Category: Addictive Behaviors
Introduction: Waterpipe (WP) smoking among college students has increased in popularity in recent years (Arrazola et al., 2015). Previous research has indicated that perceptions of the risks associated with WP smoking are overall inaccurate (Primack et al., 2008). However, more recent studies have shown evidence that awareness of the health risks associated with WP smoking may be increasing (Akl et al., 2013). Although research has exhibited negative associations between WP smoking status and risk perceptions of WP (Heinz et al., 2013), the extent to which knowledge of risks associated with WP smoking is related to WP smoking status remains unclear (Lipkus, Eissenberg, Schwartz-Bloom, Prokhorov, & Levy, 2014; Eissenberg, Ward, Smith-Simone, Maziak, 2008; Akl et al., 2013). The aims of the current study are to assess WP-related knowledge and to further investigate its associations with WP smoking status.
Methods: Undergraduate students (N = 894) at a Midwestern university completed an online survey assessing WP smoking patterns, perceived health risks of WP relative to cigarette smoking, and knowledge of WP harmfulness.
Results: The sample consisted of mostly female (66.4%) undergraduate students with a mean age of 19.7. Approximately one-third (34.8%) of respondents had reported ever smoking WP, and 20 (2.2%) had smoked WP in the past month. An independent samples t-test was conducted assessing knowledge of health risks related to WP smoking. No significant differences emerged in WP knowledge between never users (M = 5.58, SD = 3.10) and ever users (M = 5.78, SD = 3.07) of WP, t(892) = -.918, p = .359. Significant differences at the item level between ever and never WP smokers were found for items assessing addiction potential (p = .018), the likelihood of developing cancer due to WP smoking (p = .028), levels of nicotine in WP (p = .034), and levels of tar in WP (p = .018) such that more never users than ever users perceived WP smoking to be at least as harmful as cigarette smoking. No significant differences emerged for perceptions of carcinogens, harm to individual health, harm to long-term health, harm to health of a fetus, or harm from second-hand smoke (ps > .05). Overall, a large majority (87.6%) of participants reported believing that WP smoking is as harmful to a fetus as cigarette smoking. Approximately two-thirds reported that WP smoking is as addictive (62.8%), as harmful to health (62%), and as harmful to long-term health (68.2%) as cigarette smoking.
Discussion: Knowledge of WP smoking and perceptions of risks to health were not related to WP smoking status. The majority of students, regardless of use, believed that WP smoking was equally or more harmful than cigarette smoking. The results may reflect a shift in the awareness of harms related to WP smoking. Future research should investigate how this shift in awareness and knowledge may translate to WP smoking behaviors.
Susanna Lopez– Graduate Student, Oklahoma State University
Eleanor Leavens– Graduate Student, Oklahoma State University, Stillwater, Oklahoma
Emma Brett– Graduate Student, Oklahoma State University, Stillwater, Oklahoma
Thad Leffingwell– Oklahoma State University
Theodore Wagener– University of Oklahoma Health Sciences Center