Factors Associated with Hookah Use among Male High School Students: The Role of Demographic Characteristics and Hookah User and Non-User Prototypes

Background: As students' hookah use has become a widespread problem in the developing countries, it is time to understand the cognitive determinants of students' decisions to do so. This study aimed to investigate the roles of psychological and demographic factors associated with hookah use among male high school students. Methods: This descriptive-analytical study was performed among 601 high school male students, recruited through multistage sampling method in the Kermanshah City, west of Iran in 2016. The datagathering tool consisted of a self-administered questionnaire with questions about hookah use behavior and demographic, behavioral and psychological variables. Data were analyzed using SPSS18 software using chi-square and logistic regression. Results: 36.1% of the participants reported ever hookah use and 17.1% mentioned using hookah in the past month. Pleasure (28.1%) and sensation seeking (22.5%) were common reasons of hookah use. In comparison to non-users, hookah users evaluated a typical hookah user as more clever, less immature, more popular, more attractive, more self-confident, more independent, and less selfish (P<0.001). Conclusions: The results revealed the importance of psychological factors when examining students' hookah use status. Thus, design and implementation of interventions might be effective in prevention of hookah use among students.