High on Hookah : Smoking Marijuana from a Hookah among Adults in the United States, Population Assessment of Tobacco and Health Study, 2015-2019.

This study aimed to examine the trend and factors associated with smoking marijuana from a hookah device among US adults. Data were drawn from the Population Assessment of Tobacco and Health (PATH) Study, an ongoing nationally representative, longitudinal cohort study of the US population. Adult respondents who self-reported ever smoking marijuana from a hookah at Wave 5 (2018-19, N = 34,279 US adults) were included in the multivariable analysis. Trend analysis also was conducted using National Cancer Institute software from 2015 to 2019. In 2018-19, an estimated 23.6 million (9.7%) US adults reported ever smoking marijuana from a hookah. Trend analysis showed the increasing prevalence of using marijuana from a hookah device from Wave 3 (8.9%) to Wave 5 (9.7%; time trend = .007). Adults aged 25-44 years old (vs. 18-24; 13%, vs. 9%), whites (vs. Black; 11% vs. 9%), and lesbian, gay, or bisexual (LGB vs. straight; 17% vs. 9%) were more likely to report ever smoking marijuana from a hookah (). Former and current users (vs. never users) of e-cigarettes (19% and 25% vs. 5%), cigarettes (11% and 21% vs. 2%), cigars (17% and 27% vs. 3%), and pipes (21% and 33% vs. 7%) and past 30-day blunt users (vs. non-users; 39% vs. 9%) were more likely to ever smoke marijuana from a hookah (). Pregnant women (vs. non-pregnant; 12.8% vs. 8.6%;  = 0.03) were more likely to smoke marijuana from a hookah. Smoking marijuana from a hookah device is prevalent among young adults in the US, especially among vulnerable populations, and has increased significantly from 2015-2019.