UNC Hussman’s Lazard and Noar awarded major grant for hookah warning research

Experts at UNC Hussman, which continues to be at the forefront of health communications research and education, have received a major new $2.7 million grant from the National Institutes of Health to study warnings about hookah smoking. Faculty members Allison Lazard and Seth Noar will serve as co-investigators on the project, working with Wake Forest University. The team aims to promote a greater understanding of the harms of hookah and to reduce hookah smoking among young adults. The five-year grant is housed at Wake Forest, under Dr. Erin Sutfin of the Wake Forest School of Medicine, with a sub-contract awarded to UNC Hussman each year.

The harms of hookah smoking are consistently misperceived, especially among young adults. Hookah smoking is associated with serious acute and chronic harms even among infrequent users, but many users view hookah as less harmful and less addictive than cigarette smoking. And young people smoke hookah more than any age group in the country. While studies have shown that cigarette label warnings effectively inform consumers and increase motivation to quit, hookah warnings — which currently focus on nicotine addiction — aren’t likely to have the same impact.

Under the new grant, the team will develop text and image warnings to communicate the broader range of health harms from hookah. The researchers will test whether having the warnings on hookah tobacco packaging reduces the intentions to smoke hookah among young adults. And they will investigate the effect of displayed warnings at hookah cafés on smoking behavior. Lazard will lead all aspects of the warning message design and development, including managing design graduate students from UNC Hussman. Lazard and her team will also develop interactive hookah tobacco packaging that can be viewed online, to allow the researchers to experimentally test a preview of a full package among American young adults. Noar will contribute to survey design and measurement for all data collection. Both Lazard and Noar will be involved in conceptualization, development and writing of manuscripts describing findings from the study.

The grant and the work being done by the UNC Hussman scholars could inform important health policy for North Carolinians and nationwide. By reducing hookah consumption through development and testing of warnings, the study could “influence local, state, and federal policies,” Lazard said. “The proposed research has the potential to make a significant contribution towards improving the health of communities and cancer prevention.”