1. Hookah and E-cigarette Usage: Attitudes, Knowledge, and Behaviors on a
Northeastern University Campus
Courtney Berenato, Gabrielle Amoroso, Diana Sireci, Lila Olman, Erin McArdle, Brittany Bungert, Qimin Chen, Cassie
Anzalone, Kerrin Nelson
Mentors: Joyce Rhodes-Keefe, RN-C, MS, Lori Sprague, MS, RN, Rosemary Collier, MS, RN, Geraldine R. Britton, RN, PhD,
Abstract
Purpose: To explore the health beliefs, attitudes, perceptions
and knowledge of a university campus community about
hookah and e-cigarette usage.
Background: There is an increasing incidence of hookah and
electronic cigarette (e-cig, e-hookah, vape pens) usage among
the college-aged population today. At an urban Midwestern
university, undergraduate college students reported a lifetime
hookah use of 48%. However, many do not know the
deleterious effects. In a study of 4,444 North Carolina
university students, 50% of respondents stated that they did
not know whether e-cigarettes were more harmful when
compared to traditional cigarettes, with 17% reporting that
they were less harmful (Sutfin, McCoy, Morrell, Hoeppner, &
Wolfson, 2013). Likewise, Sharma, Clark, & Sharp (2014),
found that study subjects displayed a significant lack of
knowledge regarding the safety and health implications of
hookah (“water pipe”), and perceived them as “safer and less
addictive than cigarette smoking” (p.445). Current data
regarding health and emerging needs of our campus
community are limited, therefore emphasizing the need for this
research.
Methods: This study employed a descriptive research design,
using a 23-question survey. The survey was distributed at a
northeastern public university campus event with 238
respondents. A second survey will be conducted at a similar
event at a later date.
Results: Preliminary data analysis yielded a mean age for all
respondents of 21.1 years; 48% were female, 52% were male.
93% of respondents were undergraduate, and 7% were
graduate students. Responses for the merged data sets will be
analyzed using SPSS version 22.
Conclusion/Implications: Due to the fast developing nature
of these products and their marketing, these data will
contribute significantly to existing knowledge. Identification
of current usage, attitudes and knowledge of hookah and
electronic cigarettes can help us more effectively plan an
intervention to promote a healthy campus environment.
Purpose
To determine cigarette, smokeless tobacco, e-cigarette,
and e-hookah usage and knowledge of the campus
community, as well as to evaluate attitudes towards a
tobacco-free campus policy.
Objectives:
❖ To determine usage and knowledge of cigarettes,
smokeless tobacco, e-cigarettes, and e-hookah usage
within the campus community.
❖ To assess attitudes and beliefs towards a tobacco-free
campus policy.
Setting:
❖ Conducted in a high traffic area at a medium-sized
northeastern state university.
Results
Of a total of 342 students who responded
• 7% (n=24) reported smoking 100 cigarettes in their lifetime
• 54% (n=184) reported ever using hookah.
• 17% (n=57) reported ever using e-cigarettes
• 26% (n=89) reported ever using vapor hookah
• 9% (n=30) reported ever using smokeless tobacco.
A chi square test of independence was calculated comparing the
use of e-cigarettes among those who reported smoking 100
cigarettes in their lifetime. Those who have smoked 100
cigarettes in their lifetime are more likely to use e-cigarettes
than those who have not. A significant interaction was found
(x2
(1)=48.34, p<0.001).
A chi square test of independence was calculated comparing the
use of vapor hookah among those who reported smoking 100
cigarettes in their lifetime. Those who have smoked 100
cigarettes are more likely to use vapor hookah. A significant
interaction was found (x2
(1)=6.024, p<0.05).
A chi square test of independence was calculated comparing the
use of smokeless tobacco among those who reported smoking
100 cigarettes in their lifetime. Those who have smoked 100
cigarettes are more likely to use smokeless tobacco. A
significant interaction was found (x2
(1)=33.234, p<0.001).
Recommendations
❖ From the results of our research, students have responded
with a knowledge deficit of hookah and E-cigarettes. Thus
we propose an educational intervention with the use of
interactive online module programs. The material would be
research based but presented in a fun interactive format to
help students relate to the material in their college settings
and social environments as well as keep them involved in
the intervention to facilitate better learning.
Acknowledgments
Supported by the Binghamton University Academic and Faculty Development Fund & Healthy Campus Initiative
Statement of Disclosure: The author reports no actual or potential conflicts of interest. References
Sharma, E., Clark, P. I., & Sharp, K. E. (2014). Understanding psychosocial aspects of waterpipe smoking
among college students. American Journal of Health Behavior, 38(3), 440-447. doi: 10.5993/AJHB. 38.3.13
Sutfin, E. L., McCoy, T. P., Morrell, H. E. R., Hoeppner, B. B., & Wolfson, M. (2013, Aug 1). Electronic
cigarette use by college students. Drug and Alcohol Dependence, 131(3), 214-221. doi: 10.1016/ j.
drugalcdep.2013.05.00
Methodology
Design:
❖ A mixed methods study using a survey with open ended
questions.
❖ Descriptive correlational design using convenience
sampling.
❖ One page front and back survey with twenty questions.
❖ 357 total participants.
❖ Incentives to complete the survey consisted of a gift card
random drawing for participants using their email
addresses and free popcorn and/or candy.
Procedure:
❖ Responses were analyzed using SPSS version 22
❖ Responses analyzed for key themes individually and
collectively
❖ We ran descriptive statistics, chi square, and correlations
(Spearman’s Rho)