Beliefs and norms associated with waterpipe smoking intention in college students

Background – Waterpipe smoking is an emerging tobacco trend among college students. Currently, there are very few theory driven studies examining beliefs and norms associated with waterpipe smoking intention. The purpose of this study was to identify significant beliefs and norms associated with waterpipe smoking intention using the Theory of Reasoned Action (TRA) as a framework.

Research Design – This cross-sectional study used a random sample of fulltime undergraduate college students (n=223) ages 18-24 from a 4-year public institution in Central Virginia. Beliefs and norms associated with waterpipe smoking intention were captured using the investigator-developed TRA Waterpipe Questionnaire. Demographic information and Tobacco Use history was also collected using measures from the Youth Risk Behavior Survey and The College Freshman Nicotine Study.

Procedure - A web survey was employed to assess beliefs and norms associated with waterpipe smoking intention. Multiple regression models were used to identify significant beliefs and norms associated with waterpipe smoking intention.

Results/Conclusions – Of the sample (N=223) 13.5% reported current waterpipe use and 61% reported ever waterpipe smoking. Significant behavioral beliefs included smoking waterpipe “will cost a lot of money”, “will taste pleasant”, and “will allow me to have a good time with my friends”. Significant norms that emerged were perceived approval of waterpipe smoking from friends and significant others. The variables of the TRA represent prime targets for intervention and provide information that can be used to tailor waterpipe prevention messages on college campuses.