Article Text

Download PDFPDF
A comparison of cigarette- and hookah-related videos on YouTube
  1. Mary V Carroll1,
  2. Ariel Shensa1,
  3. Brian A Primack1,2
  1. 1Center for Research on Health Care, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
  2. 2Division of Adolescent Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
  1. Correspondence to Dr Brian A Primack, Center for Research on Health Care, 230 McKee Place, Suite 600, Pittsburgh, PA 15213, USA; bprimack{at}


Objective YouTube is now the second most visited site on the internet. The authors aimed to compare characteristics of and messages conveyed by cigarette- and hookah-related videos on YouTube.

Methods Systematic search procedures yielded 66 cigarette-related and 61 hookah-related videos. After three trained qualitative researchers used an iterative approach to develop and refine definitions for the coding of variables, two of them independently coded each video for content including positive and negative associations with smoking and major content type.

Results Median view counts were 606 884 for cigarettes-related videos and 102 307 for hookah-related videos (p<0.001). However, the number of comments per 1000 views was significantly lower for cigarette-related videos than for hookah-related videos (1.6 vs 2.5, p=0.003). There was no significant difference in the number of ‘like’ designations per 100 reactions (91 vs 87, p=0.39). Cigarette-related videos were less likely than hookah-related videos to portray tobacco use in a positive light (24% vs 92%, p<0.001). In addition, cigarette-related videos were more likely to be of high production quality (42% vs 5%, p<0.001), to mention short-term consequences (50% vs 18%, p<0.001) and long-term consequences (44% vs 2%, p<0.001) of tobacco use, to contain explicit antismoking messages (39% vs 0%, p<0.001) and to provide specific information on how to quit tobacco use (21% vs 0%, p<0.001).

Conclusions Although internet user-generated videos related to cigarette smoking often acknowledge harmful consequences and provide explicit antismoking messages, hookah-related videos do not. It may be valuable for public health programmes to correct common misconceptions regarding hookah use.

  • Water pipe
  • hookah
  • cigarette
  • internet
  • user-generated content
  • non-cigarette tobacco products
  • prevention
  • media
  • public policy
  • music
  • media literacy
  • advertising and promotion

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Funding This work was supported by the National Institutes of Health grant number R01-CA140150 to BAP.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.