What are young adults smoking in their hookahs? A latent class analysis of substances smoked

Abstract

Rationale Hookah smoking continues to be a popular form of tobacco use, especially among college students. Although hookahs are commonly used to smoke tobacco, anecdotal evidence suggests other substances, including herbal shisha, marijuana and hashish may be used. However, little is known about the variety of substances smoked in hookahs, or correlates associated with different substances smoked. Methods In fall 2010, 3,447 students from 8 colleges in N.C. completed an online survey. Results 44% of students reported ever smoking tobacco from a hookah. Of those ever users, 90% reported smoking flavored tobacco in a hookah, 45% marijuana, 37% herbal (non-tobacco) shisha, and 18% hashish. Latent class analysis revealed two distinct classes. The most prevalent class (77%) primarily smoked flavored tobacco, with minimal use of herbal shisha and marijuana and virtually no use of hashish. The second class (23%) primarily smoked marijuana, hashish and flavored tobacco with moderate use of herbal shisha. Logistic regression analysis adjusting for clustering within-schools revealed that males, illicit drug users, daily, nondaily and former cigarette smokers and those whose mothers had higher levels of education were significantly more likely to be in the second class compared to the first. Conclusions Rates of lifetime use of hookah were high in our sample of college students. While the majority of hookah users smoked tobacco in hookahs, they also smoked other substances, notably marijuana and herbal shisha. Prevention efforts should recognize that students are using hookahs to smoke a variety of substances.

Subjective well-being and hookah use among adults in the United States: A nationally-representative sample

“…", might have been too restrictive in capturing all who have tried use hookah. Previous studies have found that other substances besides tobacco are smoked using a water-pipe, including marijuana (Smith-Simone, et al, 2008;Sutfin et al, 2014). Thus, people who smoke non-tobacco substances with a water pipe might have responded "no" to the question.…”

Emerging adulthood themes and hookah use among college students in Southern California

“…However, past-month measures of tobacco use are in line with prior research among emerging adults (Allem, Soto, Baezconde-Garbanati, & Unger, 2013; Allem, Soto, Baezconde-Garbanati, & Unger 2015a; Allem, Soto, Baezconde-Garbanati, & Unger, 2015b). Emerging adults generally report smoking flavored tobacco in a hookah, however some use other substances such as marijuana (Sutfin, Song, Reboussin, &, Wolfson, 2014). The present study did not determine whether participants placed tobacco, or some other substance, in their hookah over the past month.…”

Assessing and Predicting Susceptibility to Waterpipe Tobacco Use Among College Students

“…For example, future waterpipe use was predicted by past 30 day marijuana use and higher scores on sensation seeking. 36 Youth higher in sensation seeking may find the sensory aspect of waterpipe (e.g., flavoring of tobacco) within the social context of use, especially appealing. Moreover, they may be persuaded unduly by ads that highlight novel and sensory experiences.…”