The Effect of Perceptions of Hookah Harmfulness and Addictiveness on the Age of Initiation of Hookah Use among Population Assessment of Tobacco and Health (PATH) Youth

Arnold E. Kuk, Meagan A. Bluestein, Baojiang Chen, Melissa Harrell, Charles E. Spells, Folefac Atem and Adriana Pérez
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Arnold E. Kuk: Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston (UTHealth), Austin, TX 78701, USA
Meagan A. Bluestein: Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston (UTHealth), Austin, TX 78701, USA
Baojiang Chen: Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston (UTHealth), Austin, TX 78701, USA
Melissa Harrell: Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston (UTHealth), Austin, TX 78701, USA
Charles E. Spells: Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston (UTHealth), Austin, TX 78701, USA
Folefac Atem: Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston (UTHealth), Dallas, TX 75207, USA
Adriana Pérez: Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston (UTHealth), Austin, TX 78701, USA

IJERPH, 2022, vol. 19, issue 9, 1-15

Abstract: Despite the negative health consequence of hookah, hookah risk perceptions are misguided among youth. Secondary data analysis of 12–17-year-old never hookah users at their first wave of PATH participation (2013–2019) was performed. The effect of perceptions of hookah harmfulness and addictiveness on the age of initiation ever, past 30-day, and fairly regular hookah use were estimated using interval-censored Cox proportional hazards models. The distribution of the age of initiation of hookah outcomes by perception levels of harmfulness and addictiveness are reported as cumulative incidence and 95% CI. Youth who perceived hookah to be neither harmful nor addictive were 173% more likely to initiate ever, 166% more likely to first report past 30-day use, and 142% more likely to first report fairly regular hookah use at earlier ages compared to youth who considered hookah to be both harmful and addictive. By age 18, 25.5% of youth who perceived hookah as neither harmful nor addictive were estimated to initiate ever hookah use while 9.3% of youth who perceived hookah as harmful and addictive were estimated to initiate ever hookah use. These findings indicate the need to provide prevention and education campaigns to change perceptions of the harmfulness and addictiveness of hookah to delay the age of initiation of hookah use.

Keywords: interval censoring; Cox regression; survival analysis; time to event; tobacco risk perception; waterpipe; narghile; shisha (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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