title: Correlates of Hookah Pipe Awareness and Perceived Harmfulness Among U.S. Adults.
abstract: BACKGROUND
  Hookah smoking has recently become a common form of smoking, and its prevalence has increased worldwide. This study determined the prevalence and correlates of hookah awareness and perceived harmfulness among U.S. adults.
  
  
  METHODS
  Weighted multivariable logistic regression analyses were performed on 6,711 adults aged ≥18 years collected from the 2013-2014 Health Information National Trends Survey (Cycles 3 and 4). Analysis was conducted in 2016.
  
  
  RESULTS
  Overall, 74.3% were aware of hookah. Of these, 73.4% believed hookah pipes were equally harmful as cigarettes whereas 15.7% believed otherwise. Older (OR=0.13, 95% CI=0.09, 0.18), black (OR=0.51, 95% CI=0.38, 0.71), Hispanic (OR=0.52, 95% CI=0.37, 0.71), and less-educated (OR=0.42, 95% CI=0.27, 0.65) respondents had lower odds of being aware of hookah. Compared with non-smokers, former smokers had 83% (95% CI=1.44, 2.33) higher odds of hookah awareness. Among those aware of hookah, older (OR=0.44, 95% CI=0.31, 0.62), black (OR=0.64, 95% CI=0.43, 0.96), and less-educated (OR=0.55, 95% CI=0.33, 0.92) respondents had lower odds of perceiving hookah as less harmful than cigarettes.
  
  
  CONCLUSIONS
  Most adults in U.S. are aware of hookah, but only 15.7% believe it is less harmful than cigarettes. This small proportion are mostly young, white, and college graduates. Targeted behavioral interventions will be necessary to increase individuals' perceived risk, knowledge, and perceived harmfulness of hookah smoking.
authors.affiliation: Saint Louis University Center for Outcomes Research (SLUCOR), St. Louis, Missouri. Electronic address: kmohamm2@slu.edu.
authors.forename: Kahee A
authors.initials: KA
authors.lastname: Mohammed
authors.affiliation: Department of Biostatistics and Bioinformatics, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana.
authors.forename: Christian J
authors.initials: CJ
authors.lastname: Geneus
authors.affiliation: Saint Louis University College of Public Health and Social Justice, St. Louis, Missouri.
authors.forename: Simon
authors.initials: S
authors.lastname: Yadgir
authors.affiliation: Saint Louis University Center for Outcomes Research (SLUCOR), St. Louis, Missouri.
authors.forename: Divya S
authors.initials: DS
authors.lastname: Subramaniam
authors.affiliation: Saint Louis University Center for Outcomes Research (SLUCOR), St. Louis, Missouri.
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Burroughs
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D000075387:Smoking Water Pipes; D012959:Socioeconomic Factors; D014481:United States; D055815:Young Adult