Hookah Smoking Among College Students: Factors Associated With a Trendy Risk Behavior

Thursday, 21 July 2016

Susan M. Norris, PhD, MSN, MA, BSN, BA, RN
Rutgers University School of Nursing-Camden, Camden, NJ, USA

Purpose:

The purpose of this research was to investigate hookah smoking behaviors and beliefs among college students.  More specifically, the study examined the practice of hookah smoking in college students ages 18-24 years, and tested hypothesized relationships between hookah use and perceptions, attitudes, subjective norms and trait sensation seeking.  

Adolescence and young adulthood are critical times for developing lifelong healthy habits.  Although cigarette use has declined, Hookah (waterpipe) use among youth is rapidly increasing in prevalence, with 10-20% of US adolescents and young adults reporting use in the previous month. Health risks are similar to cigarette smoking, yet hookah is perceived as safer and healthier, and typically occurs in a social setting. Little is known about factors associated with hookah smoking in this population.  

Methods:

A descriptive correlational research design was implemented.  A convenience sample was recruited from a large university in the United States.  A sample of 74 subjects returned completed surveys, including a socio-demographic form, a 43-item hookah questionnaire and the sensation seeking scale.  

Results:

The majority of the participants were female (n=58, 78.4%); mean age 21 (SD= 1.38); 54.8 % Caucasian, 16.4 % Hispanic, 15.1 % African American, 13.7 % Asian American. Two-thirds (66.7%) of the subjects reported ever using hookah; 6.8% reported use during the previous month.  Males and females reported lifetime use at similar rates (67.2% male, 68.8% female).  Subject data was grouped into ever users and never users. Ever users reported more positive attitudes (X2= 3.86, df=1, p=.05), lower perceived harm (X2=19.79, df=6, p=.003), higher social acceptability (subjective norms, t=2.652, df=64, p=.01) and more sensation seeking behaviors (t=4.622, df=72, p=.000).  Correlational analysis demonstrated relationships between the frequency of hookah use and social acceptability (r=.523, p=.000), lower perceived harm (r=-.346, p=.003) and sensation seeking (r=.44, p=.000).

Conclusion:

Findings contribute to the knowledge base regarding the perceptions and practice of hookah smoking in this population. Misconceptions present a risk to youth who are unaware of potential consequences. The significant differences found between ever smokers and never smokers and the significant correlations between frequency and perceptions underscore a need to consider psychosocial factors in research and implementation. This study can inform efforts to design effective strategies to reduce the likelihood of youths engaging in hookah smoking.