Socio-Demographic Characteristics of Israeli Young Adults who Smoke Hookah

Background

Recent studies demonstrated an increase in hookah smoking around the world. Similarly to cigarettes smoking, hookah smoking is a significant risk factor for chronic morbidity, such as cardiovascular and respiratory diseases and cancer. However, hookah smoking is commonly misperceived as carrying lower risk for tobacco-related diseases than cigarettes smoking.

Objectives

1) To estimate rates of hookah smoking among Israeli young adults by population group and gender.

2) To examine associations between socio-demographic characteristics and hookah smoking.

Methods

A telephone survey was conducted during 2017 using a random representative sample of the Israeli adult population, including 1,168 young adults (aged 21-44). Individuals who answered positively to the question "Do you smoke hookah?" were defined as current hookah smokers. The participants were asked about the following socio-demographic characteristics: population group (Jews/Arabs), gender, age group (21-30/31-44), religiosity (religious/non-religious), education level (≤12/>12 years of schooling), income level (0-8000/8001-12,000/>12,000 NIS). Two-tailed χ2 analyses were performed to examine associations between these factors and hookah smoking.

Results

The overall weighted prevalence of hookah smoking was 8.5% (95% CI 7.1%-10.1%): 8.4% (95% CI 6.4%-11.1%) in Jewish men, 2.7% (95% CI 1.7%-4.6%) in Jewish women, 27.4% (95% CI 20.9%-34.8%) in Arab men and 9.5% (95% CI 5.8%-15.1%) in Arab women. Hookah smokers were more likely to be Arabs (OR=4.1, p<0.001), men (OR=3.9, p<0.001), younger participants (21-30) (OR=1.7, p=0.005), and having ≤12 years of schooling (OR=1.5, p=0.044). Religiosity and income level did not seem to be associated to hookah smoking .

Conclusions and health policy implications

The characterization of hookah smokers with respect to socio-demographic characteristics is an essential step in addressing this major public health problem. Identifying sub-groups at increased risk for hookah smoking may assist in planning interventions aimed at reducing smoking-related morbidity and mortality as well as enhance tobacco control policies.