Objective: We aimed to improve understanding of young adults' perceptions and interpretations of the contexts surrounding use.
Methods: We conducted focus groups with young adult hookah users (ages 18-28) to examine hookah-use experiences and risk perceptions.
Results: Two dominant themes that emerged from the discussions were the social aspects of use (eg, "ending up" at a hookah café while out with friends), and the mental and physiological reactions to use (eg, relaxation and a "high" feeling). Participants often argued that because they only used hookah every few weeks, hookah use was much less dangerous than cigarette use.
Conclusions: Findings suggest that hookah research should account for heuristic processing and point to several areas where better health communication and stricter regulatory policies are needed.
Keywords: adult health behavior; focus groups; hookah; hookah café; tobacco; young adults.