INTRODUCTION: While cross-sectional studies have shown that hookah tobacco smoking (HTS) is an increasingly popular behavior among university students, little is known about factors associated with initiation. This study sought to determine associations between knowledge, attitudes, and normative beliefs and initiation of HTS among university students. METHODS: Data were from a prospective longitudinal cohort study of 569 randomly selected first- and second-year university students. Online questionnaires that were developed in accordance with our composite theoretical model were completed in September 2010 and April 2011. RESULTS: About one-seventh (13%) of participants initiated HTS by follow-up. Positive attitudes and favorable normative beliefs were associated with increased adjusted odds of initiation (AOR = 4.12, 95% CI = 2.56, 6.59; and AOR = 2.01, 95% CI = 1.35, 2.99, respectively), while negative attitudes were associated with decreased adjusted odds (AOR = 0.62, 95% CI = 0.48, 0.80). Correct knowledge regarding toxicants associated with HTS was not significantly associated with initiation. CONCLUSIONS: While positive attitudes and favorable normative beliefs are associated with initiation of HTS in a cohort of never-users, increased knowledge about toxins is not associated with lower initiation. It may be particularly valuable for educational interventions to attempt to alter positive attitudes and normative beliefs related to HTS.
INTRODUCTION: While cross-sectional studies have shown that hookah tobacco smoking (HTS) is an increasingly popular behavior among university students, little is known about factors associated with initiation. This study sought to determine associations between knowledge, attitudes, and normative beliefs and initiation of HTS among university students. METHODS: Data were from a prospective longitudinal cohort study of 569 randomly selected first- and second-year university students. Online questionnaires that were developed in accordance with our composite theoretical model were completed in September 2010 and April 2011. RESULTS: About one-seventh (13%) of participants initiated HTS by follow-up. Positive attitudes and favorable normative beliefs were associated with increased adjusted odds of initiation (AOR = 4.12, 95% CI = 2.56, 6.59; and AOR = 2.01, 95% CI = 1.35, 2.99, respectively), while negative attitudes were associated with decreased adjusted odds (AOR = 0.62, 95% CI = 0.48, 0.80). Correct knowledge regarding toxicants associated with HTS was not significantly associated with initiation. CONCLUSIONS: While positive attitudes and favorable normative beliefs are associated with initiation of HTS in a cohort of never-users, increased knowledge about toxins is not associated with lower initiation. It may be particularly valuable for educational interventions to attempt to alter positive attitudes and normative beliefs related to HTS.
Authors: Brian A Primack; Ariel Shensa; Kevin H Kim; Mary V Carroll; Mary T Hoban; E Victor Leino; Thomas Eissenberg; Kathleen H Dachille; Michael J Fine Journal: Nicotine Tob Res Date: 2012-05-28 Impact factor: 4.244
Authors: Isaac M Lipkus; Thomas Eissenberg; Rochelle D Schwartz-Bloom; Alexander V Prokhorov; Janet Levy Journal: Nicotine Tob Res Date: 2011-04-06 Impact factor: 4.244
Authors: Brian A Primack; Kristen R Rice; Ariel Shensa; Mary V Carroll; Erica J DePenna; Rima Nakkash; Tracey E Barnett Journal: Am J Prev Med Date: 2012-02 Impact factor: 5.043
Authors: Jens Schubert; Jürgen Hahn; Gerhard Dettbarn; Albrecht Seidel; Andreas Luch; Thomas G Schulz Journal: Toxicol Lett Date: 2011-06-25 Impact factor: 4.372
Authors: Jaime E Sidani; Ariel Shensa; Maharsi R Naidu; Jonathan G Yabes; Brian A Primack Journal: Cancer Epidemiol Biomarkers Prev Date: 2017-01-12 Impact factor: 4.254
Authors: Sarah E Adkison; Richard J O'Connor; Maansi Bansal-Travers; K Michael Cummings; Vaughan W Rees; Dorothy K Hatsukami Journal: Nicotine Tob Res Date: 2015-07-17 Impact factor: 4.244
Authors: MeLisa R Creamer; Alexandra Loukas; Xiaoyin Li; Keryn E Pasch; Kathleen Case; Brittani Crook; Cheryl L Perry Journal: Drug Alcohol Depend Date: 2016-09-11 Impact factor: 4.492