Waterpipe tobacco use in college and non-college young adults in the USA

Waterpipe tobacco smoking (WTS or hookah) is common among adolescents and college students in the USA. However, there has not yet been a large-scale, nationally representative study independently examining WTS among young adults who are not in college. This study sought to examine associations between attitudes, normative beliefs, certain socio-demographic factors and current WTS among young adults not in college and compare them to young adults in college. A total of 3131 US adults ages 1830 completed an online survey about WTS behaviour, attitudes, normative beliefs and relevant socio-demographic factors. Multivariable logistic regression was used to examine independent associations between these variables and current WTS stratified by student status. Ever WTS was reported by 29% of young adults not in college and by 35% of those in college, and current use rates were 3 and 7%, respectively. Multivariable models demonstrated that positive attitudes and perceived peer acceptability of WTS were significantly associated with increased current WTS for both young adults not in college [adjusted odds ratio (AOR) = 2.72; 95% CI: 2.003.71 and AOR = 2.02; 95% CI: 1.502.71, respectively] and young adults in college (AOR = 3.37; 95% CI: 2.484.58 and AOR = 2.05; 95% CI: 1.492.83, respectively). The magnitude of these associations was not significantly different when comparing individuals in college and not in college. Among young adults, WTS is common in non-college-based populations as well as in college-based populations. Therefore, prevention programming should extend to all young adults, not only to those in college.