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College students report positive attitudes about hookah use, are uncertain about health risks of hookah

A new study explored knowledge and attitudes about hookah and hookah use among U.S. college students. Participants (n = 403) were undergraduate students at one Midwestern university. This sample was a convenience sample; 78% of participants were White and 58% were male. Participants completed an anonymous survey about their knowledge and perceptions of hookah use, attitudes toward hookah use, substance use in the past 30 days, lifetime hookah use, and demographic characteristics. Experts in survey research and substance use helped to establish the content validity of this instrument. Initial results indicated 54% (n = 217) of participants reported lifetime hookah use and 9% (n = 36) reported past-30-day use. 148 participants reported they had used hookah at least once since beginning college. Regarding knowledge of risks, 82% believed hookah pipes could spread infections and 77% believed hookah carried the same risks as smoking; however, 70% believed hookah was a “safe alternative” to cigarettes. Leading attitudes about hookah were that it was enjoyable, it helped to cope with stress, and hookah users were more likely to use cigarettes. Participants reported their top perceived reasons for using hookah were using at parties with friends, to have fun, and because peers used hookah. Chi-square tests were used to examine the relationship between lifetime hookah use and knowledge, while a multivariate analysis of variance (MANOVA) was conducted to investigate relationships among lifetime use, attitudes, and perceived reasons for use. Results of the Chi-square analysis indicated there was no significant difference between knowledge and lifetime use (p = 0.134). MANOVA analyses found lifetime hookah use was significantly associated with attitudes (p < 0.001), as well as reasons for hookah use (p < 0.001).

Take away: In this sample, students perceived hookah use as socially acceptable and perceptions of the health risks associated with hookah use were mixed. Positive attitudes toward hookah were significantly associated with lifetime hookah use.

Fevrier, B., Nabors, L., Vidourek, R.A. & King, K.A. (2018). Hookah use among college students: Recent use, knowledge of health risks, attitude and reasons for use. Journal of Community Health [published online ahead of print April 25, 2018] doi: 10.1007/s10900-018-0519-8

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