Comparing harm beliefs and risk perceptions among young adult waterpipe tobacco smokers and nonsmokers: Implications for cessation and prevention

Abstract

IntroductionVery little is known about how waterpipe tobacco smokers and nonsmokers compare on harm beliefs about waterpipe tobacco smoking (WTS) and how these beliefs are related to risk appraisals and intentions to engage in WTS. We investigated these issues among young adult waterpipe tobacco smokers, susceptible nonsmokers, and non-susceptible nonsmokers.MethodsYoung adults ages 18 to 30 who smoked waterpipe tobacco during the last 30 days or never used waterpipe tobacco were recruited online through Turkprime. Nonsmokers were grouped as susceptible or not. Participants completed measures of harm beliefs, risk appraisals (i.e., perceived risks and worry), and desire to quit among smokers or willingness/curiosity to try waterpipe among nonsmokers.ResultsAnalyses were based on 247 smokers and 418 nonsmokers. Smokers endorsed most strongly harm beliefs that portrayed WTS as safe, followed by susceptible and then non-susceptible nonsmokers. Most harm beliefs were significantly related to risk appraisals, yet weakly associated with desire to quit or willingness/curiosity to try waterpipe tobacco, except among susceptible nonsmokers.ConclusionsGreater efforts are needed to correct maladaptive beliefs about WTS harms, especially among smokers. Among susceptible nonsmokers, harm beliefs may be more influential in predicting willingness to try WTS than risk appraisals.

Cigarette, E-Cigarette and Waterpipe Use among Young Adults: Differential Cognitions about These Three Forms of Smoking

“…Previous research has considered young adults to be particularly inclined to use waterpipes and has reported the need for public health messages to prevent the initiation and progression of waterpipe use [27][28][29]. Further research is needed into the relationship between waterpipe use and smoking multiple products, including the role of waterpipe use in the initiation or maintenance of other forms of tobacco use [30].…”

Pilot study to inform young adults about the risks of electronic cigarettes through text messaging

“…An unexpected significant increase in perceived risk of smoking hookah (i.e., waterpipe tobacco) by message recipients was identified post-exposure to the text messages. The general public holds beliefs that waterpipe use is safe (Lipkus & Mays, 2018). We offer this explanation about the increase in perceived risk of smoking hookah despite no exposure to messages about hookah.…”

Effect of risk messages on risk appraisals, attitudes, ambivalence, and willingness to smoke hookah in young adults

“…We used 4 items to capture participants’ hookah tobacco risk appraisals (i.e. perceived risks, worry about risks) ( Lipkus & Mays, 2018 ). Perceived risk of harm was measured by asking ‘What do you think is your chance of getting a serious smoking-related disease, such as cancer, lung disease, or heart disease, if you were to continue smoking waterpipe tobacco?’ (1 = no chance to 7 = certain to happen).…”

“…Willingness to smoke hookah tobacco in the future was measured using 4 items ( Lipkus & Mays, 2018 ). The items captured how likely participants would be to smoke hookah tobacco again in the future if offered it by a friend, how tempted they are to smoke hookah tobacco in the next year, if they saw themselves smoking hookah tobacco in the next year, and how curious they were about smoking hookah tobacco.…”

“…Second, young adults’ hookah tobacco use is influenced by multiple psychological factors that risk messages may affect to produce behavior change ( Akl et al, 2015 ). Young adults do not view hookah tobacco as harmful or addictive, beliefs that contribute to the high prevalence of use in young adults ( Castaneda, Barnett, Soule, & Young, 2016 ; Hair et al, 2017 ; Lipkus & Mays, 2018 ; Mermelstein, 2014 ; Roberts, Klein, Berman, Berhane, & Ferketich, 2017 ). Young adults hold positive attitudes towards hookah tobacco that are associated with hookah use ( Akl et al, 2015 ) and young adult non-users susceptible to hookah use (i.e.…”