Hookah smoking and harm perception among asthmatic adolescents: findings from the Florida youth tobacco survey

J Sch Health. 2014 May;84(5):334-41. doi: 10.1111/josh.12153.


Background: Hookah tobacco smoking has increased in prevalence among Florida adolescents and is often viewed as a safer alternative to cigarette smoking by young adults. Asthmatic adolescents are at increased risk of the negative health effects of hookah smoking. The purpose of this study is to examine if hookah use and harm perception vary by asthma status.

Methods: The Florida Youth Tobacco Survey was conducted in 2012 among 36,578 high school students. Secondary data analysis was conducted to compare the rates of hookah use among asthmatic youth to their nonasthmatic counterparts. Risk perception of hookah use compared to cigarette smoking was also assessed among asthmatic and nonasthmatic adolescents.

Results: One in 5 high school students reported lifetime asthma. These asthmatic students have a significantly higher prevalence of hookah smoking and greater perception of hookah use as being less harmful than cigarette smoking, than their nonasthmatic counterparts. Among asthmatics, 12th graders and Hispanic students had the highest prevalence of hookah smoking.

Conclusion: Common misperceptions of hookah smoking as being less harmful than cigarette smoking are prominent among high school students in Florida and are greater among students with asthma than those students who do not have asthma. Efforts to increase education to dispel the myths surrounding hookah smoking as a safer alternative to cigarette smoking needs to exist at the high school level for both students with and without asthma.

Keywords: adolescent; asthma; hookah; smoking; waterpipe.

MeSH terms

  • Adolescent
  • Adolescent Behavior
  • Age Factors
  • Asthma / epidemiology*
  • Asthma / ethnology
  • Female
  • Florida / epidemiology
  • Health Surveys
  • Humans
  • Male
  • Perception*
  • Sex Factors
  • Smoking / epidemiology*
  • Smoking / ethnology
  • Socioeconomic Factors