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Sustained Waterpipe Tobacco Smoking and Trends Over Time

  • Brian A. Primack
    Correspondence
    Address correspondence to: Brian A. Primack, MD, PhD, 230 McKee Place, Suite 600, Pittsburgh PA 15213
    Affiliations
    Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, Pennsylvania

    Division of General Internal Medicine, School of Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania

    Division of Adolescent Medicine, Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania

    Health Policy Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
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  • Peter Freedman-Doan
    Affiliations
    Youth and Social Issues Program, Institute for Social Research, University of Michigan, Ann Arbor, Michigan
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  • Jaime E. Sidani
    Affiliations
    Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, Pennsylvania

    Division of General Internal Medicine, School of Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
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  • Daniel Rosen
    Affiliations
    School of Social Work, University of Pittsburgh, Pittsburgh, Pennsylvania
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  • Ariel Shensa
    Affiliations
    Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, Pennsylvania

    Division of General Internal Medicine, School of Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
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  • A. Everette James
    Affiliations
    Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, Pennsylvania

    Health Policy Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
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  • John Wallace
    Affiliations
    Youth and Social Issues Program, Institute for Social Research, University of Michigan, Ann Arbor, Michigan

    School of Social Work, University of Pittsburgh, Pittsburgh, Pennsylvania
    Search for articles by this author
Published:September 15, 2015DOI:https://doi.org/10.1016/j.amepre.2015.06.030

      Introduction

      Use of waterpipe tobacco smoking (WTS) is now prevalent among U.S. adolescents. However, the more clinically relevant questions are whether users exhibit sustained patterns of use and whether use is increasing over time relative to other tobacco products. We aimed to examine factors associated with sustained WTS among U.S. adolescents and to compare prevalence trends between WTS and other tobacco products.

      Methods

      The Monitoring the Future project began assessing WTS among 12th-grade students in 2010. In 2014, we conducted multivariable regression analyses to examine correlates of sustained WTS, which we defined as use at least six times in the past 12 months. We used trend analysis to compare use of WTS and other types of tobacco.

      Results

      Of the 8,737 participants queried from 2010 to 2013, 18.8% (1,639) reported past-year WTS, whereas 7.2% (627) reported sustained use. Sustained WTS was inversely associated with female sex (versus male, OR=0.78, 95% CI=0.63, 0.96); African American race (versus Caucasian, OR=0.26, 95% CI=0.14, 0.48); and increased number of parents in the home (p<0.001). Sustained WTS was positively associated with increased school-level parental education (p=0.002); lower grades (p=0.005); truancy (p<0.001); lower religiosity (p<0.001); more evenings out per week (p<0.001); and dating (p=0.03). Visual inspection and non-overlapping CIs suggest that both past-year and sustained WTS are significantly increasing relative to cigarette use but not small cigar use.

      Conclusions

      Given the prevalence of sustained WTS and indications of its increase over time, it should be included in efforts related to tobacco surveillance and intervention.
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