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Prevalence and Determinants of Water Pipe Tobacco and Polytobacco Use Among 18- to 24-Year-Old Emerging Adults in the United States

Water pipe (i.e., hookah) tobacco smoking (WTS) had the highest prevalence among 18- to 24-year-olds in recent Centers for Disease Control and Prevention National Adult Tobacco Surveys (NATS). This study examines the national prevalence and determinants of current WTSs among emerging adults (EAs). Of the 3,577 EAs from the 2012 to 2013 NATS, 18.3% were current water pipe smokers; among the 4,439 EAs from the 2013 to 2014 NATS, the percentage increased to 20.1%. Multivariable analyses demonstrate that current users of cigarettes, cigar/cigarillos, pipes, and/or e-cigarettes were more likely to be current WTSs, while 22- to 24-year-old EAs and African Americans were less likely to smoke water pipe across both surveys. Different interventions and anti-marketing campaigns are needed for different tobacco products within subpopulations in the 18- to 24-year-old EA population. Strategies aimed at college students may not be as effective for noncollege EAs for stemming WTS. More representative research is needed on EAs during this pivotal period of self-exploration and self-development.