Objective: To determine associations between positive and negative attitudes and hookah tobacco smoking (HTS) among college students.
Methods: Among a random sample of university students (N = 852), multivariable logistic regression models assessed associations between positive and negative attitudes toward HTS.
Results: Positive attitudes were associated with adjusted odds of 4.32 (95% CI = 3.20, 5.82) for current HTS, whereas negative attitudes were associated with lower adjusted odds for current smoking HTS (AOR = 0.64, 95% CI = 0.53, 0.76). Positive attitudes were also associated with adjusted odds of 9.31 (95% CI = 6.77, 12.80) for intention for future hookah use among non-HTS users.
Conclusion: Positive attitudes toward HTS were more strongly associated with HTS compared to negative attitudes. It may be particularly valuable for future research and interventions to focus on decreasing positive attitudes toward HTS.