Waterpipe tobacco and electronic cigarette use in a southeast London adult sample: a cross-sectional analysis

J Public Health (Oxf). 2016 Jun;38(2):e114-21. doi: 10.1093/pubmed/fdv106. Epub 2015 Aug 25.


Background: Waterpipe tobacco and electronic cigarettes (e-cigarettes) share several features: rising popularity, use of product flavourings and concerns about marketing to youth. We sought to compare prevalence and predictors of waterpipe tobacco and e-cigarette use, and explore knowledge of waterpipe tobacco and support for interventions.

Methods: We used convenience sampling methods to conduct a cross-sectional survey among adults in the ethnically diverse southeast London area. Multivariate logistic regression identified predictors of waterpipe and e-cigarette use. Predictor variables were age, gender, ethnicity and current (past 30-day) cigarette use.

Results: Of 1176 respondents (23.0% aged 25-34 years, 56.0% male, 57.4% white ethnicity and 30.4% current cigarette smokers), 31.0% had tried waterpipe tobacco and 7.4% had tried e-cigarettes. Both products were significantly associated with younger age groups, non-white ethnicities and use of each other. Waterpipe tobacco was independently associated with consumption of cigarettes while e-cigarettes were not. Among those aware of waterpipe, a third answered incorrectly to knowledge questions. Among those self-identified as coming from a traditional waterpipe-using community, two-thirds supported further legislative and health promotion waterpipe interventions.

Conclusions: Waterpipe tobacco was common and more prevalent than e-cigarettes in this population. Interventions to prevent and control waterpipe are unlikely to marginalize traditional waterpipe-using communities.

Keywords: epidemiology; smoking; socioeconomic factors.

MeSH terms

  • Adult
  • Age Factors
  • Cross-Sectional Studies
  • Humans
  • London / epidemiology
  • Prevalence
  • Sex Factors
  • Smoking / epidemiology
  • Vaping / statistics & numerical data*
  • Water Pipe Smoking / epidemiology*