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. 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. © 2008 The Society of Behavioral Medicine