Prevalence and correlates of waterpipe tobacco smoking by college students in North Carolina

Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC 27157, United States.
Drug and alcohol dependence (Impact Factor: 3.28). 02/2011; 115(1-2):131-6. DOI: 10.1016/j.drugalcdep.2011.01.018
Source: PubMed

ABSTRACT Known most commonly in the U.S. as "hookah," waterpipe tobacco smoking appears to be growing among college students. Despite beliefs that waterpipe use is safer than cigarette smoking, research to date (albeit limited) has found health risks of waterpipe smoking are similar to those associated with cigarette smoking, including lung cancer, respiratory illness, and periodontal disease. The goals of this study were to estimate the prevalence of use among a large, multi-institution sample of college students and identify correlates of waterpipe use, including other health-risk behaviors (i.e., cigarette smoking, alcohol, marijuana, and other illicit drug use) and availability of commercial waterpipe tobacco smoking venues.
A cross-sectional sample of 3770 college students from eight universities in North Carolina completed a web-based survey in fall 2008.
Forty percent of the sample reported ever having smoked tobacco from a waterpipe, and 17% reported current (past 30-day) waterpipe tobacco smoking. Correlates associated with current waterpipe use included demographic factors (male gender, freshman class); other health-risk behaviors (daily and nondaily cigarette smoking, alcohol use, marijuana use, other illicit drug use); perceiving waterpipe tobacco smoking as less harmful than regular cigarettes; and having a commercial waterpipe venue near campus.
The results highlight the popularity of waterpipe tobacco smoking among college students and underscore the need for more research to assess the public health implications of this growing trend.

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Available from: Kimberly Wagoner, May 14, 2014
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    • "The findings from the analysis suggest that 18–24 year olds, particularly males with at least some college education, were the largest group to have tried WTS or were currently WTS users. As in other parts of the world, WTS seems to be most prevalent among educated youth, especially males (Akl et al., 2011; Primack et al., 2013; Sutfin et al., 2011). Unlike cigarette smoking and other Fig. 1. "
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    ABSTRACT: To report prevalence and correlates of waterpipe tobacco smoking (WTS) use among U.S. adults. Data were from the 2009-2010 National Adult Tobacco Survey, a nationally representative sample of U.S. adults. Estimates of WTS ever and current use were reported overall, and by sex, age, race/ethnicity, educational attainment, annual household income, sexual orientation, and cigarette smoking status. State-level prevalence rates of WTS ever were reported using choropleth thematic maps for the overall population and by sex. The national prevalence of WTS ever was 9.8% and 1.5% for current use. WTS ever was more prevalent among those who are male (13.4%), 18-24 years old (28.4%) compared to older adults, non-Hispanic White (9.8%) compared to non-Hispanic Black, with some college education (12.4%) compared to no high school diploma, and reporting sexual minority status (21.1%) compared to heterosexuals. States with highest prevalence included DC(17.3%), NV(15.8%), and CA(15.5%). WTS is now common among young adults in the US and high in regions where cigarette smoking prevalence is lowest and smoke-free policies have a longer history. To reduce its use, WTS should be included in smoke-free regulations and state and federal regulators should consider policy development in other areas, including taxes, labeling, and distribution. Copyright © 2014. Published by Elsevier Inc.
    Preventive Medicine 12/2014; 71. DOI:10.1016/j.ypmed.2014.12.012 · 2.93 Impact Factor
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    • "documented the concomitant use of other tobacco products ( Primack, Fertman, Rice, Adachi-Mejia, & Fine, 2010 ; Sutfi n et al., 2011 ), these studies have generally been conducted among small or localized samples of the population. Accurate prevalence data from large diverse samples and comparisons with other types of tobacco use are needed to determine whether waterpipe use is a serious threat to the public health or whether it is a localized phenomenon without substantial national implications. "
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    ABSTRACT: INTRODUCTION: While cigarette use is declining, smoking tobacco with a waterpipe is an emerging trend. We aimed to determine the prevalence of waterpipe use in a large diverse sample of U.S. university students and to assess the association of waterpipe use with individual and institution-related characteristics. METHODS: We assessed students from 152 U.S. universities participating in the National College Health Assessment during 2008-2009. We used multivariable regression models to determine independent associations between individual and institutional characteristics and waterpipe tobacco use in the past 30 days and ever. RESULTS: Of 105,012 respondents included in the analysis, most were female (65.7%), White (71.2%), and attending public (59.7%) nonreligious (83.1%) institutions. Mean age was 22.1 years. A total of 32,013 (30.5%) reported ever using a waterpipe to smoke tobacco. Rates for current tobacco use were 8.4% for waterpipes, 16.8% for cigarettes, 7.4% for cigars (including cigarillos), and 3.5% for smokeless tobacco. Of current waterpipe users, 51.4% were not current cigarette smokers. Although current waterpipe use was reported across all individual and institutional characteristics, fully adjusted multivariable models showed that it was most strongly associated with younger age, male gender, White race, fraternity/sorority membership, and nonreligious institutions in large cities in the western United States.Conclusions:After cigarettes, waterpipe use was the most common form of tobacco use among university students. Because waterpipe use affects groups with a wide variety of individual and institutional characteristics, it should be included with other forms of tobacco in efforts related to tobacco surveillance and intervention.
    Nicotine & Tobacco Research 05/2012; 15(1). DOI:10.1093/ntr/nts076 · 2.81 Impact Factor
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    • "First, data were from female students at one university. Future studies might employ multisite sampling and should include males, who are more likely to smoke hookah than females (Sutfin et al., 2011). Second, a more detailed assessment of hookah tobacco use during the high school years is needed. "
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    ABSTRACT: Hookah tobacco smoking has become increasingly prevalent among college students, but little is known about frequency of use or patterns of use over time, including during the transition to college. The goals of this longitudinal cohort study were to assess the: (a) lifetime prevalence, (b) current prevalence, (c) frequency of use, and (d) pattern of initiation of hookah tobacco smoking among female students during the first year of college. First-year female college students (N=483) at a large private university in upstate New York completed 13 monthly online surveys about their hookah tobacco use from August 2009 to August 2010. Lifetime prevalence of hookah use increased from 29% at college entry to 45% at one-year follow-up. The highest rates of hookah initiation occurred in the first two months of students' first semester of college. Current (past 30 days) hookah use ranged from 5% to 13% during the year after college entry. On average, hookah users reported smoking hookah two days per month. Hookah tobacco use is common among female college students. The transition to college is a vulnerable time for hookah initiation. Preventive efforts should begin in high school and continue through college, with a focus on students' first few months on campus.
    Addictive behaviors 02/2012; 37(2):221-4. DOI:10.1016/j.addbeh.2011.10.001 · 2.44 Impact Factor
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