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TABLE 2

Multinomial Logistic Regression Analyses of Factors Associated With Frequency of Hookah Smoking Among US Middle and High School Students, NYTS, 2016 (n = 20 675)

CharacteristicFormer Versus Never,a aOR (95% CI)Occasional Current Versus Never,a aOR (95% CI)Frequent Current Versus Never,a aOR (95% CI)
Overestimation of peer hookah useb    
 No (referent)    
 Yes 3.41 (3.39–3.43)* 9.30 (9.18–9.42)* 6.54 (6.42–6.66)* 
 Indeterminate 3.44 (3.40–3.49)* 7.55 (7.38–7.73)* 7.74 (7.50–7.99)* 
Tobacco use by household member    
 None (referent)    
 Hookah (alone or with other products) 3.29 (3.26–3.32)* 7.81 (7.73–7.89)* 20.56 (20.27–20.86)* 
 Nonhookah onlyc 1.58 (1.57–1.58)* 1.09 (1.09–1.10)* 1.54 (1.52–1.56)* 
Sex    
 Male (referent)    
 Female 1.12 (1.12–1.13)* 1.54 (1.53–1.55)* 0.65 (0.65–0.66)* 
 Indeterminate 1.13 (1.10–1.16)* 0.46 (0.44–0.48)* 1.41 (1.35–1.46)* 
School    
 Middle (referent)    
 High 2.66 (2.64–2.67)* 1.61 (1.60–1.62)* 1.25 (1.24–1.27)* 
 Indeterminate 1.99 (1.93–2.04)* 1.02 (0.97–1.07) 4.59 (4.40–4.78)* 
Race and/or ethnicity    
 White, non-Hispanic (referent)    
 African American, non-Hispanic 1.01 (1.00–1.01) 1.49 (1.48–1.51)* 1.39 (1.37–1.41)* 
 Asian American, non-Hispanic 0.76 (0.75–0.77)* 0.47 (0.46–0.48)* 0.73 (0.70–0.76)* 
 Hispanic 1.46 (1.46–1.47)* 1.67 (1.66–1.69)* 2.15 (2.12–2.17)* 
 Other, non-Hispanic 1.23 (1.22–1.24)* 1.25 (1.24–1.27)* 2.07 (2.03–2.10)* 
 Indeterminate 1.03 (1.02–1.04)* 1.77 (1.75–1.80)* 0.66 (0.64–0.68)* 
Do you speak a language other than English at home?    
 No (referent)     
 Yes 1.36 (1.35–1.36)* 1.68 (1.67–1.69)* 2.17 (2.15–2.19)* 
 Indeterminate 1.52 (1.50–1.54)* 1.69 (1.65–1.72)* 1.26 (1.22–1.29)* 
Perceived harm of hookah    
 No and/or little harm (referent)    
 Some and/or a lot of harm 0.33 (0.33–0.33)* 0.21 (0.21–0.22)* 0.15 (0.15–0.16)* 
 Indeterminate 0.31 (0.31–0.31)* 0.21 (0.21–0.21)* 0.51 (0.50–0.52)* 
Cigarette smoking status (past 30 d)d    
 Noncurrent and/or never smoking (referent)    
 Nonmenthol cigarette 2.51 (2.49–2.52)* 4.52 (4.48–4.56)* 9.84 (9.71–9.98)* 
 Menthol cigarette 2.95 (2.92–2.97)* 6.20 (6.14–6.25)* 19.94 (19.69–20.20)* 
 Indeterminate 2.20 (2.17–2.22)* 3.88 (3.83–3.93)* 15.18 (14.95–15.40)* 
Other tobacco product use status (past 30 d)e    
 Noncurrent and/or never use (referent)    
 Nonflavored and/or menthol 4.45 (4.43–4.48)* 10.20 (10.11–10.28)* 15.26 (14.99–15.54)* 
 Flavored 4.43 (4.41–4.45)* 14.83 (14.72–14.94)* 17.59 (17.30–17.89)* 
 Indeterminate 2.85 (2.83–2.87)* 8.52 (8.42–8.61)* 27.33 (26.83–27.84)* 
CharacteristicFormer Versus Never,a aOR (95% CI)Occasional Current Versus Never,a aOR (95% CI)Frequent Current Versus Never,a aOR (95% CI)
Overestimation of peer hookah useb    
 No (referent)    
 Yes 3.41 (3.39–3.43)* 9.30 (9.18–9.42)* 6.54 (6.42–6.66)* 
 Indeterminate 3.44 (3.40–3.49)* 7.55 (7.38–7.73)* 7.74 (7.50–7.99)* 
Tobacco use by household member    
 None (referent)    
 Hookah (alone or with other products) 3.29 (3.26–3.32)* 7.81 (7.73–7.89)* 20.56 (20.27–20.86)* 
 Nonhookah onlyc 1.58 (1.57–1.58)* 1.09 (1.09–1.10)* 1.54 (1.52–1.56)* 
Sex    
 Male (referent)    
 Female 1.12 (1.12–1.13)* 1.54 (1.53–1.55)* 0.65 (0.65–0.66)* 
 Indeterminate 1.13 (1.10–1.16)* 0.46 (0.44–0.48)* 1.41 (1.35–1.46)* 
School    
 Middle (referent)    
 High 2.66 (2.64–2.67)* 1.61 (1.60–1.62)* 1.25 (1.24–1.27)* 
 Indeterminate 1.99 (1.93–2.04)* 1.02 (0.97–1.07) 4.59 (4.40–4.78)* 
Race and/or ethnicity    
 White, non-Hispanic (referent)    
 African American, non-Hispanic 1.01 (1.00–1.01) 1.49 (1.48–1.51)* 1.39 (1.37–1.41)* 
 Asian American, non-Hispanic 0.76 (0.75–0.77)* 0.47 (0.46–0.48)* 0.73 (0.70–0.76)* 
 Hispanic 1.46 (1.46–1.47)* 1.67 (1.66–1.69)* 2.15 (2.12–2.17)* 
 Other, non-Hispanic 1.23 (1.22–1.24)* 1.25 (1.24–1.27)* 2.07 (2.03–2.10)* 
 Indeterminate 1.03 (1.02–1.04)* 1.77 (1.75–1.80)* 0.66 (0.64–0.68)* 
Do you speak a language other than English at home?    
 No (referent)     
 Yes 1.36 (1.35–1.36)* 1.68 (1.67–1.69)* 2.17 (2.15–2.19)* 
 Indeterminate 1.52 (1.50–1.54)* 1.69 (1.65–1.72)* 1.26 (1.22–1.29)* 
Perceived harm of hookah    
 No and/or little harm (referent)    
 Some and/or a lot of harm 0.33 (0.33–0.33)* 0.21 (0.21–0.22)* 0.15 (0.15–0.16)* 
 Indeterminate 0.31 (0.31–0.31)* 0.21 (0.21–0.21)* 0.51 (0.50–0.52)* 
Cigarette smoking status (past 30 d)d    
 Noncurrent and/or never smoking (referent)    
 Nonmenthol cigarette 2.51 (2.49–2.52)* 4.52 (4.48–4.56)* 9.84 (9.71–9.98)* 
 Menthol cigarette 2.95 (2.92–2.97)* 6.20 (6.14–6.25)* 19.94 (19.69–20.20)* 
 Indeterminate 2.20 (2.17–2.22)* 3.88 (3.83–3.93)* 15.18 (14.95–15.40)* 
Other tobacco product use status (past 30 d)e    
 Noncurrent and/or never use (referent)    
 Nonflavored and/or menthol 4.45 (4.43–4.48)* 10.20 (10.11–10.28)* 15.26 (14.99–15.54)* 
 Flavored 4.43 (4.41–4.45)* 14.83 (14.72–14.94)* 17.59 (17.30–17.89)* 
 Indeterminate 2.85 (2.83–2.87)* 8.52 (8.42–8.61)* 27.33 (26.83–27.84)* 

Multinomial logistic regression analyses were controlled for all factors listed. Hookah smoking frequency was classified as never smoker (not even 1 or 2 puffs; n = 17 562), former smoker (last smoked hookah >30 d ago; n = 1395), current occasional smoker (smoked hookah on less than one-third of the past 30 d [1–9 d]; n = 564), and current frequent smoker (smoked hookah on greater than or equal to one-third of the past 30 d [10–30 d]; n = 199). Indeterminate responses include missing or “not sure” responses. CI, confidence interval.

a

Never hookah smokers were the reference category within the multinomial logistic regression analyses.

b

Respondents were asked how many students in their grade they thought used hookah out of 10 (perceived prevalence). A difference score (δ) was computed to measure the gap between perceived prevalence and grade-specific actual prevalence. Respondents were then dichotomized as either overestimating (δ >0) or not overestimating (δ ≤0) peer hookah use.

c

Assessed nonhookah product use by household members included e-cigarettes, cigarettes, bidis, cigars, pipes, and smokeless tobacco.

d

Menthol cigarette smoking was a report of smoking mentholated cigarettes or predominantly menthol brands (Newport and/or Kool).

e

Assessed other noncigarette tobacco products included e-cigarettes, bidis, cigars, pipes, roll-your-own tobacco, and smokeless tobacco Flavored noncigarette tobacco products were those that tasted like “menthol (mint), alcohol (wine, cognac), candy, fruit, chocolate, or other sweets.”

*

P < .05.

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