title: Waterpipe smoking among secondary school students in Hong Kong.
abstract: OBJECTIVE
  To examine the prevalence of waterpipe smoking and its associated factors among adolescents in Hong Kong.
  
  
  METHODS
  We analyzed data of the School-based Survey on Smoking among Students 2012/2013 from a representative sample of 45,857 secondary school students in Hong Kong (mean age 14.8, SD 1.9). We conducted Chi-square tests and t test to compare current (past 30 days) waterpipe users and nonusers by sociodemographic variables and other covariates. Univariate and multivariable logistic regression models were used to examine the factors associated with current waterpipe smoking.
  
  
  RESULTS
  Overall, 1.2 % of students reported current waterpipe smoking, of whom 43 % reported concurrent use of cigarettes. Waterpipe was the most popular alternative tobacco product (non-cigarette) used by students. Current waterpipe smoking was associated with older age, male sex, higher self-perceived family financial status, poor knowledge about the harm of cigarette smoking, positive attitudes toward smoking, current cigarette smoking, other tobacco use, and alcohol consumption.
  
  
  CONCLUSIONS
  Waterpipe smoking was the most popular alternative tobacco product among Hong Kong adolescents. Despite the low prevalence, it should be routinely monitored. Education programs and cessation interventions need to address waterpipe smoking in addition to cigarette smoking.
authors.affiliation: School of Public Health, The University of Hong Kong, 5/F William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong.
authors.forename: Nan
authors.initials: N
authors.lastname: Jiang
authors.affiliation: School of Public Health, The University of Hong Kong, 5/F William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong. syho@hku.hk.
authors.forename: Sai Yin
authors.initials: SY
authors.lastname: Ho
authors.affiliation: School of Nursing, The University of Hong Kong, 4/F William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong.
authors.forename: Man Ping
authors.initials: MP
authors.lastname: Wang
authors.affiliation: School of Public Health, The University of Hong Kong, 5/F William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong.
authors.forename: Lok Tung
authors.initials: LT
authors.lastname: Leung
authors.affiliation: School of Public Health, The University of Hong Kong, 5/F William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong.
authors.forename: Tai Hing
authors.initials: TH
authors.lastname: Lam
mesh_terms: D000293:Adolescent; D000367:Age Factors; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology*; D012959:Socioeconomic Factors
keywords: Adolescent; Hong Kong; Tobacco; Waterpipe smoking