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Hookah Use and Myths Among Young Adults


Ask young adults whether hookah smoking is harmful to their health, and the majority say no. This belief and others are among some hookah myths that persist among young users, according to a new study. Other recent research also highlights trends among young adult smokers.

Hookah study #1
In a study conducted in Southern California by a team from the University of California Los Angeles (UCLA), a total of 91 young adults (mean age, 24) were interviewed in hookah lounges. The researchers found that:

  • 57 percent said hookah smoking was not hurting their health
  • 60 percent said they smoked hookah to be social
  • 24 percent said they had smoked hookah before age 18
  • 73.6 percent smoked hookah more than once a week
  • 35 percent believed that the fruit flavors used in the tobacco actually were detoxifiers and made the tobacco harmless
  • 16 percent said hookah tobacco does not contain nicotine and is not addictive

These findings, including the misinformation concerning health issues and hookah smoking, are of concern to healthcare providers. Mary Rezk-Hanna, the study’s lead researchers and a UCLA nursing doctoral student, noted that since use of hookahs is increasing, especially among young people, “our goal was to identify factors influencing perceptions, attitudes and preferences toward hookah smoking.” Hopefully this effort will be helpful in developing “effective prevention and intervention strategies that target young-adult hookah smokers.”

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Hookah study #2
In another new study, investigators looked at hookah smoking among US high school students. Eighteen percent of the 5,540 high school seniors questioned said they had used hookah within the past year. Overall, the hookah users:

  • Were more likely to be white than black
  • Had parents who were well educated
  • Had a weekly income of more than $50 per week from a part-time job or $11 to $50 weekly from other sources
  • Were most likely to be hookah smokers if they also smoked cigarettes

Hookah study #3
The population in this study consisted of 1,799 college students at a small Northeastern university. Among the factors of interest to the authors were the relationships between use of hookah and other substances, perceived stress levels, and mental health issues.
Here’s what they found:

  • 14.1 percent (253 individuals) said they had used hookah within the past month
  • Students who used hookah were more likely to also smoke cigarettes or marijuana or to use alcohol, cocaine, and/or amphetamines. However, the strongest association was between use of hookah, alcohol, and cigarettes.
  • The authors did not find any significant relationship between using hookah and mental health issues or perceived stress levels

The bottom line
Hookah smoking is gaining in popularity among young people. In addition to misconceptions about the dangers of this habit, individuals who use hookah also tend to use other harmful substances, which can compound the negative impact. Some people smoke marijuana or herbal shisha in hookahs as well.

In April of this year, the Food and Drug Administration took its first step toward regulating currently unregulated tobacco products, which includes hookahs and e-cigarettes. The potential impact of such a step or others to educate the public about the risks of hookah use are yet to be realized.

Goodwin RD et al. Hookah use among college students: prevalence, drug use, and mental health. Drug and Alcohol Dependence 2014 Aug 1; 141:16-20
Palamar JJ et al. Hookah use among US high school seniors. Pediatrics 2014 Jul 7. Epub ahead of print
Rezk-Hanna M et al. Hookah smoking among young adults in Southern California. Nursing Research 2014; 63(4): 300