While rates of cigarette use among college students have decreased, hookah use is on the rise, with estimates ranging from 20 to 40 percent for lifetime use, to 5 to 20 percent for current use. Dr. Tracey Barnett, an associate professor in the department of epidemiology in the University of Florida College of Public Health and Health Professions and the College of Medicine, has conducted several studies of usage rates and trends of alternative tobacco products among Florida teens and college students.
In a recent study, published online ahead of print in the journal Public Health, Ms. Gail Castañeda, a doctoral student studying with Dr. Barnett, and colleagues examined positive and negative beliefs and attitudes about hookah smoking during a series of focus groups with college-aged hookah users.
“It’s important to study hookah use from a generational perspective, given youth are the population with the highest prevalence of use,” Dr. Barnett said. “Understanding their reasons for use is imperative for building targeted intervention or prevention efforts.”
In their conversations with 40 young adults aged 18 to 24, the UF team identified nine major themes in hookah smoking’s appeal to young adults: autonomy, personalization, novelty, convenience, global orientation, entertainment, collaboration, health and social network value.
Several specific aspects of hookah smoking were attractive to young adults, including the ability to personalize the experience with flavored tobacco, the atmosphere of hookah lounges, partaking in a foreign cultural custom, hookah’s acceptability within their social networks, convenience and affordability.
Many users also reported that they believed hookah use was non-addictive, a healthier alternative to cigarette smoking and a transient behavior that was a part of their college experience. Campus health promotion efforts should try to dispel students’ myths about hookah being safer or healthier than cigarette smoking, the researchers said.
“Moreover, anti-hookah smoking health education initiatives should be reinforced by policy efforts aiming to include hookah smoking in all current smoke-free ordinances,” the authors write. “The lack of policies restricting hookah smoking indoors has exacerbated misconceptions regarding hookah smoking’s safety, and hookah bar establishments continue to remain exempt from clean indoor air legislation.”
The project was funded by a grant from the National Cancer Institute. Study authors also included Dr. Eric Soule, a postdoctoral research fellow at the Virginia Commonwealth University Center for the Study of Tobacco Products, and Dr. Mary Ellen Young, a clinical professor in the UF department of occupational therapy.