Hookah use as a predictor of other tobacco product use: A longitudinal analysis of Texas college students

• Published in: Addictive behaviors Vol. 87; pp. 131 - 137
• Main Authors: Case, Kathleen R., Creamer, MeLisa R., Cooper, Maria R., Loukas, Alexandra, Perry, Cheryl L.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-12-2018; Elsevier Science Ltd
• Subjects: Adolescent; Adult; Cigar Smoking - epidemiology; Cigar Smoking - psychology; Cigarette Smoking - epidemiology; Cigarette Smoking - psychology; Cigarettes; College students; Colleges & universities; Data processing; Demographics; Electronic cigarettes; Female; Hookah; Humans; Impulsive Behavior; Longitudinal Studies; Male; Nicotine; Personality; Prevalence; Risk Factors; Risk taking; Smoking; Students - statistics & numerical data; Texas - epidemiology; Tobacco; Tobacco products; Universities; Vaping - epidemiology; Vaping - psychology; Water Pipe Smoking - epidemiology; Water Pipe Smoking - psychology; Young Adult; Texas; United States > US; College students; Tobacco products; Electronic cigarettes; Hookah
• ISSN: 0306-4603; 1873-6327
• DOI: 10.1016/j.addbeh.2018.06.028

Hookah use is particularly prevalent among U.S. college students; however, few studies have investigated whether hookah use is a risk factor for the initiation of other tobacco products. This study examined whether hookah use predicted subsequent initiation of other combustible tobacco products (conventional cigarettes and cigar products) and Electronic Nicotine Delivery Systems (ENDS) among Texas college students during a 2.5-year study period.
This study involved a longitudinal analysis of data from Waves 1–6, with 6 months between each wave, of the Marketing and Promotions Across Colleges in Texas Project (Project M-PACT). Two separate multilevel discrete-time survival analyses were used to model the associations between past 30-day hookah use and subsequent initiation of 1) other combustible tobacco products, and 2) ENDS during the 2.5 year study period, after controlling for demographic, other tobacco use, and risk-taking personality characteristics (i.e. sensation seeking and impulsivity).
After controlling for covariates, past 30-day hookah use was associated with significantly higher odds of subsequent initiation of other combustible tobacco products. Past 30-day hookah use also predicted subsequent initiation of ENDS after controlling for covariates.
This study is one of the first to demonstrate that hookah use is a predictor of subsequent initiation of other combustible tobacco products and ENDS among college students. These findings suggest that hookah may prime individuals to use other tobacco products, which has important implications for prevention programs and future research.
•Few studies have examined hookah use as a predictor of other tobacco product use.•Hookah use predicted the subsequent initiation of other combustible tobacco products.•Hookah use predicted subsequent initiation of ENDS among Texas college students.•Hookah may prime individuals to use tobacco products, including emergent products.