Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health in Austin, Austin, TX.
Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC.
Nicotine Tob Res. 2019 Nov 19;21(12):1590-1599. doi: 10.1093/ntr/nty135.
Given the US Food and Drug Administration (FDA)'s authority to regulate hookah, more research is needed to inform regulations intended to prevent youth from using hookah. This systematic review summarizes and assesses the literature related to hookah use among adolescents (11 to ≤18 years of age) in the United States from 2009 to 2017.
Database searches yielded 867 peer-reviewed articles. After duplicates were removed, authors reviewed 461 articles for inclusion. Included articles (n = 55) were coded for study themes, study quality, and their relevance to FDA's research priorities. A qualitative synthesis is presented.
The following themes were identified: (1) prevalence of hookah use (n = 42), (2) tobacco use transitions (n = 7), (3) sociodemographic correlates (n = 35), (4) psychosocial risk factors (n = 21), (5) concurrent use of other tobacco products (n = 31), (6) concurrent use of other substances (n = 9), and (7) other (n = 15)-which includes low prevalence themes. The qualitative synthesis showed increasing rates of hookah use. Older age, male gender, positive social normative beliefs, higher peer use, as well as lower perceived risk were associated with hookah use. Longitudinal studies of youth hookah use showed bidirectional relationships between use of hookah and other tobacco products. All articles fell within FDA's research priority related to "behavior," and three priorities ("impact analysis," "health effects," and "toxicity") have not been explored for hookah use among US youth since 2009.
The prevalence of hookah use among youth in the United States is increasing, thus more research is needed to inform policies targeted to protect this vulnerable population.
This study represents a novel contribution to our understanding of hookah use among youth in the United States from 2009-the year that the Family Smoking Prevention and Tobacco Control Act was passed-to 2017. In recent years, hookah has become a more popular tobacco product among US youth; however, to date, no systematic reviews of hookah use among this population exist. Results highlight implications for future US FDA regulatory policy and identify gaps in research to be addressed in future studies.
鉴于美国食品和药物管理局（FDA）有权监管水烟，因此需要更多的研究来为旨在防止青少年使用水烟的法规提供信息。本系统评价总结并评估了 2009 年至 2017 年期间美国青少年（11 至≤18 岁）使用水烟的相关文献。
数据库检索产生了 867 篇同行评议文章。在去除重复项后，作者对 461 篇文章进行了纳入评估。纳入的文章（n=55）根据研究主题、研究质量以及与 FDA 研究重点的相关性进行了编码。本文呈现了定性综合分析的结果。
确定了以下主题：（1）水烟使用的流行率（n=42），（2）烟草使用的转变（n=7），（3）社会人口统计学相关性（n=35），（4）心理社会风险因素（n=21），（5）同时使用其他烟草制品（n=31），（6）同时使用其他物质（n=9），以及（7）其他主题（n=15），包括低流行率主题。定性综合分析表明水烟使用的比例不断增加。年龄较大、男性、积极的社会规范信念、较高的同伴使用率以及较低的感知风险与水烟使用有关。青少年水烟使用的纵向研究表明，水烟和其他烟草制品的使用之间存在双向关系。所有文章都属于 FDA 与“行为”相关的研究重点，自 2009 年以来，关于美国青少年水烟使用，FDA 的三个研究重点（“影响分析”、“健康影响”和“毒性”）尚未得到探索。
美国青少年中水烟使用的流行率正在上升，因此需要更多的研究来为针对保护这一弱势群体的政策提供信息。
本研究是对我们理解 2009 年《家庭吸烟预防和烟草控制法案》通过以来美国青少年水烟使用情况的一个新贡献。近年来，水烟已成为美国青少年中更受欢迎的烟草制品；然而，迄今为止，针对这一人群的水烟使用尚无系统评价。研究结果强调了对未来美国 FDA 监管政策的影响，并确定了未来研究中需要解决的研究空白。
