Tobacco and nicotine products are more commonly use among sexual minority (SM; lesbian, gay, and bisexual) individuals than those who identify as heterosexual. Use of hookah (waterpipe tobacco smoking) has also been growing in popularity due to its candy and fruit flavors and the belief that hookah tobacco smoking is safer than traditional cigarette smoking. The 2013-2014 PATH study found that around 4.0% of heterosexual individuals report hookah smoking while 11.3% of gay/lesbian adults and 12.5% of bisexual adults report hookah smoking. Hookah use is a growing concern among the SM population as SM individuals have been shown to have a 60% to more than two times greater risk of concurrent substance use compared to heterosexual individuals. Therefore, this study compares concurrent substance use among SM adult current hookah smokers and their heterosexual counterparts.
The study’s sample consisted of data from SM and heterosexual individuals who participated in W1 (2013-2014) and W2 (2014-2015) of the PATH study. Participants were asked to report sex, sexual orientation, age, education, race/ethnicity, and income level. A mental health scale was also used to assess perceived mental health status among respondents. Lastly, participants were asked about past 30 day hookah use, use of other tobacco products, and use of other substances (cannabis, alcohol, stimulants, painkillers/sedatives, cocaine, methamphetamine, and other drugs). Data was analyzed using logistic regression models.
Results of the data analysis showed that current hookah use was higher among SM individuals than heterosexual individuals. In addition perceived mental health ratings were significantly lower and perceived past week emotional problems were higher among SM hookah users compared to heterosexual hookah users. SM hookah users also had a significantly higher prevalence of alcohol, cannabis, stimulant, and pain killer/sedative/tranquilizer use than heterosexuals. Among those age 18-24, SM hookah users had higher odds of reporting cannabis and pain killer/sedative/tranquilizer use as compared to their heterosexual counterparts.
Takeaway: Among young adult hookah smokers, those who identify as sexual minority may have higher risk of concurrent cannabis and pain killer/sedative/tranquilizer use as compared to their heterosexual counterparts.