Analysis of State-Specific Prevalence, Regional Differences, and Correlates of Hookah Use in U.S. Adults, 2012-2013.
OBJECTIVE
To investigate the state-specific prevalence, regional differences, and correlates of hookah use among U.S. adults.


METHODS
We analyzed the most recent nationally representative data of adults from the National Adult Tobacco Survey (NATS) 2012-2013 (n = 60192). State-specific prevalence of lifetime and current hookah use was calculated and mapped. Multivariate logistic regression was performed to determine the association between sociodemographic characteristics, regional differences, and hookah use.


RESULTS
Among U.S. adults (≥18 years), overall prevalence of lifetime hookah use was 12.3%, while current use was 3.9%. Mapping of state-specific prevalence revealed that the West tended to have higher rates of use, while the South tended to have lower ones. In the adjusted model, we observed that current hookah use was positively associated with younger adults, males, non-Hispanic adults, those with higher education and income statuses, being single, those living in the West, and current cigarette use.


CONCLUSIONS
The prevalence of hookah use varies by state, region, and sociodemographic characteristics among adults. Future research, including longitudinal studies, are needed to identify geographic and sociodemographic characteristics and trends among hookah users, investigate hookah-related health outcomes, and evaluate targeted public health efforts aimed at this emerging threat.


CONCLUSIONS
This study investigates state-level prevalence, regional differences, and sociodemographic characteristics of hookah use among U.S. adults, using the most recent NATS. Hookah use was positively associated with younger adults and those living in the West. This study adds to the understanding of the geographic and sociodemographic factors underlying hookah use, which can be used to develop much needed evidence-based regulations and programs that are responsive to the needs of different risk groups.
Department of Pediatrics, New York University School of Medicine, New York, NY.
Su Hyun
SH
Park
Department of Population Health, New York University School of Medicine, New York, NY.|College of Global Public Health, New York University, New York, NY.
Dustin T
DT
Duncan
Department of Population Health, New York University School of Medicine, New York, NY.|New York University in Abu Dhabi, Public Health Research Center, Abu Dhabi, UAE.
Omar El
OE
Shahawy
Department of Population Health, New York University School of Medicine, New York, NY.|College of Global Public Health, New York University, New York, NY.|New York University in Abu Dhabi, Public Health Research Center, Abu Dhabi, UAE.
Jenni A
JA
Shearston
Department of Pediatrics, New York University School of Medicine, New York, NY.|Brooklyn College, New York, NY.
Lily
L
Lee
Department of Population Health, New York University School of Medicine, New York, NY.
Kosuke
K
Tamura
Department of Population Health, New York University School of Medicine, New York, NY.|College of Global Public Health, New York University, New York, NY.|New York University in Abu Dhabi, Public Health Research Center, Abu Dhabi, UAE.
Scott E
SE
Sherman
Department of Pediatrics, New York University School of Medicine, New York, NY.|College of Global Public Health, New York University, New York, NY.|New York University in Abu Dhabi, Public Health Research Center, Abu Dhabi, UAE.|Department of Environmental Medicine, New York University, New York, NY.
Michael
M
Weitzman
D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003710:Demography; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D016540:Smoking Cessation / Q000379:methods; D014481:United States; D000073867:Water Pipe Smoking / Q000453:epidemiology*; D055815:Young Adult