Date of Award

Spring 5-16-2014

Degree Type


Degree Name

Master of Public Health (MPH)


Public Health

First Advisor

Kymberle Sterling

Second Advisor

Monica Swahn


Hookah use has been increasing in recent years. This is possibly due to the fact that hookah is often believed to be a safer alternative for tobacco consumption. This misperception is often amplified by marketing and advertising by tobacco companies on the internet. Since advertising on the internet is not regulated, there needs to be an understanding of the relationship between how a person uses the internet and the perceptions that they hold about hookah smoking. Secondary data from a cross-sectional survey on hookah use was analyzed for this study. This survey assessed many aspects of hookah use like initiation, risk perceptions, smoking behaviors but it also assessed the participant’s internet behaviors. This study focused on the internet behaviors, risk perceptions of hookah use, and socio-demographic variables. Participants (age 18-31 years) were sampled from two public universities in Georgia. Pearson correlations, chi-squared test and frequencies were conducted to establish whether there was a relationship between internet usage and risk perceptions. Overall, participants (n=1049) believed that cigarettes delivered more toxins, were more addictive, and more likely to be associated with cancer. A large majority of participants did not believe that only hookah was associated with addictiveness, chemical toxins, and diseases. The most utilized ways the participants used the internet were for email, homework/research/work, listening to music, and contacting friends. Participants hardly used the internet for meeting new people, creating or maintaining webpages, playing games, and for spiritual/religious topics. The following internet behaviors were most likely to be associated with an increase in the acknowledgment of the risk of smoking hookah: email, shopping, news, music/theater/art, and health/medicine information. The chi squared test showed that there was a relationship between internet use and risk perception. There was also a relationship for internet use and gender and race. However, there were no relationships found between risk perception and gender or race. A relationship was found between risk perceptions for hookah and certain ways that the internet is used by young adults. More focused research is needed in order to fully understand these relationships. These findings can help influence tobacco interventions and tobacco policies related to the internet.