Understanding Tobacco-Related Attitudes Among College and Noncollege Young Adult Hookah and Cigarette Users

Objective: To examine differences in tobacco-related attitudes and hookah and cigarette use among college and noncollege young adults. Participants: Time-location samples of young adult bar patrons in San Diego, California (N = 2,243), Tulsa (N = 2,095) and Oklahoma City (N = 2,200), Oklahoma, Albuquerque (N = 1,044) and Las Cruces (N = 894), New Mexico, between September 2009 and July 2011. Methods: Multinomial logistic regression examined associations between hookah and cigarette use and tobacco-related attitudes. Results: Current college students and graduates are less likely to smoke cigarettes, but more likely to use hookah. Among current hookah users, 22.6% were hookah-only users and 77.4% were dual users (cigarettes and hookah). College status is associated with different hookah use patterns, and those with anti-tobacco industry attitudes were more likely to smoke hookah. Conclusions: Novel interventions are needed for college students using hookah. Existing strategies targeting smokers with anti-tobacco industry messages may be irrelevant to hookah users.