Larger and private colleges and universities seem to attract hookah cafes and lounges, but smoke-free policies decrease these odds, according to findings published in the American Journal of Preventive Medicine this month.
That may bode well for the long-term health of college-age students.
Waterpipe smoking, more commonly known as hookah, boasts enticing flavors and a healthier reputation, increasing its popularity among college students. It is estimated that more than 10 percent of U.S. college students are current users.
However, recent evidence refutes claims that hookah is less harmful than cigarettes. According to the Centers for Disease Control and Prevention, hookah contains many of the same harmful toxins as cigarette smoke and has been associated with lung cancer, respiratory illness, low birth weight and periodontal disease.
A greater density of hookah establishments may promote hookah smoking, as higher numbers of tobacco retailers have been associated with higher levels of cigarette smoking, according to the research team, which included Florida faculty members Dr. Fredrick Kates, a clinical assistant professor in the College of Public Health and Health Professions’ department of health services research, management and policy, and Dr. Ramzi Salloum, an assistant professor in the College of Medicine’s department of health outcomes and policy, along with researchers at Florida International University, the University of South Carolina and the University of Michigan.
“Waterpipe smoking establishments are almost entirely unregulated, and there is very little information available on the industry’s expansion,” Dr. Salloum said. “Given the industry’s appeal for young adults and its efforts to target this age demographic, since many of them are under the legal drinking age, it is crucial to document hookah establishments’ proximity to colleges and universities and note the impact smoke-free campus policies can have.”
The researchers identified 1,690 establishments nationwide that offered waterpipe smoking in the fall of 2014 using online directories, compared with an estimated 725 outlets in a study from 2010. This total likely underestimates the number of actual establishments, since not all of them are listed in online directories, which included Yelp, Hookah-Hookah, the Better Business Bureau and Hoover’s directories. Although the methods for calculating the numbers in these two studies differ, it appears the industry is rapidly expanding.
Among the 1,454 colleges and universities with residential student populations greater than 250 around the country, 554, or 38 percent, had at least one establishment that offered hookah within 3 miles, and 719, or 50 percent, had at least one within 9 miles. When examining differences by the size of the institution, 75 percent of institutions with more than 20,000 full-time students had at least one establishment within 3 miles, compared with 30 percent of institutions with fewer than 2,500 students. In addition, hookah establishments were almost twice as likely to be located near private institutions compared with public institutions.