Water pipe tobacco smoking in the United States: Findings from the National Adult Tobacco Survey

Abstract Objective To report prevalence and correlates of water pipe tobacco smoking (WTS) use among U.S. adults. Methods Data were from the 2009–2010 National Adult Tobacco Survey, a nationally representative sample of U.S. adults. Estimates of WTS ever and current use were reported overall, and by sex, age, race/ethnicity, educational attainment, annual household income, sexual orientation, and cigarette smoking status. State-level prevalence rates of WTS ever were reported using choropleth thematic maps for the overall population and by sex. Results The national prevalence of WTS ever was 9.8% and 1.5% for current use. WTS ever was more prevalent among those who are male (13.4%), 18–24 years old (28.4%) compared to older adults, non-Hispanic White (9.8%) compared to non-Hispanic Black, with some college education (12.4%) compared to no high school diploma, and reporting sexual minority status (21.1%) compared to heterosexuals. States with highest prevalence included DC (17.3%), NV (15.8%), and CA (15.5%). Conclusion WTS is now common among young adults in the US and high in regions where cigarette smoking prevalence is the lowest and smoke-free policies have a longer history. To reduce its use, WTS should be included in smoke-free regulations and state and federal regulators should consider policy development in other areas, including taxes, labeling, and distribution.