title: Hookah Use Predicts Cigarette Smoking Progression Among College Smokers.
abstract: BACKGROUND
  Hookah use is increasingly common among U.S. college students, but little is known regarding the relationship between hookah and cigarette use. The purpose of this study was to test the hypothesis that the added nicotine exposure from hookah use may accelerate the uptake of cigarettes.
  
  
  METHODS
  An ethnically diverse sample of college students (n = 256; 43% female) who had smoked cigarettes in the past month completed 2 in-person interviews over 6 months. This study was a secondary analysis of data collected for a longitudinal study of young adult cigarette smoking patterns. Analyses examined 6-month changes in past 30 day cigarettes smoked and number of days smoking, controlling for age, nicotine dependence, marijuana use, and the respective baseline variable for each outcome.
  
  
  RESULTS
  Current hookah use (any use in past 30 days) was endorsed by 34% of participants at baseline, while 94% reported lifetime use. Change in past 30 day number of cigarettes (p = .043) and number of smoking days (p = .040) differed significantly between those who did or did not report recent hookah use at baseline. Hookah users reported a greater number of cigarettes smoked at the 6-month follow-up, while nonusers decreased their smoking quantity. For number of smoking days in the past 30, hookah users reported a smaller decrease than nonusers.
  
  
  CONCLUSIONS
  Recent hookah use predicted increased cigarette smoking over 6 months in a college sample. These are the first prospective data demonstrating this relationship, indicating the value of developing strategies to prevent hookah use among college students.
authors.affiliation: Department of Psychiatry, University of California, San Diego, CA; Mental Health Care Line, VA San Diego Healthcare System, San Diego, CA; nmdoran@ucsd.edu.
authors.forename: Neal
authors.initials: N
authors.lastname: Doran
authors.affiliation: San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA; VA Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA.
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Godfrey
authors.affiliation: Department of Psychiatry, University of California, San Diego, CA; Mental Health Care Line, VA San Diego Healthcare System, San Diego, CA;
authors.forename: Mark G
authors.initials: MG
authors.lastname: Myers
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology*; D013334:Students; D014029:Tobacco Use Disorder / Q000209:etiology*; D014481:United States / Q000453:epidemiology; D014495:Universities; D055815:Young Adult