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Stress and risk for hookah use among African-American college students

African American youth and young adults have very high rates of tobacco use. Alternative routes of using tobacco, such as hookah, play a big role in these statistics. A recent study used data from the fall 2012 American College Health Association-National College Health Assessment to observe trends in the relationship between stress and hookah use among African American students.


The data collected showed that about 25% of African American students had used hookah, and about a third of those students had done so in the past 30 days. Within this sample of students, over half of them had used alcohol in the past 30 days, 15.6% had used marijuana, and 10.6% had used other tobacco products. Twice as many hookah users, compared to non-users, used alcohol. Hookah users were more likely to use marijuana and other tobacco products as well.


Interestingly, gender, international student status, Greek affiliation, year in school, institutional characteristics, and employment status did not have an affect on hookah use. However, when examining stress levels and hookah use, stressors such as finances, academics, and family problems were the most strongly linked to use. A higher proportion of hookah users reported that they had trouble handling these stressors in the past 12 months compared to non-users.


This study shows that universities could focus intervention efforts towards younger students, those who experience high amounts of stress, and those who use other substances. Availability of hookah is also a concern, so creating awareness of the risks associated with its use could be a key strategy in deterring students from using hookah.


Take Away: Hookah use is associated with alcohol and other drug use, as well as difficulty handling stress among African American college students.


Cunningham-Williams, R.M., Jones, B.D., Butler-Barnes, S.T., et al. (2018). Stress, stressors, and substance use: Differential risk for hookah use among African American college students. Journal of Ethnicity in Substance Abuse. doi.org/10.1080/15332640.2018.1511492

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