Adriana Pérez1, Arnold E Kuk2, Meagan A Bluestein3, Melissa B Harrell4, Cheryl L Perry5, Baojiang Chen6. 1. Department of Biostatistics and Data Science, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health Austin Campus, Austin, TX 78701, USA; Michael & Susan Dell Center for Healthy Living, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health Austin Campus, Austin, TX 78701, USA. Electronic address: adriana.perez@uth.tmc.edu. 2. Michael & Susan Dell Center for Healthy Living, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health Austin Campus, Austin, TX 78701, USA. Electronic address: Arnold.e.kuk@uth.tmc.edu. 3. Michael & Susan Dell Center for Healthy Living, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health Austin Campus, Austin, TX 78701, USA. Electronic address: Melissa.B.Harrell@uth.tmc.edu. 4. Michael & Susan Dell Center for Healthy Living, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health Austin Campus, Austin, TX 78701, USA; Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health Austin Campus, Austin, TX 78701, USA. Electronic address: Melissa.B.Harrell@uth.tmc.edu. 5. Department of Health Promotion and Behavioral Sciences at the University of Texas Health Science Center at Houston (UTHealth), School of Public Health Austin Campus, Austin, TX 78701, USA. Electronic address: Cheryl.L.Perry@uth.tmc.edu. 6. Department of Biostatistics and Data Science, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health Austin Campus, Austin, TX 78701, USA; Michael & Susan Dell Center for Healthy Living, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health Austin Campus, Austin, TX 78701, USA. Electronic address: Baojiang.Chen@uth.tmc.edu.
Abstract
OBJECTIVE: This study reports the prospectively estimated age of initiation of susceptibility to, ever, past 30-day, and fairly regular hookah use. DESIGN: Secondary data analyses of the first four waves (2013-2017) of the PATH study, a nationally representative longitudinal cohort study of US youth (ages 12-17). METHODS: Youth who were never hookah users at their first wave of participation were identified (n = 16,678; N = 31,136,834). Four outcomes were analyzed, age of first report of: (i) susceptibility to use, (ii) ever use, (iii) past 30-day use, and (iv) fairly regular hookah use. The age of hookah initiation of each outcome was estimated. Weighted interval censoring survival analyses and Cox regression models were conducted to estimate the age of initiation of each hookah use outcome, and to estimate differences in age of initiation by sex and by race, respectively. RESULTS: Around 11% of youth were classified as susceptible to hookah use by 13 years of age, 8% reported initiating ever hookah use by age 17, almost 10% reported initiating past 30-day hookah use by age 19, and 3% reported initiating fairly regular hookah use by age 20. Females and Hispanics were at higher risk of becoming susceptible to and ever hookah use at earlier ages compared to males and Non-Hispanic White youth. CONCLUSION: Education, communication campaigns, and proven culturally targeted tobacco interventions that reach youth at ages before they first become susceptible or start using hookah use are needed to prevent the onset of hookah use among vulnerable youth.
OBJECTIVE: This study reports the prospectively estimated age of initiation of susceptibility to, ever, past 30-day, and fairly regular hookah use. DESIGN: Secondary data analyses of the first four waves (2013-2017) of the PATH study, a nationally representative longitudinal cohort study of US youth (ages 12-17). METHODS: Youth who were never hookah users at their first wave of participation were identified (n = 16,678; N = 31,136,834). Four outcomes were analyzed, age of first report of: (i) susceptibility to use, (ii) ever use, (iii) past 30-day use, and (iv) fairly regular hookah use. The age of hookah initiation of each outcome was estimated. Weighted interval censoring survival analyses and Cox regression models were conducted to estimate the age of initiation of each hookah use outcome, and to estimate differences in age of initiation by sex and by race, respectively. RESULTS: Around 11% of youth were classified as susceptible to hookah use by 13 years of age, 8% reported initiating ever hookah use by age 17, almost 10% reported initiating past 30-day hookah use by age 19, and 3% reported initiating fairly regular hookah use by age 20. Females and Hispanics were at higher risk of becoming susceptible to and ever hookah use at earlier ages compared to males and Non-Hispanic White youth. CONCLUSION: Education, communication campaigns, and proven culturally targeted tobacco interventions that reach youth at ages before they first become susceptible or start using hookah use are needed to prevent the onset of hookah use among vulnerable youth.
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