Determinants of hookah use among high school students

Area of Science:

• Public Health
• Adolescent Health
• Tobacco Control

Background:

• Hookah use is rising among youth, yet data on high school populations are scarce.
• This study investigates hookah initiation, prevalence, cessation, and psychosocial risk factors in adolescents.

Purpose of the Study:

• To assess the prevalence and patterns of hookah use among high school students.
• To identify psychosocial risk factors associated with hookah use initiation and maintenance.
• To examine perceptions of harm and social acceptability of hookah compared to other tobacco products.

Main Methods:

• A cross-sectional survey was conducted among 689 high school students in San Diego County.
• Data were collected on hookah use history, initiation sources, and perceptions of harm and social acceptability.
• Statistical analyses compared characteristics of ever-users, current users, and former users.

Main Results:

• Hookah ever-use was 26.1%, with 10.3% current use.
• Friends and hookah lounges were primary sources of initiation.
• Students perceived hookah as more socially acceptable and less harmful than cigarettes, cigars, and smokeless tobacco.
• Ever-users and current users were more likely to have smoked cigarettes, know of local hookah lounges, and perceive hookah as safer and more socially acceptable.

Conclusions:

• Hookah use is increasingly normalized among adolescents, influenced by risk perception.
• The proximity of hookah lounges is associated with higher hookah use rates in high school students.
• Regulation of hookah lounges should be considered to mitigate adolescent use.