Huang Li-Ling, Sutfin Erin L, Kowitt Sarah, Patel Tanha, Ranney Leah, Goldstein Adam O
research collaborator, Center for Regulatory Research on Tobacco Communication, Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
associate professor and vice chair, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina.
N C Med J. 2017 May-Jun;78(3):149-155. doi: 10.18043/ncm.78.3.149.
Although youth cigarette smoking has declined in the United States, use of alternative tobacco products, such as hookah, has increased. This study assesses changes in prevalence of use from 2011 to 2013, and examines factors associated with current hookah use among North Carolina high school students in 2013. Data came from the North Carolina Youth Tobacco Survey in 2011 (n = 4,791) and 2013 (n = 4,092). STATA (StataCorp LLC) logistic regression survey procedures account for the complex survey design and sampling weights. Prevalence of reported current hookah use significantly increased from 3.6% (95% CI: 2.8-4.5) in 2011 to 6.1% (95% CI: 4.9-7.5) in 2013 while reported lifetime hookah use increased from 9.8% (95% CI: 8.0-12.0) in 2011 to 12.6% (95% CI: 11.0-14.4) in 2013. Correlates of current hookah use included having a weekly disposable income over $50 (adjusted odds ratio (AOR) = 2.05, 95% CI: 1.25-3.35), currently smoking cigarettes (AOR = 4.57, 95% CI: 1.80-11.62), and living with hookah users (AOR = 6.45, 95% CI: 3.21-12.93). Participant self-reports of "liking" or positively commenting on tobacco products on social media were associated with current hookah use (AOR = 1.83, 95% CI: 1.84-4.52). Frequent exposure to online tobacco advertisements (AOR = 1.61, 95% CI: 1.13-2.28) were also associated with current hookah use. Comprehensive product specific communication and policy interventions are needed to educate youth about the dangers of hookah use and reduce social acceptability among youth. To decrease hookah use in North Carolina, policymakers should consider restoring funding for comprehensive tobacco prevention and control programs, and equalizing tobacco tax rates for all tobacco product types.
尽管美国青少年吸烟率有所下降，但水烟等另类烟草产品的使用却有所增加。本研究评估了2011年至2013年期间水烟使用流行率的变化，并调查了2013年北卡罗来纳州高中生当前水烟使用的相关因素。数据来自2011年（n = 4791）和2013年（n = 4092）的北卡罗来纳州青少年烟草调查。STATA（StataCorp有限责任公司）逻辑回归调查程序考虑了复杂的调查设计和抽样权重。报告的当前水烟使用率从2011年的3.6%（95%置信区间：2.8 - 4.5）显著增加到2013年的6.1%（95%置信区间：4.9 - 7.5），而报告的终生水烟使用率从2011年的9.8%（95%置信区间：8.0 - 12.0）增加到2013年的12.6%（95%置信区间：11.0 - 14.4）。当前水烟使用的相关因素包括每周可支配收入超过50美元（调整后的优势比（AOR）= 2.05，95%置信区间：1.25 - 3.35）、当前吸烟（AOR = 4.57，95%置信区间：1.80 - 11.62）以及与水烟使用者同住（AOR = 6.45，95%置信区间：3.21 - 12.93）。参与者在社交媒体上对烟草产品的“喜欢”或正面评价与当前水烟使用相关（AOR = 1.83，95%置信区间：1.84 - 4.52）。频繁接触在线烟草广告（AOR = 1.61，95%置信区间：1.13 - 2.28）也与当前水烟使用相关。需要全面的针对特定产品的宣传和政策干预措施，以教育青少年水烟使用的危害，并降低青少年中的社会接受度。为了减少北卡罗来纳州的水烟使用，政策制定者应考虑恢复对全面烟草预防和控制项目的资金投入，并使所有烟草产品类型的烟草税率均等。
