Psychosocial Factors and Health-Risk Behaviors Associated with Hookah use among College Students.

Introduction: Prevalence of hookah or waterpipe smoking is increasing in the United States, particularly among college-aged students. Little research has examined the relationship between hookah smoking, other risk-seeking behaviors, and specific personality factors. The current study aims to address this gap in the literature.

Methods: A random sample of 10,000 students at two southeastern state universities were recruited to complete an online survey containing 230 questions assessing sociodemographics, other substance use, and psychosocial factors. Of students invited to participate, 2,206 (22.1%) returned a completed survey.

Results: Past 30-day hookah use was found among 6.8% (n=141) of the sample. Binary logistic regression indicated that, after controlling for age, ethnicity, and highest parental education, hookah use was associated with being male (p<.001), being a nondaily or daily smoker versus a nonsmoker (p<.001), more frequent alcohol consumption (p<.001), greater sensation seeking (p<.001), lower levels of conscientiousness (p<.001), and greater openness to experiences (p=.01).

Conclusions: Understanding the psychological and personality profiles of hookah users may allow public health practitioners and health care providers to identify high-risk individuals and design targeted interventions addressing users and those at risk for use.