High Rates of Hookah Use in Pregnancy and Preconception: Prevalence and Correlates of an Often-Overlooked Tobacco Product

Abstract

Background:

Despite evidence that hookah poses similar risks to other tobacco products, it is often (mis)perceived as less harmful. Few studies have investigated the prevalence and correlates of hookah use during pregnancy. The present study sought to characterize the prevalence of and sociodemographic and psychosocial characteristics associated with hookah use during pregnancy and 3 months prior (i.e., preconception) in a large sample of pregnant women.

Materials and Methods:

Pregnant women (N = 900) from the Northeast United States completed a telephone screener assessing sociodemographics, mental health, and substance use during pregnancy and preconception. Women were categorized into three groups: any hookah use, cigarette and other tobacco (C&OT) use, and no tobacco use. Generalized linear models were used to calculate risk ratios.

Results:

Approximately 8.8% (n = 79) of the women in our sample reported hookah use during preconception and pregnancy, and the majority (n = 57) reported exclusive hookah use. Women who identified as Hispanic/Latinx were more than 2.5 times as likely to report hookah use than C&OT or no tobacco use. Women who drank alcohol during pregnancy were more than 1.5 times as likely to report hookah use than C&OT or no tobacco use.

Conclusions:

The prevalence of hookah during pregnancy and preconception in the present socioeconomically disadvantaged and ethnoracially varied sample is notably higher than in previous samples estimated using nationally representative data. Women who use hookah during pregnancy demonstrate a distinct sociodemographic and psychosocial profile, which suggests potential targets for intervention, such as alcohol use.