title: Hookah use among college students: prevalence, drug use, and mental health.
abstract: BACKGROUND
  There is consistent evidence that hookah use is as, if not more, harmful than cigarette use. Yet, hookah users underestimate the potential deleterious effects of hookah use. This study examined the rates of hookah use and associated demographic characteristics in a sample of undergraduates at a small Northeastern university. This study also examined the relationships between hookah use and other substance use, mental health problems, and perceived levels of stress.
  
  
  METHODS
  Data were drawn from the Spring 2009 American Health Association-National College Health Assessment (ACHA-NCHA) at one small, Northeastern university (N=1799). The relationships between hookah use and other substance use, mental health problems, and perceived stress levels were examined using logistic regression analyses.
  
  
  RESULTS
  Hookah use (in the past month) was reported among 14.1% (253/1799) of this sample of undergraduates. Hookah users were more likely to use other substances, including cigarettes, cannabis, alcohol, cocaine, and amphetamines. The strongest associations emerged between hookah use and alcohol and cigarette use. There were no significant associations found between hookah use and any mental health problems or perceived stress levels.
  
  
  CONCLUSIONS
  Hookah users are significantly more likely to use other substances, including alcohol, cigarettes, cannabis, cocaine, and amphetamines compared with non-hookah users. In contrast to cigarette smoking, hookah use does not appear to be associated with mental health problems or perceived stress levels in this sample of undergraduates. Further investigation into the prevalence and correlates of hookah use is needed in representative population samples.
authors.affiliation: Department of Psychology, Queens College and The Graduate Center, City University of New York (CUNY), Flushing, NY 11367, USA; Department of Epidemiology, Mailman School of Public Health, New York, NY, USA. Electronic address: renee.goodwin@qc.cuny.edu.
authors.forename: Renee D
authors.initials: RD
authors.lastname: Goodwin
authors.affiliation: Department of Psychology, Queens College and The Graduate Center, City University of New York (CUNY), Flushing, NY 11367, USA.
authors.forename: Alice
authors.initials: A
authors.lastname: Grinberg
authors.affiliation: Department of Psychology, Queens College and The Graduate Center, City University of New York (CUNY), Flushing, NY 11367, USA; Department of Epidemiology, Mailman School of Public Health, New York, NY, USA.
authors.forename: Jack
authors.initials: J
authors.lastname: Shapiro
authors.affiliation: Department of Psychology, Columbia University, New York, NY, USA.
authors.forename: Diana
authors.initials: D
authors.lastname: Keith
authors.affiliation: Health Promotion and Student Health Department, Columbia University, New York, NY, USA.
authors.forename: Michael P
authors.initials: MP
authors.lastname: McNeil
authors.affiliation: Department of Psychology, Queens College and The Graduate Center, City University of New York (CUNY), Flushing, NY 11367, USA.
authors.forename: Farah
authors.initials: F
authors.lastname: Taha
authors.affiliation: Department of Psychology, Queens College and The Graduate Center, City University of New York (CUNY), Flushing, NY 11367, USA.
authors.forename: Bianca
authors.initials: B
authors.lastname: Jiang
authors.affiliation: Department of Psychology, Columbia University, New York, NY, USA; Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA.
authors.forename: Carl L
authors.initials: CL
authors.lastname: Hart
mesh_terms: D000293:Adolescent; D015897:Comorbidity; D055030:Drug Users / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*; D013334:Students / Q000523:psychology / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014495:Universities; D055815:Young Adult
keywords: Drug use; Epidemiology; Mental health; Tobacco