Correlates of susceptibility to waterpipe tobacco smoking in young adults

Mahmood A Alalwan; Lauren Long; Elise M Stevens; Brittney Keller-Hamilton; Andrea C Villanti; Glenn Leshner; Theodore L Wagener; Darren Mays

doi:10.1371/journal.pone.0307058

Correlates of susceptibility to waterpipe tobacco smoking in young adults

PLoS One. 2024 Jul 16;19(7):e0307058. doi: 10.1371/journal.pone.0307058. eCollection 2024.

Authors

Mahmood A Alalwan¹, Lauren Long¹, Elise M Stevens², Brittney Keller-Hamilton¹, Andrea C Villanti³, Glenn Leshner⁴, Theodore L Wagener¹, Darren Mays¹

Affiliations

¹ Department of Internal Medicine, The Ohio State University College of Medicine, Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, United States of America.
² Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, United States of America.
³ Department of Health, Behavior, Society, and Policy, Rutgers School of Public Health, Rutgers Institute for Nicotine & Tobacco Studies, New Brunswick, New Jersey, United States of America.
⁴ Gaylord College of Journalism and Mass Communication, University of Oklahoma, Norman, Oklahoma, United States of America.

Abstract

Introduction: Many US young adults are susceptible to waterpipe (i.e., hookah) tobacco smoking (WTS) initiation, but research on factors associated with WTS susceptibility is limited. We examined sociodemographic, other tobacco and substance use, and attitudes and perceptions correlates of WTS susceptibility among young adults.

Methods: Baseline data from a randomized trial testing WTS risk messages was collected in US young adults aged 18 to 30 years who never used waterpipe tobacco but were susceptible to WTS (n = 294). Extent of susceptibility to WTS was defined using the average score of a valid scale with higher scores indicating higher susceptibility. Correlates were sociodemographics, other tobacco and substance use, and attitudes and perceptions. Multiple linear regression models identified correlates of greater WTS susceptibility.

Results: Participants averaged 25 (SD 3.2) years of age, 60% were male, 22% were Black non-Hispanic, 47% completed some college education, and 66% were employed. Our models consistently showed that more positive attitudes toward WTS (β = -0.08, p<0.01), lower perceived addictiveness relative to cigarettes (β = -0.09, p = 0.04), and greater perceived social acceptability of WTS (β = 0.05, p<0.01) were positively correlated with WTS susceptibility. Additionally, young adults who smoked cigarillos (β = 0.53, p<0.01), used cannabis (β = 0.14, p = 0.02), and Black non-Hispanic versus White non-Hispanic young adults (β = 0.18, p = 0.03) also had higher WTS susceptibility.

Conclusions: Findings suggest that WTS prevention efforts require multicomponent interventions including targeting subpopulations at greater risk based on race/ethnicity and other tobacco and substance use. These interventions should consider attitudes and social acceptability of WTS as modifiable targets to maximize public health benefits.

Copyright: © 2024 Alalwan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

MeSH terms

Adolescent
Adult
Female
Health Knowledge, Attitudes, Practice
Humans
Male
Tobacco, Waterpipe
Water Pipe Smoking* / epidemiology
Young Adult

Grants and funding

Research reported in this study was supported by the National Cancer Institute of the National Institutes of Health (NIH) and the U.S. Food and Drug Administration (FDA) Center for Tobacco Products (Award Number R01CA229082). Dr. Stevens’ contributions were supported by the National Institute of Drug Abuse (NIDA) of the NIH and FDA Center for Tobacco Products (Award Number R00DA046563). Dr. Keller-Hamilton’s contributions were supported by NIDA (Award Number K01DA055696). The funders were not involved in the design of the study, collection of data, analysis of data, or the decision to submit the results for publication The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or FDA.