title: Trajectories of Hookah Use: Harm Perceptions from Youth to Young Adulthood.
abstract: OBJECTIVE
  Hookah use has increased in United States, especially among young adults. This study investigates the role of harm perceptions of hookah use over a 2-year period in a nationally representative sample of youth and young adults as they transition to young adulthood.
  
  
  METHODS
  Using a probability-based, nationally representative, longitudinal cohort of youth aged 15-21, we analyzed the 7536 participants who completed all 4 waves. Ordered logit growth models examined changes over time in hookah use, and whether that relationship varies by baseline harm perceptions.
  
  
  RESULTS
  Results show that age, sex, parental education, race, and smoking status are significant predictors of hookah use. Additionally, those who perceive hookah as "less harmful" than cigarettes have the highest probability of current hookah use over time, compared to those with more accurate harm perceptions.
  
  
  CONCLUSIONS
  This study helps confirm the influence of harm perceptions of hookah tobacco on hookah use among youth and young adults. Increased public education efforts aimed at youth and young adults can help shift knowledge, attitudes and beliefs regarding the health consequences of hookah use.
authors.affiliation: Vice President, Evaluation Science and Research at Truth Initiative, Washington, DC;, Email: ehair@truthinitiative.org.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Hair
authors.affiliation: Managing Director, Evaluation Science and Research at Truth Initiative Washington, DC.
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Rath
authors.affiliation: Research Analyst, Evaluation Science and Research at Truth Initiative, Washington, DC.
authors.forename: Lindsay
authors.initials: L
authors.lastname: Pitzer
authors.affiliation: Senior Research Assistant, Evaluation Science and Research at Truth Initiative, Washington, DC.
authors.forename: Brittany
authors.initials: B
authors.lastname: Emelle
authors.affiliation: Project Manager, Schroeder Institute at Truth Initiative, Washington, DC.
authors.forename: Ollie
authors.initials: O
authors.lastname: Ganz
authors.affiliation: Senior Research Associate, Evaluation Science and Research at Truth Initiative, Washington, DC.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Halenar
authors.affiliation: Managing Director, Evaluation Science and Research at Truth Initiative, Washington, DC.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Cantrell
authors.affiliation: Chief Evaluation Science and Research Officer at Truth Initiative.
authors.forename: Donna
authors.initials: D
authors.lastname: Vallone
mesh_terms: D000293:Adolescent; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D000075387:Smoking Water Pipes; D064424:Tobacco Use / Q000009:adverse effects*; D014481:United States; D055815:Young Adult