Hookah use among U.S. adults: Findings from the 2009-2010 National Adult Tobacco Survey

Background

Water pipes, or hookahs, are smoked using charcoal-heated tobacco that passes through water before it is inhaled. In recent years, hookahs have become increasingly popular in the U.S.; however, data on the extent of ever and current use among U.S. adults are limited.

Methods: We used data from the 2009-2010 National Adult Tobacco Survey, a national landline and cellular telephone survey of non-institutionalized U.S. adults aged ≥18 years in the 50 U.S. states and District of Columbia. Prevalence of ever and current hookah use was assessed overall and by sex, age, race/ethnicity, educational attainment, sexual orientation, martial status, U.S. region, and current use of cigarettes or smokeless tobacco. Multivariate logistic regression was used to identify predictors of ever and current hookah use.

 

Results:

Among all U.S. adults, 9.8% reported ever using hookahs and 1.5% reported current use. Following multivariate adjustment, ever use of hookah was higher among current cigarette smokers (Odds Ratio [OR]: 2.4, 95% Confidence Interval [CI]: 2.1-2.7), males (OR: 2.0, 95% CI: 1.8-2.2), 18-24 year olds (OR: 2.1, 95% CI: 1.7-2.4), those with ≥bachelors degree (OR: 2.5, 95% CI: 2.1-2.9), other non-Hispanics (1.4, 95% CI: 1.1-1.7), and lesbian, gay, bisexual, or transgender individuals (OR:1.3, 95% CI: 1.0-1.7).

 

Conclusion: 

One in ten U.S. adults has ever used a hookah, with ever use being particularly high among certain subpopulations, including cigarette smokers and younger adults. These findings underscore opportunities for enhanced efforts to reduce all forms of tobacco use, including hookah smoking, particularly among subpopulations with the greatest burden.