. Mevcut durum ve mevzuattaki karmaşa nargile salonu işleticilerinin kurallara tabi olmadan hizmet vermelerine yol açmaktadır. Bu araştırmada, nargile salonları konusu açılış şartları, tabi olacağı kurallar bağlamında bir sağlık politikası sorunu olarak ele alınacaktır. Düzce İli örneğinden yola çıkılarak mevcut durum ve ilgili kamu çalışanlarının önerilerini sunmak amaçlanmıştır. Bu kapsamda Düzce ilinde bulunan 42 kafe denetlenmiş, denetlemelerden elde edilen sübjektif veriler odak grup toplantılarında ile değerlendirilmiş ve kurum temsilcilerinin önerileri derlenerek bir kamu politikası önerisi sunulmuştur.

Hookah venue employees’ knowledge and perceptions of hookah tobacco smoking

BackgroundRecent years showed sharp proliferation of hookah bars worldwide with scarcity of workplace safety regulations. Hookah server employees are at high risk for elevated harm. This study reported hookah smoke...

Intention to quit water pipe smoking among Iranian women: a qualitative directed content analysis

BackgroundWater-pipe smoking is the most common type of tobacco used among Iranian women. The aim of this study was to explain women’s perceptions of their intention for quitting water-pipe smoking based on the theory of planned behavior.MethodsThe study was a qualitative content analysis which was carried out over 4 months in 2016 in Tehran-Iran. The participants were 26 women ages 18 to 45-years-old who smoked water-pipe and were selected through snowball sampling. The study was performed in hookah cafes, parks, and homes. The data were collected through individual interviews. The interviews were open-ended questions based on the theory of planned behavior. Directed content analysis was used to analyze the data.ResultsFindings showed that women did not intend to quit water-pipe in that time. Main contributing factors influencing not having intention of cessation were positive attitude and false beliefs toward hookah smoking, as well as having peers and family members who smoked water-pipe or approved its use. Although most females realized the obstacles associated with hookah cessation, they believed that quitting water-pipe smoking was up to them and could control more barriers.ConclusionSocial pressure, positive attitude and false beliefs towards hookah smoking, as well as external and internal obstacles diminished women ‘s intention for cessation. Therefore, it is recommended to apply the theory of planned behavior into behavior change interventions in order to increase the intention to quit water-pipe smoking.

When, How, & Where Tobacco Initiation and Relapse Occur During U.S. Air Force Technical Training.

Military personnel are at high risk for tobacco use, particularly during the first year of military service. Technical Training follows an 8½week tobacco ban during basic military training and is a vulnerable time for personnel to both reinitiate and initiate tobacco use. Thus, this can be a crucial time to promote tobacco policies and interventions. However, there is limited research examining when, how, and where personnel access tobacco during the first year of service, particularly among users of newer products (eg, electronic cigarettes[e-cigarettes]). Thus, the purpose of the current study is to explore the timing, source, and location of tobacco use during Technical Training across all types of products. Furthermore, this study will examine differences in demographic characteristics and prior tobacco history in relationship to these tobacco behaviors. Participants were U.S. Air Force recruits completing Technical Training (2017-2018). Protocol was approved by the Institutional Review Board at the 59th Medical Wing of the U.S. Air Force. During the first week of Technical Training, Airmen were consented to participate in the study and completed a questionnaire about demographics and tobacco use history. Next, Airmen were randomized to receive one of three tobacco prevention interventions as part of military training. At a 3-month follow-up, during the last week of Technical Training, consented participants completed a questionnaire about current tobacco use. Airmen reported when (ie, first month vs. after), how (ie, "bummed" from another airman, bought on or off base, received from the internet or event), and where (ie, designated smoking areas on base, off base, bar or club, friend's house, cigar lounge, hookah bar, or vape shop) they used tobacco during Technical Training. Descriptive statistics were used to examine these behaviors across all tobacco products. Additionally, Wilcoxon-Mann-Whitney and Kruskal-Wallis tests compared differences in demographic characteristics and baseline tobacco use in relationship to these tobacco behaviors. No significant differences were found when comparing prior users and first-time users in relationship to tobacco behaviors during Technical Training; however, significant differences in educational background and age were found in regard to the source and location of tobacco use. Additionally, how and where Airmen first used tobacco during Technical Training differed across products. Cigarettes and smokeless tobacco were equally likely to be bought on or off base and most commonly first used at a designated smoking area on base. However, e-cigarettes, cigarillos/little cigars, and hookah were more likely to be bought off base, and first used at a specialty store (ie, vape shop, hookah bar, or cigar lounge). Tobacco use behaviors during Technical Training differed depending on the type of product. Specifically, new and emerging products were more likely to be bought off base and first used at a specialty store. Thus, military polices regulating on base tobacco pricing might not reduce the growing prevalence of e-cigarettes. Future policies might consider addressing the density of off-base tobacco retailers to reduce the high rates of tobacco use in this population.

Determinants of Adolescent Hookah Pipe Use: A Systematic Review

Adolescent hookah pipe use is increasing at a rapid rate, thus posing a major public health concern globally. The hookah pipe is a gateway substance to other substances that may be more harmful. Yet, at present, little is known about why adolescents are so drawn to this mechanism. It is this gap that this study attempted to fill. This study, therefore, aimed to review the determinants of adolescent hookah pipe use. An electronic search of 12 databases identified studies investigating determinants of adolescent hookah pipe use. Twenty-five studies sampling a total of 88,988 adolescents who use the hookah pipe were included. This study found that adolescent hookah pipe use is determined by an interplay of family factors, peer/friends factors, individual factors, school factors, the actual hookah pipe mechanism, advertisements, and awareness of hookah pipe lounges or bars. Prevention and early intervention strategies aimed at reducing adolescent hookah pipe use is needed.