Policy Implications and Research Recommendations: A Review of Hookah Use Among US College Students
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The rate of Hookah use among college students during the last decade is about 30%. Although college students perceive hookah use as a safer alternative to conventional cigarettes, hookah use increases the risk of disease and nicotine dependence, and therefore remains an area of concern. Presently, the US Food and Drug Administration (FDA) has little regulation for the manufacture, distribution, or sale of hookah. This review attempts to assess empirical literature relating to hookah use while focusing on the consequences for regulatory policy. PubMed (including MEDLINE 2010–2017), PsycINFO, EBSCO, Scopus (Elsevier) databases were examined to pinpoint articles published in English. The following terms were used in the searches: Hookah or Waterpipe or nargile or “arghile” or “shisha” or “hubble bubble” or “alternative tobacco product” or “flavored tobacco”. Hookah use may initiate smoking among tobacconaïve college students. College students who use hookah are generally not aware of the increased risks for tobacco related diseases as it relates to their behavior. In addition, few public health messages target college-age adults with anti-hookah messages. A lack of information regarding the dangers and potential harms of hookah use may be misinterpreted as a sign of “safety” which inadvertently may imply a suggestion of no need for safety measures. Hence, a research agenda that would inform about health policy actions has been proposed.
KeywordsHookah Shisha Waterpipe Co-occurring substance use Marijuana Hookah and other drug use
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Conflict of interest
All authors declare that they have no conflicts of interest.
- 3.Berg, C. J., Stratton, E., Schauer, G. L., Lewis, M., Wang, Y., Windle, M., & Kegler, M. (2015). Perceived harm, addictiveness, and social acceptability of tobacco products and marijuana among young adults: Marijuana, hookah, and electronic cigarettes win. Substance Use & Misuse, 50(1), 79–89.CrossRefGoogle Scholar
- 6.Conway, K. P., Green, V. R., Kasza, K. A., Silveira, M. L., Borek, N., Kimmel, H. L., … Reissig, C. J. (2017). Co-occurrence of tobacco product use, substance use, and mental health problems among adults: Findings from Wave 1 (2013–2014) of the Population Assessment of Tobacco and Health (PATH) Study. Drug and Alcohol Dependence, 177, 104–111CrossRefPubMedPubMedCentralGoogle Scholar
- 9.Gilreath, T. D., Leventhal, A., Barrington-Trimis, J. L., Unger, J. B., Cruz, T. B., Berhane, K. … Pentz, M. A. (2015). Patterns of alternative tobacco product use: Emergence of hookah and E-cigarettes as preferred products amongst youth. Journal of Adolescent Health, 58, 181–185CrossRefPubMedGoogle Scholar
- 12.Grigsby, T. J., Forster, M., Soto, D. W., & Unger, J. B. (2017). Changes in the strength of peer influence and cultural factors on substance use initiation between late adolescence and emerging adulthood in a Hispanic sample. Journal of Ethnicity in Substance Abuse, 16(2), 137–154.CrossRefPubMedGoogle Scholar
- 14.Heinz, A. J., Giedgowd, G. E., Crane, N. A., Veilleux, J. C., Conrad, M., Braun, A. R., … Kassel, J. D. (2013). A comprehensive examination of hookah smoking in college students: Use patterns and contexts, social norms and attitudes, harm perception, psychological correlates and co-occurring substance use. Addictive Behaviors, 38(11), 2751–2760.CrossRefPubMedGoogle Scholar
- 19.MacLean, R. R., Pincus, A. L., Smyth, J. M., Geier, C. F., & Wilson, S. J. (2017). Extending the balloon analogue risk task to assess naturalistic risk taking via a mobile platform. Journal of Psychopathology & Behavioral Assessment, 40, 1–10.Google Scholar
- 28.Robinson, J. N., Wang, B., Jackson, K. J., Donaldson, E. A., & Ryant, C. A. (2017). Characteristics of hookah tobacco smoking sessions and correlates of use frequency among US adults: Findings from Wave 1 of the Population Assessment of Tobacco and Health (PATH) Study. Nicotine & Tobacco Research, https://doi.org/10.1093/ntr/ntx060.CrossRefGoogle Scholar
- 36.Trinidad, D. R., Pierce, J. P., Sargent, J. D., White, M. M., Strong, D. R., Portnoy, D. B., … Shi, Y. (2017). Susceptibility to tobacco product use among youth in wave 1 of the population Assessment of tobacco and health (PATH) study. Preventive Medicine, 101, 8–14.CrossRefPubMedPubMedCentralGoogle Scholar
- 37.World Health Organization. (2013). WHO report on the global tobacco epidemic, 2013: Enforcing bans on tobacco advertising, promotion and sponsorship. Geneva: World Health Organization.Google Scholar