Abstract
Background
Although waterpipe tobacco smoking seems to be increasing on U.S. university campuses, these data have come from convenience samples.
Purpose
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.
References
Shihadeh A. Investigation of the mainstream smoke aerosol of the argileh water pipe. Food and Chem Toxicol. 2003; 41: 143–152.
Shihadeh A, Azar S, Antonius C, Haddad A. Towards a topographical model of narghile water-pipe cafe smoking. Biochem Pharmacol Behav. 2004; 791: 75–82.
Djordjevic MV, Stellman SD, Zang E. Doses of nicotine and lung carcinogens delivered to cigarette smokers. J Nat Cancer Institute. 2000; 92: 106–111.
Shihadeh A, Saleh R. Polycyclic aromatic hydrocacrbons, carbon monoxide, “tar”, and nicotine in the mainstream smoke aerosol of the narghile water pipe. Food Chem Toxicol. 2005; 43: 655–661.
Shafagoj YA, Mohammed FI, Hadidi KA. Hubble-bubble (water pipe) smoking: Levels of nicotine and cotinine in plasma, saliva and urine. Int J Clin Pharmacol Ther. 2002; 40: 249–255.
Chaouachi K. The medical consequences of narghile (hookah, shisha) use in the world. Rev Epidemiol Sante Publique. 2007; 553: 165–170. Mar.
Bedwani R, Renganathan E, El-Kwhsky F, et al. Epidemiology of bladder cancer in Alexandria, Egypt: Tobacco smoking. Int J Cancer. 1997; 73: 64–67.
Maziak W, Ward WD, Eissenberg T. Factors related to frequency of narghile (waterpipe) use: The first insights on tobacco dependence in narghile users. Drug Alcohol Depend. 2004; 76: 101–106.
Ward KD, Eissenberg T, Rastam S, et al. The tobacco epidemic in Syria. Tob Control. 2006; 15: 24–29.
Jabbour S, El-Roueiheb Z, Sibai AM. Narghile (water-pipe) smoking and incident coronary heart disease: A case-control study. Ann Epidemiol. 2003; 13: 570.
Hookah cafes on the rise. Smokeshop Magazine; 2004.
Lewin T. Collegians smoking hookahs...filled with tobacco. The New York Times. April 19, 2006.
Primack BA, Aronson JD, Agarwal AA. An old custom, a new threat to tobacco control. Am J Public Health. 2006; 968: 1339. Aug.
Smith SY, Curbow B, Stillman FA. Harm perception of nicotine products in college freshmen. Nicotine Tob Res. 2007; 9: 977–982.
Smith-Simone SY, Maziak W, Ward KD, Eissenberg T. Waterpipe tobacco smoking: Knowledge, attitudes, beliefs, and behavior in two U.S. samples. Nicotine Tob Res.. 2008; 10: 393–398.
Maziak W, Eissenberg T, Rastam S, et al. Beliefs and attitudes related to narghile (waterpipe) smoking among university students in Syria. Ann Epidemiol. 2004; 149: 646–654. Oct.
Ajzen I, Fishbein M. Understanding Attitudes and Predicting Social Behavior. Englewood Cliffs, NJ: Prentice-Hall; 1980.
American College Health Association. National College Health Assessment 2004: ACHA-NCHA 2004. Baltimore, MD: American College Health Association; 2004.
Ward KD, Eissenberg T, Gray J, Srinivas V, Wilson N, Maziak W. Characteristics of American waterpipe users: A preliminary report. Nicotine Tob Res.. 2007; 9: 1339–1346.
Maziak W, Eissenberg T, Ward KD. Patterns of waterpipe use and dependence: Implications for intervention development. Pharmacol Biochem Behav. 2005; 801: 173–179. Jan.
Primack BA, Switzer GE, Dalton MA. Improving measurement of normative beliefs involving smoking among adolescents. Arch Pediatr Adolesc Med. 2007; 1615: 434–439. May.
Morrell HER, Cohen LM, Bacchi D, West J. Predictors of smoking and smokeless tobacco use in college students: A preliminary study using Web-based survey methodology. J Am Coll Health. 2005; 542: 108–115.
Sax LJ, Gilmartin SK, Bryant AN. Assessing response rates and nonresponse bias in web and paper surveys. Res High Educ. 2003; 444: 409–431.
White AM, Jamieson-Drake DW, Swartzwelder HS. Prevalence and correlates of alcohol-induced blackouts among college students: Results of an E-mail survey. J Am Coll Health. 2002; 513: 117–131.
Pealer LN, Weiler RM, Pigg RM, Miller D, Dorman SM. The feasibility of a web-based surveillance system to collect health risk behavior data from college students. Health Educ Behav. 2001; 285: 547–559.
Porter SR, Whitcomb ME. Non-response in student surveys: The role of demographics, engagement, and personality. Res High Educ. 2005; 462: 127–152.
Acknowledgments
Dr. Primack is supported by a Physician Faculty Scholar Award from the Robert Wood Johnson Foundation, a career development award from the National Cancer Institute (K07-CA114315), and a grant from the Maurice Falk Foundation. Dr. Eissenberg’s research is supported by R01-CA103827, R01-DA11082, and R01-TW005962.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Primack, B.A., Sidani, J., Agarwal, A.A. et al. Prevalence of and Associations with Waterpipe Tobacco Smoking among U.S. University Students. ann. behav. med. 36, 81–86 (2008). https://doi.org/10.1007/s12160-008-9047-6
Received:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12160-008-9047-6