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Waterpipe Tobacco Use in the United Kingdom: A Cross-Sectional Study among University Students and Stop Smoking Practitioners

Jawad, Mohammed, Choaie, Elham, Brose, Leonie, Dogar, Omara, Grant, Aimee, Jenkinson, Elizabeth, McEwen, Andy, Millett, Christopher and Shahab, Lion 2016. Waterpipe Tobacco Use in the United Kingdom: A Cross-Sectional Study among University Students and Stop Smoking Practitioners. PLoS ONE 11 (1) 10.1371/journal.pone.0146799

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Introduction Despite cigarette-like adverse health outcomes associated with waterpipe tobacco smoking and increase in its use among youth, it is a much underexplored research area. We aimed to measure the prevalence and patterns of waterpipe tobacco use and evaluate tobacco control policy with respect to waterpipe tobacco, in several universities across the UK. We also aimed to measure stop smoking practitioners’ encounter of waterpipe tobacco smoking. Methods We distributed an online survey to six UK universities, asking detailed questions on waterpipe tobacco. Multivariable logistic regression models, adjusted for age, gender, ethnicity, graduate status, university and socioeconomic status (SES) assessed associations between waterpipe tobacco smoking (single use and dual use with cigarettes) and sociodemographic variables. SES was ascertained by average weekly self-spend on non-essentials. We also descriptively analysed data from a 2012 survey of stop smoking practitioners to assess the proportion of clients that used waterpipe regularly. Results f 2217 student responses, 66.0% (95% CI 63.9–68.0%) had tried waterpipe tobacco smoking; 14.3% (95% CI 12.8–15.8%) reported past-30 day use, and 8.7% (95% CI 7.6–9.9%) reported at least monthly users. Past-30 day waterpipe-only use was associated with being younger (AOR 0.95, 95% CI 0.91–0.99), male (AOR 1.44, 95% CI 1.08–1.94), higher SES (AOR 1.16, 95% CI 1.06–1.28) and belonging to non-white ethnicities (vs. white, AOR 2.24, 95% CI 1.66–3.04). Compared to less than monthly users, monthly users were significantly more likely to have urges to smoke waterpipe (28.1% vs. 3.1%, p<0.001) report difficulty in quitting (15.5% vs. 0.8%, p<0.001), report feeling guilty, and annoyed when criticised about waterpipe smoking (19.2% vs. 9.2%, p<0.001). Nearly a third (32.5%) of respondents who had tried waterpipe had violated the UK smokefree law and a quarter (24.5%) reporting seeing health warnings on waterpipe tobacco packaging or apparatuses. Of 1,282 smoking cessation practitioners, a quarter (23.4%, 95% CI 21.5–26.1%) reported having some clients who regularly use waterpipes, but 69.5% (95% CI 67.0–72.0%) never ask clients about waterpipe use. Three quarters (74.8%, 95% CI 72.4–77.1%) want more information about waterpipe tobacco smoking. Conclusions While two thirds of university students have ever tried waterpipe tobacco, at least monthly use is less common. Regular users display features of waterpipe tobacco dependence, and a substantial minority of SSS practitioners encounter clients who regularly use waterpipe. The lack of training on waterpipe for SSS practitioners and reported violations of smokefree laws for waterpipe highlight the need for regular surveillance of and a coordinated tobacco control strategy for waterpipe use.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Uncontrolled Keywords: © 2016 Jawad et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Publisher: Public Library of Science
ISSN: 1932-6203
Date of First Compliant Deposit: 30 March 2016
Date of Acceptance: 21 December 2015
Last Modified: 27 Mar 2020 02:27

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