Brief Original ReportEmerging tobacco products: Hookah use among New Jersey youth
Introduction
Worldwide hookah use has occurred for centuries, traditionally among Middle Eastern populations (Knishkowy and Amitai, 2005, Maziak et al., 2004). Hookah use in the U.S. is a more recent phenomenon, particularly popular among the college-aged population and typically in social settings (Eissenberg et al., 2008, Grekin and Ayna, 2008, Primack et al., 2008). Although there have been some published studies of hookah use among U.S. college students (Eissenberg et al., 2008, Grekin and Ayna, 2008, Primack et al., 2008), a paucity of data exists on adolescent use. Only two studies, one in Arizona and one in Florida, provide results of hookah-specific questions added to their state's Youth Tobacco Survey (YTS). Primack et al. (2008) found that 10.3% of Arizona high school students had tried hookahs and 5.4% reported current use, while Barnett and colleagues (2009) found 11% of public high school students in Florida had tried hookahs. This study adds to the current research, using New Jersey YTS (NJYTS) data to explore factors associated with hookah use.
Section snippets
Methods
This UMDNJ-IRB approved study was conducted using 2008 NJYTS data (Jordan et al., 2009). A two stage cluster sample design was used to produce a representative statewide sample of 9th–12th grade students. Current hookah use was defined as any use in the past 30 days. Other variables of interest included gender, race/ethnicity, grade, current cigarette use, current other tobacco product (OTP) use (cigars, smokeless tobacco, and bidis), and two variables to access risk perception (cigars are safer
Results
A response rate of 81% was achieved and 3010 students participated. The prevalence of current hookah use among all New Jersey high school students was 9.7%; hookah use did not significantly differ by gender or race/ethnicity (see Table 1). Current hookah use trended upward by grade level. High school students who reported currently smoking cigarettes or currently using other tobacco products (OTPs) were more likely to report current hookah use compared to those who did not report currently
Discussion
Hookah use is popular among adolescents in New Jersey. Almost one out of ten high school students reported having smoked a hookah in the past month, a rate almost twice that of Arizona students (Primack et al., 2009). In addition, Asians, current cigarette smokers, current OTP users, those who perceive cigars as safer than cigarettes and those who perceive smoking makes one look cool or helps someone to fit in were more likely to report current hookah use. These findings merit further
Conclusion
These data represent the first assessment of hookah use among New Jersey youth and one of few state-specific prevalence estimates. The prevalence of hookah use, higher likelihood of concurrent tobacco use among current hookah users and misperceptions of safety and popularity of tobacco among adolescents are cause for concern and action. The development and regular implementation of standardized hookah prevalence questions in our national and state surveillance systems would provide trend data
Conflict of interest statement
Co-authors Heather M. Jordan and Cristine D. Delnevo are informed of the Journal's Conflict of Interest policy and have no related activities to disclose.
Funding source
Completion of this work was partially supported by a contract from the New Jersey Department of Health and Senior Services, through funding from the Master Settlement Agreement.
Acknowledgments
The authors acknowledge Mary Hrywna, MPH for her editing and manuscript review.
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