Social context of smoking hookah among college students: scale development and validation

To develop an instrument that measures the social context of hookah use among college students.

A pool of 50 potential items, based on 44 in-depth interviews with regular college hookah smokers, was administered to a sample of 274 hookah users between October and December 2011.

Participants were approached in hookah bars and asked to complete the survey.

A principle components analysis revealed 3 reliable factors: social facilitation, family/cultural influence, and alternative to smoking cigarettes and drinking. These were examined across different categories of hookah use: Weekly hookah users were more likely to smoke in a context of social facilitation than the other 2 groups. Similar effects were observed for family/cultural influence. Asians were more likely to smoke in a context of family and cultural influence than non-Asians.

This scale has potential for identifying situation-specific contexts of hookah use that may help in designing effective interventions for college students.