title: Correlates of hookah use and predictors of hookah trial in U.S. young adults.
abstract: BACKGROUND
  Hookah, or waterpipe, tobacco smoking has increased among young adults (YAs) in the U.S., but few prospective studies have examined predictors of hookah use. The current study examined correlates of hookah use and predictors of hookah initiation at a 6-month follow-up in a nationally representative, prospective sample of U.S. YAs.
  
  
  METHODS
  Data were drawn from a subset of participants aged 18-24 years at study entry from two waves of the Legacy Young Adult Cohort Study. Wave 5 was completed in July 2013 by 1,555 participants and 74% (n=1,150) completed follow-up 6 months later in January 2014. Weighted bivariate and multivariable analyses were conducted in June 2014 to estimate the prevalence and correlates of ever and past 30-day hookah use and to examine associations between baseline covariates and hookah initiation 6 months later.
  
  
  RESULTS
  At baseline (Wave 5), almost 25% of the sample had ever used hookah and 4% reported past 30-day use. Alcohol, marijuana, and cigarette use were more prevalent among ever and past 30-day hookah users than among never users. Eight percent of never users at baseline reported trying hookah at the 6-month follow-up. Significant predictors of hookah trial in a multivariable model included college enrollment; alcohol, marijuana, and cigarette use; and perceptions that hookah is less harmful than cigarettes.
  
  
  CONCLUSIONS
  Results highlight rapid transitions in hookah use and several risk factors for initiation. Future studies should examine how these factors could be used as intervention targets to reduce tobacco use in this vulnerable age group.
authors.affiliation: Schroeder Institute for Tobacco Research and Policy Studies, Legacy, Washington, District of Columbia; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. Electronic address: avillanti@legacyforhealth.org.
authors.forename: Andrea C
authors.initials: AC
authors.lastname: Villanti
authors.affiliation: Schroeder Institute for Tobacco Research and Policy Studies, Legacy, Washington, District of Columbia.
authors.forename: Caroline O
authors.initials: CO
authors.lastname: Cobb
authors.affiliation: Schroeder Institute for Tobacco Research and Policy Studies, Legacy, Washington, District of Columbia.
authors.forename: Amy M
authors.initials: AM
authors.lastname: Cohn
authors.affiliation: Department of Research and Evaluation, Legacy, Washington, District of Columbia.
authors.forename: Valerie F
authors.initials: VF
authors.lastname: Williams
authors.affiliation: Department of Research and Evaluation, Legacy, Washington, District of Columbia; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Rath
mesh_terms: D000293:Adolescent; D000428:Alcohol Drinking / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008385:Marijuana Smoking / Q000453:epidemiology; D015999:Multivariate Analysis; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*; D000066608:Underage Drinking / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D055815:Young Adult