Water-Pipe Tobacco Smoking: An Emerging Health Risk Behavior inAdolescents in the United States

Objective: To assess the attitude and practices of adolescents regarding water-pipe smoking (WPS) in a predefined 'perceived' high risk group of youth 12-18 years of age in the Detroit metropolitan area. Methods: This was a cross-sectional survey (conducted March1 st through June 30 th , 2008) in which participants completed a self-reported questionnaire, which included demographics, WPS, other types of smoking, and their perception about the hazards of WPS. Results: A total of 272 (85% response rate (272/320) surveys were completed. One hundred and sixty seven (61%) were WPS "users". Fifty-six (22%) used WPS at home, 34 (13%) at coffee shops, 74 (29%) at both locations, and 3 (1%) at other locations. Relative to non-users, WPS users were more likely to be cigarette smokers (OR = 1.7, unadjusted OR = 2.5, p < 0.05), to have someone else in the household who uses WPS (OR = 2.2), to believe that WPS is safe (OR = 1.4, unadjusted OR = 2.0) and that WPS is less harmful than cigarettes (OR = 1.2 unadjusted OR = 1.6, p<0.05). In addition WPS use was associated with less likelihood of believing that one may acquire an infection (OR = 0.9) and that the toxicity of the inhalants was equivalent to cigarette smoking (OR = 0.8). Conclusions: WPS represents a growing public health issue for adolescents in the US. Aggressive education of adolescents is essential in combating the misperception associated this form of smoking.