Differing psychosocial risk profiles of young adult waterpipe, cigar, and cigarette smokers

Waterpipe tobacco smoking is spreading worldwide, and its prevalence in the U.S. is uncertain. Few studies have examined the psychosocial aspects of tobacco smoking in young adults, particularly among alternative forms such as waterpipe. To address this gap, we examined the association of psychosocial characteristics (i.e., demographics, social norms, pluralistic ignorance, and risk perception) with waterpipe, cigar, and cigarette smoking in college freshmen. Data are from a cross-sectional internet survey conducted during spring semester 2004 at a private university, N=411. Multinomial logistic regression was used to determine the association between psychosocial risk factors and waterpipe, cigar, and cigarette smoking. The main findings are: (1) the psychosocial risk profiles of smokers differ by type of use (i.e., ever versus current) and type of tobacco product (i.e., cigarette, cigar, or waterpipe), and (2) freshmen perceived the waterpipe as the most attractive product to use among their peers. This study provides some of the first data on the association of psychosocial characteristics and various forms of tobacco smoking in young adults. This area of research is becoming increasingly important as a surge of waterpipe use among college students is becoming evident and interventions to reduce and prevent use are critically needed. Campus officials, health educators, health care providers, and policymakers need not only pay attention to conventional forms of tobacco smoking such as cigarettes and cigars but to more avant-garde methods of tobacco smoking such as waterpipe in order to design more informed prevention, treatment, and policy strategies for college-age youth.