Hookah use among U.S. college students: results from the National College Health Assessment II.
BACKGROUND
Tobacco use is the leading cause of morbidity and mortality in the United States. Hookah use is a growing tobacco trend among young adults; yet little is known about how young adult college student hookah smokers differ from nonsmokers or cigarette smokers.


METHODS
Results from 18- to 24-year-old participants in the Fall 2008-Spring 2009 National College Health Assessment II (N = 82,155) were used in multinomial logistic regression models to compare nonsmokers, cigarette-only smokers, hookah-only smokers, and dual (cigarette and hookah) users.


RESULTS
Ten percent of the sample reported hookah use in the last 30 days. Compared with nonsmokers, cigarette, hookah, and dual users were more likely to be younger, male, White, and use other substances (including alcohol). Compared with nonsmokers, hookah and dual users were more likely to be members of fraternities/sororities (odds ratio [OR] = 1.17 and 1.14, respectively), live in the West (OR = 1.49 and 1.31, respectively), and attend larger institutions. Compared with cigarette-only smokers, hookah and dual users were more likely to be younger, male, live on campus, live in the West, attend large institutions, and were less likely to attend public institutions. Compared with cigarette-only smokers, hookah-only users were more likely to be non-White and less likely to use marijuana or other drugs.


CONCLUSIONS
Hookah-only and dual users are demographically different than cigarette-only or nonsmoking college students. Interventions for tobacco use on college campuses should address the demographic differences among tobacco users (including polysubstance use) and attempt to recruit students as entering freshman to provide education and prevent hookah use uptake.
Translational Tobacco Reduction Research Program, WV Prevention Research Center and Mary Babb Randolph Cancer Center, Department of Community Medicine, West Virginia University, 1 Medical Center Drive, PO Box 9190, Morgantown, WV 26505, USA. tjarrett@hsc.wvu.edu
Traci
T
Jarrett
John
J
Blosnich
Cindy
C
Tworek
Kimberly
K
Horn
D000293:Adolescent; D003625:Data Collection; D003710:Demography; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D012737:Sex Factors; D012907:Smoking / Q000208:ethnology / Q000639:trends*; D013334:Students / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D014495:Universities; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult