Prevalence of and associations with waterpipe tobacco smoking among U.S. university students.
BACKGROUND
Although waterpipe tobacco smoking seems to be increasing on U.S. university campuses, these data have come from convenience samples.


OBJECTIVE
We aimed to determine the prevalence of and associations with waterpipe tobacco smoking among a random sample of students.


METHODS
We surveyed a random sample of graduate and undergraduate students at a large, urban university. We used multivariate modeling to determine independent associations between belief-related predictors and waterpipe tobacco smoking.


RESULTS
Of the 647 respondents, waterpipe smoking was reported in 40.5%, over the past year in 30.6%, and over the past 30 days in 9.5%. Over half of the sample (52.1%) perceived that tobacco smoking from a waterpipe was less addictive than cigarette smoking. In fully adjusted multivariate models, 1-year waterpipe smoking was associated with low perceived harm (OR = 2.54, 95% CI = 1.68, 3.83), low perceived addictiveness (OR = 4.64, 95% CI = 3.03, 7.10), perception of high social acceptability (OR = 20.00, 95% CI = 6.03, 66.30), and high perception of popularity (OR = 4.72, 95% CI = 2.85, 7.82).


CONCLUSIONS
In this sample, lifetime waterpipe use was as common as lifetime cigarette use. Perception of harm, perception of addictiveness, social acceptability, and popularity were all strongly related to waterpipe smoking.
Primack
Brian A
BA
Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. bprimack@pitt.edu
Sidani
Jaime
J
Agarwal
Aaron A
AA
Shadel
William G
WG
Donny
Eric C
EC
Eissenberg
Thomas E
TE
D000280:Administration, Inhalation; D003430:Cross-Sectional Studies; D005260:Female; D005374:Filtration / Q000295:instrumentation; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D015233:Models, Statistical; D012016:Reference Values; D012044:Regression Analysis; D012907:Smoking / Q000523:psychology*; D012938:Social Perception; D013334:Students; D014029:Tobacco Use Disorder / Q000523:psychology*; D014495:Universities; D014867:Water; D055815:Young Adult; D014026:Nicotiana
D014867:Water