Trajectories of hookah use: Harm perceptions from youth to young adulthood

Elizabeth Hair, Jessica M. Rath, Lindsay Pitzer, Brittany Emelle, Ollie Ganz, Michael J. Halenar, Jennifer Cantrell, Donna Vallone

Research output: Contribution to journalArticlepeer-review


Objectives: Hookah use has increased in United States, especially among young adults. This study investigates the role of harm perceptions of hookah use over a 2-year period in a nationally representative sample of youth and young adults as they transition to young adulthood. Methods: Using a probability-based, nationally representative, longitudinal cohort of youth aged 15-21, we analyzed the 7536 participants who completed all 4 waves. Ordered logit growth models examined changes over time in hookah use, and whether that relationship varies by baseline harm perceptions. Results: Results show that age, sex, parental education, race, and smoking status are significant predictors of hookah use. Additionally, those who perceive hookah as "less harmful" than cigarettes have the highest probability of current hookah use over time, compared to those with more accurate harm perceptions. Conclusions: This study helps confirm the influence of harm perceptions of hookah tobacco on hookah use among youth and young adults. Increased public education efforts aimed at youth and young adults can help shift knowledge, attitudes and beliefs regarding the health consequences of hookah use.

Original languageEnglish (US)
Pages (from-to)240-247
Number of pages8
JournalAmerican Journal of Health Behavior
Issue number3
StatePublished - May 2017


  • Adolescent health
  • Harm perceptions
  • Hookah
  • Longitudinal survey
  • Tobacco

ASJC Scopus subject areas

  • Health(social science)
  • Social Psychology
  • Public Health, Environmental and Occupational Health


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