Stress, stressors, and substance use: Differential risk for hookah use among African American college students

Abstract

Using differential, multivariable risk models, we assessed the contribution of substance use and stress/traumatic events to hookah use among African American college students (n = 1,402) using data from the Fall 2012 American College Health Association-National College Health Assessment (ACHA-NCHA) II. Lifetime hookah use was 24.8%, with 34.2% of lifetime users having done so in the past 30 days. Compared to nonusers, hookah users had significantly higher use rates of alcohol, marijuana, other tobacco, and other drugs. Furthermore, hookah use was more likely among those with cumulative stress, yet less likely among older students. An implication is that prevention messages may need to be tailored for African American college students and particularly target younger students, substance users, and those with cumulative stress. These findings also inform policy discussions regarding hookah use on college campuses.

Keywords:

• Hookah smoking
• substance use
• stress
• African American
• college students
• health promotion

Acknowledgments

We thank the American College Health Association for providing access to the American College Health Association–National College Health Assessment II, Survey Period Fall 2012. Baltimore, MD: American College Health Association, Mary Hoban, PhD, CHES, Director; (2013-11-2013).

We also thank Ms. Courtney D. Williams for her clerical assistance in the finalization and submission of this manuscript.

An earlier, unpublished version of this manuscript was included in a larger dissertation thesis (Jones) in partial fulfillment of the requirements for a doctoral degree in the Department of Education, Washington University in St. Louis.

Disclosure statement

The authors declare no conflicts of interest.

The opinions, findings, and conclusions reported in this manuscript are those of the authors and are in no way meant to represent the corporate opinions, views, or policies of Washington University or the American College Health Association (ACHA). These entities do not warrant or assume any liability or responsibility for the accuracy, completeness, or usefulness of any information presented in this manuscript.

Additional information

Funding

This project was supported in part by Washington University Brown School Faculty Fund (Cunningham-Williams) and the Washington University Chancellor’s Graduate Fellowship Program while she was a student (Jones).