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Knowledge, attitudes, and normative beliefs as predictors of hookah smoking initiation: A longitudinal study of university students

Sidani, JE and Shensa, A and Barnett, TE and Cook, RL and Primack, BA (2014) Knowledge, attitudes, and normative beliefs as predictors of hookah smoking initiation: A longitudinal study of university students. Nicotine and Tobacco Research, 16 (6). 647 - 654. ISSN 1462-2203

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Introduction: While cross-sectional studies have shown that hookah tobacco smoking (HTS) is an increasingly popular behavior among university students, little is known about factors associated with initiation. This study sought to determine associations between knowledge, attitudes, and normative beliefs and initiation of HTS among university students. Methods: Data were from a prospective longitudinal cohort study of 569 randomly selected first- and second-year university students. Online questionnaires that were developed in accordance with our composite theoretical model were completed in September 2010 and April 2011. Results: About one-seventh (13%) of participants initiated HTS by follow-up. Positive attitudes and favorable normative beliefs were associated with increased adjusted odds of initiation (AOR = 4.12, 95% CI = 2.56, 6.59; and AOR = 2.01, 95% CI = 1.35, 2.99, respectively), while negative attitudes were associated with decreased adjusted odds (AOR = 0.62, 95% CI = 0.48, 0.80). Correct knowledge regarding toxicants associated with HTS was not significantly associated with initiation. Conclusions: While positive attitudes and favorable normative beliefs are associated with initiation of HTS in a cohort of never-users, increased knowledge about toxins is not associated with lower initiation. It may be particularly valuable for educational interventions to attempt to alter positive attitudes and normative beliefs related to HTS. © The Author 2013. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Sidani, JEjaime.sidani@pitt.eduJES107
Shensa, Aariel.shensa@pitt.eduARS146
Barnett, TE
Cook, RL
Primack, BAbprimack@pitt.eduBPRIMACK
Centers: Other Centers, Institutes, Offices, or Units > Center for Research on Media, Technology, and Health
Date: 1 January 2014
Date Type: Publication
Journal or Publication Title: Nicotine and Tobacco Research
Volume: 16
Number: 6
Page Range: 647 - 654
DOI or Unique Handle: 10.1093/ntr/ntt201
Schools and Programs: School of Medicine > Medicine
School of Medicine > Pediatrics
Refereed: Yes
ISSN: 1462-2203
Other ID: NLM PMC4015087 [Available on 06/01/15]
PubMed Central ID: PMC4015087
PubMed ID: 24323574
Date Deposited: 31 Jul 2014 20:33
Last Modified: 04 Feb 2019 15:56


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