Hookah smoking in young adults: It's all in the attitude

Background: Hookah smoking is a form of smoking tobacco that mainly serves as a social outlet for young adults. The prevalence of hookah smoking is on the rise and brings with it a preponderance of health issues including shortness of breath, carbon monoxide toxicity and nicotine exposure. Methods: Mixed methods research was implemented during the fall semester 2011 at the University of Tampa (UT). A survey, guided by the theory of reasoned action, was disseminated to the students(n=746). Twenty four intercept interviews took place on campus composing of a diverse student body of both hookah smokers and nonsmokers that helped to inform the survey response options. Results: Sixty three percent of students identified peer influence as their decision on whether or not to smoke hookah in the future and subsequently, 26.2% of students believed that their family were influential over their hookah smoking practices. Three hundred and fifty eight students (48.5%) stated that the social activity was a very important factor resulting from hookah smoking. Factor analysis revealed five underlying attitudinal factors contributing to intention to smoke. “College life” and “Thrill” had the highest correlation with intention to smoke hookah. Conclusion: Understanding influencers and latent attitudinal factors related to hookah smoking may provide direction for health promotion campaigns as many young adults are unaware of the potential dangers that are associated with hookah smoking. Colleges should consider emphasizing alternative activities and events in attempt to preclude young adults from smoking hookah.