Skip Navigation
Grant Details

Grant Number: 5R01CA140150-05 Interpret this number
Primary Investigator: Primack, Brian
Organization: University Of Pittsburgh At Pittsburgh
Project Title: Waterpipe Tobacco Smoking Among U.S. Adolescents and Young Adults
Fiscal Year: 2014
Back to top


Abstract

DESCRIPTION (provided by applicant): Tobacco smoking using a waterpipe (a.k.a., hookah) is an emerging trend and a threat to U.S. public health. Waterpipe tobacco smoke contains large amounts of toxicants (e.g., CO, tar, nicotine, and heavy metals) and has been associated with addiction and other adverse health consequences. Despite these facts, convenience sample studies demonstrate that 20-40 percent of U.S. University students report waterpipe tobacco smoking in the past year. Moreover, 30-50 percent of waterpipe tobacco smokers have never used cigarettes, suggesting that waterpipes deliver tobacco to millions of individuals who otherwise would have been naive to nicotine. Learning more about U.S. waterpipe users, mechanisms of waterpipe smoking uptake, and the trajectory and consequences of its use will be essential for developing targeted interventions to prevent waterpipe tobacco smoking from becoming a new strain in the U.S. tobacco epidemic. The American College Health Association's new National College Health Assessment (NCHA) surveys more than 90,000 individuals annually and will be the first large scale survey to include basic items that assess waterpipe tobacco smoking. This project leverages these data to help us determine the prevalence and correlates of waterpipe tobacco smoking among a large sample of U.S. university students (Specific Aim 1). Multivariable models will assess independent associations between waterpipe smoking outcomes and (1) respondent factors such as age, gender, race/ethnicity, socioeconomic status, and other substance use; and (2) environmental variables such as college/university setting, and geographic region. Next, we will use qualitative assessments to inform a theoretical framework describing the factors related to uptake of waterpipe tobacco smoking (Specific Aim 2). This component will involve (1) a national content analysis of waterpipe tobacco Web sites; (2) direct ethnographic observation of behavior in 8 different settings where waterpipe tobacco is smoked; and (3) 6 in- depth focus groups with waterpipe tobacco users stratified by age and gender. These analyses will inform our theoretical model describing the factors related to uptake of waterpipe tobacco smoking. Finally, we will conduct a nationally-representative, longitudinal study of 3700 individuals aged 15-30 investigating the trajectories and consequences of waterpipe tobacco smoking (Specific Aim 3). Data from this study will enable us (1) to test the conceptual model from Specific Aim 2; and (2) to determine longitudinal associations between waterpipe tobacco experimentation and subsequent tobacco use and intention outcomes. In sum, waterpipe tobacco smoking appears to be a growing public health threat, particularly among U.S. late adolescents and young adults. This timely and innovative project will combine analysis of an existing data set, intensive qualitative assessments, and an original longitudinal data collection to provide crucial information that will ultimately help develop interventions aimed at reducing the public health threat posed by waterpipe tobacco smoking.

Back to top


Publications

The LWDS-10J: reliability and validity of the Lebanon Waterpipe Dependence Scale among university students in Jordan.
Authors: Primack BA, Khabour OF, Alzoubi KH, Switzer GE, Shensa A, Carroll MV, Azab M, Eissenberg T
Source: Nicotine Tob Res, 2014 Jul;16(7), p. 915-22.
EPub date: 2014 Feb 26.
PMID: 24571810
Related Citations

Back to top


Associations between race, ethnicity, religion, and waterpipe tobacco smoking.
Authors: Primack BA, Mah J, Shensa A, Rosen D, Yonas MA, Fine MJ
Source: J Ethn Subst Abuse, 2014;13(1), p. 58-71.
PMID: 24564560
Related Citations

Back to top


Knowledge, attitudes, and normative beliefs as predictors of hookah smoking initiation: a longitudinal study of university students.
Authors: Sidani JE, Shensa A, Barnett TE, Cook RL, Primack BA
Source: Nicotine Tob Res, 2014 Jun;16(6), p. 647-54.
EPub date: 2013 Dec 9.
PMID: 24323574
Related Citations

Back to top


Measurement of social capital among clinical research trainees.
Authors: Primack BA, Colditz JB, Cohen E, Switzer GE, Robinson GF, Seltzer DL, Rubio DM, Kapoor WN
Source: Clin Transl Sci, 2014 Feb;7(1), p. 33-7.
EPub date: 2013 Oct 3.
PMID: 24118964
Related Citations

Back to top


The predictive utility of attitudes toward hookah tobacco smoking.
Authors: Barnett TE, Shensa A, Kim KH, Cook RL, Nuzzo E, Primack BA
Source: Am J Health Behav, 2013 Jul;37(4), p. 433-9.
PMID: 23985224
Related Citations

Back to top


Associations of mental health problems with waterpipe tobacco and cigarette smoking among college students.
Authors: Primack BA, Land SR, Fan J, Kim KH, Rosen D
Source: Subst Use Misuse, 2013 Feb;48(3), p. 211-9.
EPub date: 2013 Jan 10.
PMID: 23302059
Related Citations

Back to top


Associations between hookah tobacco smoking knowledge and hookah smoking behavior among US college students.
Authors: Nuzzo E, Shensa A, Kim KH, Fine MJ, Barnett TE, Cook R, Primack BA
Source: Health Educ Res, 2013 Feb;28(1), p. 92-100.
EPub date: 2012 Sep 17.
PMID: 22987864
Related Citations

Back to top


Substance and hookah use and living arrangement among fraternity and sorority members at US colleges and universities.
Authors: Sidani JE, Shensa A, Primack BA
Source: J Community Health, 2013 Apr;38(2), p. 238-45.
PMID: 22903805
Related Citations

Back to top


US health policy related to hookah tobacco smoking.
Authors: Primack BA, Hopkins M, Hallett C, Carroll MV, Zeller M, Dachille K, Kim KH, Fine MJ, Donohue JM
Source: Am J Public Health, 2012 Sep;102(9), p. e47-51.
EPub date: 2012 Jul 24.
PMID: 22827447
Related Citations

Back to top


ER vs. ED: a comparison of televised and real-life emergency medicine.
Authors: Primack BA, Roberts T, Fine MJ, Dillman Carpentier FR, Rice KR, Barnato AE
Source: J Emerg Med, 2012 Dec;43(6), p. 1160-6.
EPub date: 2012 Jul 4.
PMID: 22766407
Related Citations

Back to top


Tobacco, marijuana, and alcohol use in university students: a cluster analysis.
Authors: Primack BA, Kim KH, Shensa A, Sidani JE, Barnett TE, Switzer GE
Source: J Am Coll Health, 2012;60(5), p. 374-86.
PMID: 22686360
Related Citations

Back to top


Waterpipe smoking among U.S. university students.
Authors: Primack BA, Shensa A, Kim KH, Carroll MV, Hoban MT, Leino EV, Eissenberg T, Dachille KH, Fine MJ
Source: Nicotine Tob Res, 2013 Jan;15(1), p. 29-35.
EPub date: 2012 May 28.
PMID: 22641433
Related Citations

Back to top


Role of video games in improving health-related outcomes: a systematic review.
Authors: Primack BA, Carroll MV, McNamara M, Klem ML, King B, Rich M, Chan CW, Nayak S
Source: Am J Prev Med, 2012 Jun;42(6), p. 630-8.
PMID: 22608382
Related Citations

Back to top


Waterpipe tobacco and cigarette smoking among university students in Jordan.
Authors: Khabour OF, Alzoubi KH, Eissenberg T, Mehrotra P, Azab M, Carroll MV, Afifi RA, Primack BA
Source: Int J Tuberc Lung Dis, 2012 Jul;16(7), p. 986-92.
EPub date: 2012 Apr 16.
PMID: 22525279
Related Citations

Back to top


Association of established smoking among adolescents with timing of exposure to smoking depicted in movies.
Authors: Primack BA, Longacre MR, Beach ML, Adachi-Mejia AM, Titus LJ, Dalton MA
Source: J Natl Cancer Inst, 2012 Apr 4;104(7), p. 549-55.
EPub date: 2012 Mar 14.
PMID: 22423010
Related Citations

Back to top


A comparison of cigarette- and hookah-related videos on YouTube.
Authors: Carroll MV, Shensa A, Primack BA
Source: Tob Control, 2013 Sep;22(5), p. 319-23.
EPub date: 2012 Feb 23.
PMID: 22363069
Related Citations

Back to top


U.S. hookah tobacco smoking establishments advertised on the internet.
Authors: Primack BA, Rice KR, Shensa A, Carroll MV, DePenna EJ, Nakkash R, Barnett TE
Source: Am J Prev Med, 2012 Feb;42(2), p. 150-6.
PMID: 22261211
Related Citations

Back to top


Motives for smoking in movies affect future smoking risk in middle school students: an experimental investigation.
Authors: Shadel WG, Martino SC, Setodji C, Haviland A, Primack BA, Scharf D
Source: Drug Alcohol Depend, 2012 Jun 1;123(1-3), p. 66-71.
EPub date: 2011 Nov 8.
PMID: 22074766
Related Citations

Back to top


College students and use of K2: an emerging drug of abuse in young persons.
Authors: Hu X, Primack BA, Barnett TE, Cook RL
Source: Subst Abuse Treat Prev Policy, 2011 Jul 11;6, p. 16.
EPub date: 2011 Jul 11.
PMID: 21745369
Related Citations

Back to top


Using ecological momentary assessment to determine media use by individuals with and without major depressive disorder.
Authors: Primack BA, Silk JS, DeLozier CR, Shadel WG, Dillman Carpentier FR, Dahl RE, Switzer GE
Source: Arch Pediatr Adolesc Med, 2011 Apr;165(4), p. 360-5.
PMID: 21464384
Related Citations

Back to top


Burnout among early career clinical investigators.
Authors: Primack BA, Dilmore TC, Switzer GE, Bryce CL, Seltzer DL, Li J, Landsittel DP, Kapoor WN, Rubio DM
Source: Clin Transl Sci, 2010 Aug;3(4), p. 186-8.
PMID: 20718821
Related Citations

Back to top


Smoking motives in movies are important for understanding adolescent smoking: a preliminary investigation.
Authors: Shadel WG, Martino SC, Haviland A, Setodji C, Primack BA
Source: Nicotine Tob Res, 2010 Aug;12(8), p. 850-4.
EPub date: 2010 Jun 24.
PMID: 20576800
Related Citations

Back to top


Water pipe tobacco smoking among university students in Jordan.
Authors: Azab M, Khabour OF, Alkaraki AK, Eissenberg T, Alzoubi KH, Primack BA
Source: Nicotine Tob Res, 2010 Jun;12(6), p. 606-12.
EPub date: 2010 Apr 23.
PMID: 20418383
Related Citations

Back to top


Waterpipe and cigarette smoking among college athletes in the United States.
Authors: Primack BA, Fertman CI, Rice KR, Adachi-Mejia AM, Fine MJ
Source: J Adolesc Health, 2010 Jan;46(1), p. 45-51.
EPub date: 2009 Jul 8.
PMID: 20123257
Related Citations

Back to top


Water-pipe tobacco smoking among middle and high school students in Arizona.
Authors: Primack BA, Walsh M, Bryce C, Eissenberg T
Source: Pediatrics, 2009 Feb;123(2), p. e282-8.
PMID: 19171581
Related Citations

Back to top


Prevalence of and associations with waterpipe tobacco smoking among U.S. university students.
Authors: Primack BA, Sidani J, Agarwal AA, Shadel WG, Donny EC, Eissenberg TE
Source: Ann Behav Med, 2008 Aug;36(1), p. 81-6.
EPub date: 2008 Aug 22.
PMID: 18719977
Related Citations

Back to top


An old custom, a new threat to tobacco control.
Authors: Primack BA, Aronson JD, Agarwal AA
Source: Am J Public Health, 2006 Aug;96(8), p. 1339.
EPub date: 2006 Jun 29.
PMID: 16809578
Related Citations

Back to top