The prevalence of hookah use among college students is increasing. However, while one hookah session can expose an individual to over 40 times the amount of smoke compared to smoking a cigarette, the health consequences associated with hookah use are not widely known. Researchers aimed to determine if college students are aware of the tobacco and nicotine content in hookah, and how their knowledge and perceptions influence their hookah use. Undergraduate students age 18-29 years old (N = 5451) completed online surveys. Students were asked about their hookah and other tobacco/nicotine use and intensity of use during the last 30 days. They were also asked to report whether or not they think hookah contains tobacco and nicotine, as well as their perceptions of hookah’s harmfulness and addictiveness. About half of the students reported ever using hookah, while 16.8% reported current (past 30 days) hookah use. Current users were more likely to be younger and used a greater number of other tobacco products. Of the sample, 26.9% reported hookah does not contain tobacco, and 38.1% reported hookah does not contain nicotine. Non-current users were more likely to believe hookah did not contain tobacco, while no difference between users and non-users was found with regard to nicotine. Findings of this study indicate that college students’ knowledge that hookah contains tobacco is associated with increased odds of current hookah use, while greater perceptions of harm were associated with decreased odds of current use and lower intensity of use. The results indicated there was no association between knowledge of nicotine or perceptions of addictiveness and hookah use, although increased perceptions of addictiveness were associated with higher intensity among users.
Take away: Given that almost 40% of students did not know that hookah contains nicotine and almost 30% did not know it contains tobacco, college prevention programs and warning labels are needed that include messages to educate both college users and non-users of hookah contents and health consequences.