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Correlates of Hookah Pipe Awareness and Perceived Harmfulness Among U.S. Adults

Published:December 15, 2016DOI:https://doi.org/10.1016/j.amepre.2016.10.032

      Introduction

      Hookah smoking has recently become a common form of smoking, and its prevalence has increased worldwide. This study determined the prevalence and correlates of hookah awareness and perceived harmfulness among U.S. adults.

      Methods

      Weighted multivariable logistic regression analyses were performed on 6,711 adults aged ≥18 years collected from the 2013–2014 Health Information National Trends Survey (Cycles 3 and 4). Analysis was conducted in 2016.

      Results

      Overall, 74.3% were aware of hookah. Of these, 73.4% believed hookah pipes were equally harmful as cigarettes whereas 15.7% believed otherwise. Older (OR=0.13, 95% CI=0.09, 0.18), black (OR=0.51, 95% CI=0.38, 0.71), Hispanic (OR=0.52, 95% CI=0.37, 0.71), and less-educated (OR=0.42, 95% CI=0.27, 0.65) respondents had lower odds of being aware of hookah. Compared with non-smokers, former smokers had 83% (95% CI=1.44, 2.33) higher odds of hookah awareness. Among those aware of hookah, older (OR=0.44, 95% CI=0.31, 0.62), black (OR=0.64, 95% CI=0.43, 0.96), and less-educated (OR=0.55, 95% CI=0.33, 0.92) respondents had lower odds of perceiving hookah as less harmful than cigarettes.

      Conclusions

      Most adults in U.S. are aware of hookah, but only 15.7% believe it is less harmful than cigarettes. This small proportion are mostly young, white, and college graduates. Targeted behavioral interventions will be necessary to increase individuals’ perceived risk, knowledge, and perceived harmfulness of hookah smoking.
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      References

        • Maziak W.
        • Taleb Z.B.
        • Bahelah R.
        • et al.
        The global epidemiology of waterpipe smoking.
        Tob Control. 2015; 24: i3-i12https://doi.org/10.1136/tobaccocontrol-2014-051903
        • Akl E.A.
        • Gaddam S.
        • Gunukula S.K.
        • Honeine R.
        • Jaoude P.A.
        • Irani J.
        The effects of waterpipe tobacco smoking on health outcomes: a systematic review.
        Int J Epidemiol. 2010; 39: 834-857https://doi.org/10.1093/ije/dyq002
        • Jukema J.B.
        • Bagnasco D.E.
        • Jukema R.A.
        Waterpipe smoking: not necessarily less hazardous than cigarette smoking. Possible consequences for (cardiovascular) disease.
        Neth Heart J. 2014; 22: 91-99https://doi.org/10.1007/s12471-013-0501-0
        • Aslam H.M.
        • Saleem S.
        • German S.
        • Qureshi W.A.
        Harmful effects of shisha: literature review.
        Int Arch Med. 2014; 7: 16https://doi.org/10.1186/1755-7682-7-16
        • Sterling K.L.
        • Mermelstein R.
        Examining hookah smoking among a cohort of adolescent ever smokers.
        Nicotine Tob Res. 2011; 13: 1202-1209https://doi.org/10.1093/ntr/ntr146
        • Grekin E.R.
        • Ayna D.
        Waterpipe smoking among college students in the United States: a review of the literature.
        J Am Coll Health. 2012; 60: 244-249https://doi.org/10.1080/07448481.2011.589419
        • Primack B.A.
        • Shensa A.
        • Kim K.H.
        • et al.
        Waterpipe smoking among U.S. university students.
        Nicotine Tob Res. 2013; 15: 29-35https://doi.org/10.1093/ntr/nts076
        • Grinberg A.
        Subjective well-being and hookah use among adults in the United States: a nationally-representative sample.
        Drug Alcohol Depend. 2015; 153: 242-249https://doi.org/10.1016/j.drugalcdep.2015.05.020
        • Salloum R.G.
        • Thrasher J.F.
        • Kates F.R.
        • Maziak W.
        Water pipe tobacco smoking in the United States: findings from the National Adult Tobacco Survey.
        Prev Med. 2015; 71: 88-93https://doi.org/10.1016/j.ypmed.2014.12.012
        • McMillen R.
        • Maduka J.
        • Winickoff J.
        Use of emerging tobacco products in the United States.
        J Environ Public Health. 2012; 2012https://doi.org/10.1155/2012/989474
        • Aljarrah K.
        • Ababneh Z.Q.
        • Al-Delaimy W.K.
        Perceptions of hookah smoking harmfulness: predictors and characteristics among current hookah users.
        Tob Induc Dis. 2009; 5: 16https://doi.org/10.1186/1617-9625-5-16
        • Heinz A.J.
        • Giedgowd G.E.
        • Crane N.A.
        • et al.
        A comprehensive examination of hookah smoking in college students: use patterns and contexts, social norms and attitudes, harm perception, psychological correlates and co-occurring substance use.
        Addict Behav. 2013; 38: 2751-2760https://doi.org/10.1016/j.addbeh.2013.07.009
        • Nuzzo E.
        • Shensa A.
        • Kim K.H.
        • et al.
        Associations between hookah tobacco smoking knowledge and hookah smoking behavior among U.S. college students.
        Health Educ Res. 2013; 28: 92-100https://doi.org/10.1093/her/cys095
        • Smith-Simone S.
        • Maziak W.
        • Ward K.D.
        • Eissenberg T.
        Waterpipe tobacco smoking: knowledge, attitudes, beliefs, and behavior in two U.S. samples.
        Nicotine Tob Res. 2008; 10: 393-398https://doi.org/10.1080/14622200701825023
        • Wackowski O.A.
        • Delnevo C.D.
        Young adults’ risk perceptions of various tobacco products relative to cigarettes: results from the National Young Adult Health Survey.
        Health Educ Behav. 2016; 43: 328-336https://doi.org/10.1177/1090198115599988
        • Westat
        Health Information National Trends Survey 4 (HINTS 4) Cycle 4 Methodology Report.
        Westat, for the National Cancer Institute, Rockville, MD2015
        • Westat
        Health Information National Trends Survey 4 (HINTS 4) Cycle 3 Methodology Report.
        Westat, for the National Cancer Institute, Rockville, MD2014
        • Nelson D.E.
        • Kreps G.L.
        • Hesse B.W.
        • et al.
        The Health Information National Trends Survey (HINTS): development, design, and dissemination.
        J Health Commun. 2004; 9 (discussion 481-444): 443-460
        • King B.A.
        • Alam S.
        • Promoff G.
        • Arrazola R.
        • Dube S.R.
        Awareness and ever-use of electronic cigarettes among U.S. adults, 2010-2011.
        Nicotine Tob Res. 2013; 15: 1623-1627https://doi.org/10.1093/ntr/ntt013
        • Pearson J.L.
        • Richardson A.
        • Niaura R.S.
        • Vallone D.M.
        • Abrams D.B.
        e-Cigarette awareness, use, and harm perceptions in U.S. adults.
        Am J Public Health. 2012; 102: 1758-1766https://doi.org/10.2105/AJPH.2011.300526
        • Zhu S.H.
        • Gamst A.
        • Lee M.
        • Cummins S.
        • Yin L.
        • Zoref L.
        The use and perception of electronic cigarettes and snus among the U.S. population.
        PLoS One. 2013; 8: e79332https://doi.org/10.1371/journal.pone.0079332
        • Calvanese A.V.
        • Bingham M.V.
        • Martinasek M.P.
        • Friesen B.K.
        Understanding attitudes, beliefs, and information seeking regarding hookah smoking in parents of college students: an exploratory qualitative pilot study.
        Respir Care. 2015; 60: 959-966https://doi.org/10.4187/respcare.03726
        • Baumann A.W.
        • Kohler C.
        • Kim Y.I.
        • et al.
        Differences in electronic cigarette awareness, use history, and advertisement exposure between Black and White hospitalized cigarette smokers.
        J Cancer Educ. 2015; 30: 648-654https://doi.org/10.1007/s13187-014-0767-y
        • Barnett T.E.
        • Smith T.
        • He Y.
        • et al.
        Evidence of emerging hookah use among university students: a cross-sectional comparison between hookah and cigarette use.
        BMC Public Health. 2013; 13: 302https://doi.org/10.1186/1471-2458-13-302
        • Cavazos-Rehg P.A.
        • Krauss M.J.
        • Kim Y.
        • Emery S.L.
        Risk factors associated with hookah use.
        Nicotine Tob Res. 2015; 17: 1482-1490https://doi.org/10.1093/ntr/ntv029
        • Ambrose B.K.
        • Rostron B.L.
        • Johnson S.E.
        • et al.
        Perceptions of the relative harm of cigarettes and e-cigarettes among U.S. youth.
        Am J Prev Med. 2014; 47: S53-S60https://doi.org/10.1016/j.amepre.2014.04.016