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

Prev Med. 2015 Feb;71:88-93. doi: 10.1016/j.ypmed.2014.12.012. Epub 2014 Dec 20.


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.

Keywords: Hookah; Shisha; Smoking; Tobacco; Water pipe.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Female
  • Health Surveys
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Prevalence
  • Sex Distribution
  • Sexuality / statistics & numerical data
  • Smoking / epidemiology*
  • United States / epidemiology
  • Water
  • Young Adult


  • Water