Samir Soneji1,2,3, Kristin E Knutzen2, Shannon Gravely4, Tara Elton-Marshall5,6,7, James Sargent1,2, Elizabeth Lambert8, Nahla Hilmi8,9, Eva Sharma10, Kia J Jackson11, Baoguang Wang11, Joelle Robinson11, Pete Driezen4, Michelle Bover Manderski12, Maansi Bansal-Travers13, Andrew Hyland13, Mark Travers13, Duck-Hye Yang10, Rui Dang14, Geoffrey T Fong12,15,16. 1. Dartmouth-Hitchcock Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA. 2. Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, NH, USA. 3. Department of Health Behavior, University of North Carolina, Chapel Hill, NC, USA. 4. Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada. 5. Social and Epidemiological Research Department, Centre for Addiction and Mental Health, London, Ontario, Canada. 6. Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada. 7. Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. 8. Division of Epidemiology, Services and Prevention Research, National Institute on Drug Abuse, Bethesda, MD, USA. 9. Kelly Government Solutions, Rockville, MD, USA. 10. Westat, Rockville, MD, USA. 11. Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA. 12. Center for Tobacco Studies, School of Public Health, Rutgers, State University of New Jersey, Piscataway, NJ, USA. 13. Department of Health Behavior, Division of Cancer Prevention and Population Sciences, Roswell Park Comprehensive Cancer Center, Buffalo, New York, NY, USA. 14. University of Information Science and Technology, Ohrid, North Macedonia. 15. Ontario Institute for Cancer Research, Toronto, Ontario, Canada. 16. School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.
Abstract
BACKGROUND AND AIMS: The prevalence of hookah smoking has increased in the United States since at least 2010, especially among youth and young adults. This study assessed self-reported reasons for hookah smoking cessation and transition to or maintenance of high-frequency hookah smoking among current hookah smokers. DESIGN: Separately analyzed data from the Population Assessment of Tobacco and Health (PATH) study, a longitudinal cohort study. Frequency of and reasons for hookah smoking were ascertained at wave 1 (2013-14); frequency of hookah smoking and past-year cessation were ascertained at wave 2 (2014-15). Weighted multivariable logistic and ordinal logistic regression models were fitted to predict hookah smoking cessation and frequency of hookah smoking at wave 2, respectively, accounting for demographic and behavioral risk factors, reasons for hookah smoking and frequency of hookah smoking at wave 1. SETTING: United States. PARTICIPANTS: A total of 693 youth and 4400 adult past-year hookah smokers. MEASUREMENTS: Self-reported tobacco-use patterns and associated health behaviors were measured via audio computer-assisted self-interviews (ACASI). FINDINGS: At wave 1, 5.9% of youth and 7.5% of adults were past-year hookah smokers. Among all age groups, the leading reasons for hookah smoking were enjoyment of socializing while smoking, the availability of appealing flavors and believing that it was less harmful than cigarette smoking. The odds of cessation were lower for adults who liked hookah flavors [adjusted odds ratio (aOR) = 0.40; 95% confidence interval (CI) = 0.26-0.62] compared with adults who did not like hookah flavors. The odds of transitioning to, or maintaining, monthly or more frequent hookah smoking at wave 2, compared with cessation or less than monthly smoking, were higher for adults who liked hookah flavors [adjusted proportional odds ratio (aPOR) = 2.10; 95% CI = 1.48-2.99 and enjoyed socializing while smoking hookah (aPOR = 1.82; 95% CI =1.13-2.94) compared with adults who did not like hookah flavors or socializing. CONCLUSION: The availability of appealing flavors, affordability and socialization while smoking hookah in the United States are associated with reduced likelihood of cessation and increased likelihood of high-frequency hookah smoking.
BACKGROUND AND AIMS: The prevalence of hookah smoking has increased in the United States since at least 2010, especially among youth and young adults. This study assessed self-reported reasons for hookah smoking cessation and transition to or maintenance of high-frequency hookah smoking among current hookah smokers. DESIGN: Separately analyzed data from the Population Assessment of Tobacco and Health (PATH) study, a longitudinal cohort study. Frequency of and reasons for hookah smoking were ascertained at wave 1 (2013-14); frequency of hookah smoking and past-year cessation were ascertained at wave 2 (2014-15). Weighted multivariable logistic and ordinal logistic regression models were fitted to predict hookah smoking cessation and frequency of hookah smoking at wave 2, respectively, accounting for demographic and behavioral risk factors, reasons for hookah smoking and frequency of hookah smoking at wave 1. SETTING: United States. PARTICIPANTS: A total of 693 youth and 4400 adult past-year hookah smokers. MEASUREMENTS: Self-reported tobacco-use patterns and associated health behaviors were measured via audio computer-assisted self-interviews (ACASI). FINDINGS: At wave 1, 5.9% of youth and 7.5% of adults were past-year hookah smokers. Among all age groups, the leading reasons for hookah smoking were enjoyment of socializing while smoking, the availability of appealing flavors and believing that it was less harmful than cigarette smoking. The odds of cessation were lower for adults who liked hookah flavors [adjusted odds ratio (aOR) = 0.40; 95% confidence interval (CI) = 0.26-0.62] compared with adults who did not like hookah flavors. The odds of transitioning to, or maintaining, monthly or more frequent hookah smoking at wave 2, compared with cessation or less than monthly smoking, were higher for adults who liked hookah flavors [adjusted proportional odds ratio (aPOR) = 2.10; 95% CI = 1.48-2.99 and enjoyed socializing while smoking hookah (aPOR = 1.82; 95% CI =1.13-2.94) compared with adults who did not like hookah flavors or socializing. CONCLUSION: The availability of appealing flavors, affordability and socialization while smoking hookah in the United States are associated with reduced likelihood of cessation and increased likelihood of high-frequency hookah smoking.
Authors: Laura R Stroud; George D Papandonatos; Eva Sharma; Nancy C Jao; Samantha Goldman; Chrystal Vergara-Lopez; Lori A J Scott-Sheldon Journal: Addict Behav Date: 2021-11-26 Impact factor: 3.913