Hookah Smoking: Assessing College Students' Behaviors, Attitudes, and Knowledge

Purpose: The objective of this study was to assess college students' behaviors, attitudes, and knowledge regarding hookah smoking.Methods: A convenience sample of 200 students from various majors, including allied health and nursing students, was used to conduct this study at a university located in the Midwestern United States. Respondents were asked about any past, current, and future hookah smoking behaviors. Likert-scale questions were used to assess attitudes regarding hookah smoking. Respondents were also asked ten questions regarding the history of and health effects of hookah smoking. A knowledge score was calculated based on the number of questions answered correctly. Survey data were analyzed using independent sample t-tests and a one-way ANOVA test at a significance level of p<0.05.Results: A total of 200 out of 204 surveys were returned, yielding an overall response rate of 98%. Sixty-eight percent of respondents reported having participated in hookah smoking, with time of first-time use ranging from 14 to 21 years of age. About one third of the respondents (32%) reported participating in hookah smoking in the previous 30 days. The majority (68%)of respondents estimated that they would not participate in hookah smoking in five years time. Over half of the respondents reported that it is socially acceptable to participate in hookah smoking and 43% reported that hookah smoking has relaxation benefits. The overall mean knowledge score regarding the health effects of hookah usage was 4.4 questions correct out of 10. There was a significant difference (p=.038) in the mean knowledge scores between hookah users (4.70) and non-users (3.81). When comparing the knowledge of allied health and nursing majors to all other majors, the allied health and nursing group scored significantly higher (p=.017) than the non-allied health and nursing majors, with mean scores of 4.80 and 3.81, respectively. Thirty-nine percent of the respondents were unaware that hookah tobacco and related smoke can cause oral cancer.Conclusion: Based on the high rates of college student use and the low knowledge scores, this study supports need for more education about hookah smoking and its health consequences.