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. 2015 Dec;17(12):1482-90.
doi: 10.1093/ntr/ntv029. Epub 2015 Feb 2.

Risk Factors Associated With Hookah Use

Patricia A Cavazos-Rehg  1 , Melissa J Krauss  2 , Yoonsang Kim  3 , Sherry L Emery  3
Affiliations

Risk Factors Associated With Hookah Use

Patricia A Cavazos-Rehg et al. Nicotine Tob Res. 2015 Dec.

Abstract

Background: Potential harms associated with hookah smoking are largely unrecognized and it is emerging as a trendy behavior. To help inform policy and preventive interventions, we used responses from a population survey of US adults to examine risk factors associated with hookah involvement.

Method: An online survey of 17 522 US adults was conducted in 2013. The nationally representative sample was drawn from GfK Group's KnowledgePanel plus off-panel recruitment. Multinomial logistic regression was used to examine the relationships between tobacco use patterns across multiple products (cigarettes, cigars, and dissolvables), perceived harms towards regular pipe/hookah use, and demographic characteristics with hookah involvement (never used, ever used with/without reusing intent).

Result: Nearly one in five (16%) of the respondents had smoked hookah at least once in their life ("ever users"). Ever users of hookah were at higher risk of having used cigarettes, cigars, and dissolvable tobacco products (all P < .01). Odds for hookah use were greater for those who perceived regular pipe/hookah use as less dangerous (P < .05). Odds for hookah involvement were higher among young adults (P < .001), individuals with higher educational attainment (P < .01), and Hispanics/Latinos (P < .05).

Conclusions: Information about the public health harms associated with hookah smoking should be delivered to individuals at-risk for hookah smoking. It is likely that misconceptions about the safety of hookah smoking could be driving, at least in-part, its increase in popularity.

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Figures

Figure 1.
Figure 1.
The distribution of hookah use without reusing intent and with reusing intent differed significantly by cigarette use (Rao-Scott chi-square = 443.5, df = 6, P < .0001), cigar use (Rao-Scott chi-square = 855.4, df = 4, P < .0001), and use of dissolvable products (Rao-Scott chi-square = 285.9, df = 2, P < .0001).
Figure 2.
Figure 2.
The distribution of hookah use without intent to use again and with intent to use again differed significantly by age (Rao-Scott chi-square = 717.7, df = 10, P < .0001), gender (Rao-Scott chi-square = 41.9, df = 2, P < .0001), race (Rao-Scott chi-square 66.1, df = 6, P < .0001), and education level (Rao-Scott chi-square = 77.1, df = 4, P < .0001).
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