title: Hookah and Alcohol Use among Young Adult Hookah Smokers: A Mixed Methods Study.
abstract: OBJECTIVE
  Hookah tobacco smoking has grown steadily in popularity among young adults in the United States. Little attention has been given to the relationship between hookah smoking and another behavior that is common among young adults - alcohol use. The purpose of this study was to examine hookah and alcohol use among young adults.
  
  
  METHODS
  Forty young adult hookah smokers (55% female) participated in focus group sessions on hookah use beliefs and a brief survey examining hookah and alcohol use including drinking alcohol before, during, or after smoking hookah.
  
  
  RESULTS
  Quotes from the focus groups indicated that alcohol use may promote hookah use among individuals who have little or no hookah smoking experience. Alcohol use, binge drinking, and alcohol use before, during, and after hookah use were common among the participants regardless of legal drinking age status. Nearly half of the participants preferred to drink alcohol while smoking hookah due to the improved physical and social effects they associated with combining the 2 behaviors.
  
  
  CONCLUSIONS
  For some young adult hookah smokers, alcohol appears to enhance the hookah smoking experience and may play a role in hookah smoking initiation. Future research and interventions should address the association between hookah and alcohol use.
authors.affiliation: Virginia Commonwealth University, Department of Psychology, Center for the Study of Tobacco Products, Richmond, VA, USA. eksoule@vcu.edu.
authors.forename: Eric K
authors.initials: EK
authors.lastname: Soule
authors.affiliation: University of Florida, Department of Behavioral Science and Community Health, Gainesville, FL, USA.
authors.forename: Tracey E
authors.initials: TE
authors.lastname: Barnett
authors.affiliation: University of Maryland, School of Public Health, College Park, MD, USA.
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Curbow
authors.affiliation: University of Florida, Department of Behavioral Science and Community Health, Gainesville, FL, USA.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Moorhouse
authors.affiliation: George Mason University, Department of Global and Community Health, Fairfax, VA, USA.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Weiler
mesh_terms: D000428:Alcohol Drinking / Q000453:epidemiology*; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D012907:Smoking / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D055815:Young Adult